Investigations for venous disease

Question 1

How does the duplex work?

Answer 1

Looks at flow rates using colours

Question 2

How do trendelenburg and perthays work?

Answer 2

Trendelenberg (Tourniquet) - Superficial Veins

Lie down, elevate and milk leg and press on SFJ.

Stand up and if the varicose veins do not reappear it is SFJ problem.

2/3 cm lateral and 2/3cm inferior to pubic tubercle

POSITIVE - veins stay empty - SFJ problem.

If negative keep moving down

Perthes - Deep Veins

Similar but get them to move to check deep veins are working

Question 3

How does the Ankle Brachial Pressure Index work?

Answer 3

Looks at arterial pressure in the ankle and brachial artery

Normal is over 0.8

If it <0.8 - claudiation (reduced pressure in ankle)

If it is <0.6 you get ischaemia and pain

Question 4

What is a normal ABPI?

Answer 4

0.9 - 1.2

Question 5

What are the four ways to investigate Venous veins?

Answer 5

1. Duplex US
2. Trendelenburg
3. Perthes
4. Ankle Brachial Pressure index (ensures it is not arterial)