A Venous Duplex Scan is a type of dedicated ultrasound to look at the venous system. The ultrasound uses sound waves to see the veins and evaluate blood flow within them. This exam is commonly used for veins in the legs and abdomen, but it can be applied to any other veins such as the neck or arms. One benefit of this exam is that it helps detect blood clots in the veins of the legs before they become dislodged and potentially pass to the lungs. Using a specialized Doppler technique, movement of blood within the vessels can be measured—this helps you see where the vein is open and where it may be blocked potentially by a blood clot. A Venous Duplex Scan provides detailed pictures of these blood vessels to help physicians determine the extent and cause of limited blood flow and to identify venous disease.
This procedure is performed to evaluate symptoms including leg pain or swelling, leg heaviness, excessive varicose veins, leg discoloration, shortness of breath, or suspected blood clots in your legs and/or lungs. A pulmonary embolism is the sudden blockage usually by a blood clot which may have traveled from the legs to form a blood clot in the lungs. By far the most common use of a venous duplex or venous ultrasound is to evaluate the patient for a condition called Deep Vein Thrombosis (DVT).
Deep Vein Thrombosis (DVT) is a blood clot that forms in a vein deep inside your body. Often DVT affects veins in the legs. Risk factors include:
- Age. Being older than 60 increases your risk of DVT
- Being overweight or obese
- Birth control pills (oral contraceptives) or hormone replacement therapy
- Cancer
- Family or personal history of deep vein thrombosis or pulmonary embolism
- Heart failure
- Inflammatory diseases
- Inheriting a blood-clotting disorder
- Injury or surgery
- Pregnancy
- Sitting in the same position for long periods of time (long plane or car rides)
- Smoking
A vein condition is May-Thurner Syndrome, an uncommon vascular condition that affects a vein in your pelvis. It occurs when a nearby artery compresses the left iliac vein—typically congenital. The compression prevents blood from flowing properly, leading to narrowing and scarring. This can also predispose you to leg swelling or formation of repeated new clots typically only in one leg. A venous duplex can be utilized to evaluate for such abnormalities within the vein.
Other circumstances, such as compression from an adjacent tumor, or evaluation of your veins after placement of an inferior vena cava filter (IVC filter) are all additional circumstances this exam may be utilized. The exam can also be used to monitor your veins in a scheduled fashion after having a procedure where reconstruction of the veins (vein recanalization) was required or where clot from the veins had to be removed (venous thrombectomy).
For this procedure, you will lay face-up on a moveable exam table and you may be turned to either side. Warm gel is placed over the area to be tested (typically from the groin/upper thigh to the lower calf) and an ultrasound probe is gently passed back and forth over the skin. The sound waves emitted from the ultrasound are used to construct a picture of the vein, and additional techniques are used to see how blood is flowing through the vein itself. During ultrasounds, specifically for evaluation for DVT, the technologist will apply firm compression to each portion of the vein, starting at the hip, and in certain portions mild pressure may be applied to your calf to see how blood flows through the vein.
Why choose Fairfax Vascular Center?
While an ultrasound is a simple exam, there are many factors that go into successful imaging and interpretation. These range from high-quality, updated ultrasound machines, experienced ultrasound technologists and experienced vascular and interventional radiologists. These factors are particularly important when performing venous duplexes to make sure an abnormal vein or clot within the vein is not missed.
The specialists at Fairfax Vascular Center have the largest combined clinical and imaging experience in management and treatment of venous disease in the region. This includes complicated deep vein thrombosis (involving both legs or even your abdomen), reconstruction of veins in the setting of long-term blockages, as well as removal of complex IVC filters. Our interventional radiologists are vein specialists that follow and manage their patients in clinical visits, as well as help design imaging protocols and interpret venous studies of varying complexity, and furthermore perform both simple and complex venous procedures.
Geographically, we are among the most experienced dedicated vascular specialists for diagnostic imaging related to the vascular system and vascular disease. Thanks to our rigorous emphasis on quality of imaging and interpretation, we are able to provide our patients with the utmost in experience and care.
Have a discussion with your physician to determine if a venous duplex or venous ultrasound is an appropriate part of your work up.
