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This is a case of a female patient that was diagnosed with an isolated deep vein thrombosis of the right popliteal vein.
The patient attended a 6 months ultrasound follow up scan after a course of oral anticoagulant therapy that revealed complete recanalisation of the popliteal vein and evidence of deep venous reflux.
The main objectives of the venous ultrasound assessment performed after the occurrence of a deep vein thrombosis are the evaluation of patency and competency of the affected vein.
Venous reflux can be demonstrated using either colour flow Doppler or/and pulsed wave Doppler.
When using colour flow Doppler, attention must be paid to the colour scale setting as venous reflux will appear with the some colour represented on the top of the colour scale bar.
The confirmation of venous reflux and the evaluation of its length can be determined using pulsed wave Doppler. As demonstrated in the video using provocation manoeuvre, (calf compression) it is possible to visualise retrograde venous flow after calf release which last longer than 1 second. While 1 second is used as the cut off value for defining deep venous reflux, 0.5 seconds is used for the definition of superficial venous reflux.


TAKE HOME MESSAGE:
When performing an ultrasound assessment after the occurrence of a deep vein thrombosis ascertain to check for patency (residual thrombosis) and competency (reflux) of the affected vein.

Popliteal vein reflux after deep vein thrombosis | Ultrasound

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