Differences in Saphenous Vein Reflux Detection According to Patient Positioning

Abstract

Objective

—To demonstrate differences in saphenous reflux detection performed with the use of a simplified protocol with the patient in the supine or reverse Trendelenburg positions (nonstanding) compared with an extensive protocol with the patient standing.

Methods

—Reflux detection in the standing and nonstanding positions were compared for measurements at the great saphenous vein (GSV-thigh, GSV-calf), small saphenous vein (SSV), and common femoral vein/saphenofemoral junction (CFV/SFJ). Reflux longer than 1 sec was considered a positive finding. A total of 171 measurement comparisons were made in 40 extremities of 20 women, ages 54 ± 13 years (range 34–82), all evaluated for varicose veins. False-negative (FN) results were calculated for standing and nonstanding positions compared with positive results obtained in the other position.

Results

—FN results in the nonstanding position were 49% (16/33), 38% (12/32), 27% (12/45), and 26% (9/35) for GSV-calf, GSV-thigh, SSV, and CFV/SFJ, respectively. FN results for the standing position were 6% (1/18) and 7% (2/28) for GSV-calf and CFV/SFJ, respectively. Technologists perceptions were that coaptable veins in the nonstanding position and detection of low-velocity reflux in the standing position influenced the results.

Conclusions

—The data collected favored evaluation of saphenous vein reflux in women with varicose veins in the standing position.