The role of noninvasive testing in the evaluation of chronic venous problems

Abstract Noninvasive instrumentation is now available to evaluate venous function in patients with a wide variety of chronic venous problems. The present analysis attempts to review the use of directional flow detection by Doppler ultrasound, venous refilling or maximal venous outflow by plethysmography, and the newly introduced venous imaging techniques (B‐mode and duplex scanning) in evaluation of patients with varicose veins, the postphlebitic syndrome, sequelae after acute deep‐vein thrombosis, and venous reconstructive surgery. Venous refilling time recorded by the photoplethysmograph is the simplest technique for assessment of venous dysfunction, and it can identify venous stasis or ulcer as a result of long saphenous vein insufficiency. Both the B‐mode and the duplex scan allow direct examination of venous valve motion and determination of valve competency. The latter technique holds promise in the evaluation of venous valve reconstructive surgery and, more important, in accurate assessment of venous valve damage following acute deep‐vein thrombosis.