Duplex Ultrasound

What is Duplex Ultrasound?

It is a diagnostic, painless, test that uses  sound waves to detect problems in the veins and arteries. There is no radiation or x-ray involved and ultrasound is a safe test that can be performed in the physician’s office, by the physician or a registered vascular ultrasound technologist.
Duplex ultrasound shows the direction of blood flow through your vessels
and measures the speed of the flow of blood. It can also be used to
estimate the diameter of a blood vessel and the presence of blood
clots or cholesterol narrowing in the blood vessel.

What will the ultrasound mapping show?

An ultrasound mapping takes under an hour and is performed with the
patient in a standing position. The technologist will scan the
veins in your legs, noting the direction of blood flow. A normal vein
carries blood in only one direction up to the heart. If one or several
valves in your leg veins are damaged, blood will temporarily flow downward.
This is termed “reflux.” Occasionally, the sonographer will ask you to perform a
Valsalva maneuver in which you hold your breath. This can show the presence of early reflux. Throughout the examination, the sonographer will take photographs of the ultrasound tracings to document that your veins are damaged for insurance coverage.

The tracing above exhibits reflux in a vessel because blue indicates blood flow in one direction and red indicates the opposite direction.  Blood in veins should only flow in one direction.

After the examination, your physician will review the findings with the
vascular technologist and go over the results with you, making
recommendations for treatment.

Treatments for varicose veins with reflux include endovenous laser ablation and foam sclerotherapy.  Duplex ultrasound is used to guide the physician when performing either of these treatments since the veins usually cannot be visualized.