Related Experiment Video
Updated: Aug 10, 2026

Continuous Venous-Arterial Doppler Ultrasound During a Preload Challenge
Published on: January 20, 2023
Hand-held Doppler as a screening test in primary varicose veins
W B Campbell1, P G Niblett, B M Ridler
1Department of Surgery, Royal Devon and Exeter Hospital, UK.
Background:
Hand-held Doppler is in common use for evaluating varicose veins, but its accuracy in identifying the exact sites of venous reflux is inferior to that of duplex scanning. It has been suggested that duplex should be used to investigate all varicose veins, but this is currently impractical, and should be unnecessary if hand-held Doppler examination were shown to be an adequate screening test.
Methods:
Eighty-five patients (122 legs) with primary varicose veins were evaluated using a hand-held Doppler in the outpatient clinic, according to a protocol. Patients then had venous duplex imaging.
Results:
Different methods of assessing the long saphenous vein (LSV) (tourniquet and tapping tests, and examination at and below the groin) had similar sensitivities for detecting reflux (75-86 per cent), and together detected 91 per cent of cases. Six of the nine missed had a competent saphenofemoral junction, and five had low-velocity reflux. Hand-held Doppler assessment missed 11 cases of popliteal fossa reflux; only four involved the short saphenous vein (SSV), and most had low-velocity popliteal vein reflux.
Conclusion:
Hand-held Doppler examination missed LSV or SSV incompetence in 11 per cent of legs, but these included cases with short-duration and low-velocity reflux of dubious clinical importance.
Related Concept Videos
Assessing Blood pressure using a doppler ultrasound
Pre-Procedural Guidelines for Doppler Ultrasound Blood Pressure Assessment:
Preparation of Equipment:
Assessment of the Cardiovascular System III: Palpation
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above the...
Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
Varicose Veins I: Introduction
Varicose Veins II: Diagnostic Studies and Interprofessional Care
Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies

