Effect of patient positioning on the duration of venous reflux in duplex ultrasound for venous insufficiency

Abstract

Introduction

There is currently little research regarding optimum patient position for venous insufficiency assessment although standing is considered the gold standard in many professional guidelines. Some patients are unable to stand for the examination and scanning patients in a standing position is physically challenging for the sonographer. This pilot study aimed to evaluate the effect of varying patient positioning on the duration of venous reflux.

Method

Venous reflux duration was measured in symptomatic participants with suspected venous insufficiency. Measurements were taken in the standing position (gold standard) and four alternative positions: 25° reverse-Trendelenburg (RT) tilt, sitting on the edge of the examination couch, 10° RT tilt and 0° RT tilt. The mean reflux duration measured in each different position was compared with the gold standard.

Results

Complete measurements were obtained from 16 patients (8 men and 8 women). For an incompetent vein, statistical analysis demonstrated a significant difference only between the standing position and the 0° position (U = 19.0; exact P < 0.01 [2-tailed]).

Conclusion

Results suggest that several alternative positions could be used for assessing incompetent veins as long as the patient is not lying supine with 0° tilt. This would offer much greater flexibility, which may be of benefit to both patients and sonographers.