Dynamic duplex ultrasound for the evaluation of venous circulation in the lower limbs: A pilot study using a portable device.

Abstract

IntroductionVenous color Doppler ultrasound, it is the gold standard for diagnosing venous insufficiency and deep vein thrombosis (DVT), guiding therapeutic decisions, and monitoring post-treatment outcomes. This article explores the indications, methodology, clinical relevance, and interpretation of a new modality of execution of DUS: the dynamic test.Materials and MethodsFive adult volunteers with confirmed CVD CEAP class C0s were enrolled after informed consent. A portable wireless ultrasound probe with B-mode, color and pulsed Doppler capabilities was used. The probe was mounted on the patient's lower limb using a dedicated support harness, which provided stable probe positioning without restricting limb mobility. The probe was placed over the small saphenous vein (SSV) in the proximal of the leg in the posterior region, just below the popliteal fossa. The examination was conducted while the patient was walking.ResultsIn one patient, a variation in the diameter of the SSV could be observed at the end of the test. In all cases, it was possible to observe a lower amplitude (msec) of the systolic peak (SP) during walking, if compared with that obtained after calf compression maneuvers. There were no differences in the systolic velocity peak between the examination conducted with activation maneuvers and the dynamic one. Reflux during dynamic movement was detected in 2/5 patients (40%) in the SSV that was not observed in static assessments.ConclusionsDynamic color Doppler ultrasound (D-DUS) using a portable probe enables real-time assessment of lower limb venous flow during physiological motion. This approach may reveal pathological reflux not evident in static examinations, offering a valuable addition to conventional venous diagnostics.