Name of the Procedure:

Duplex Scan of Extremity Veins, Complete Bilateral Study (with responses to compression and other maneuvers)

• Common Names: Venous Doppler Ultrasound, Duplex Ultrasound

Summary

A Duplex scan of extremity veins is a non-invasive imaging test that uses high-frequency sound waves to visualize the veins in both legs or arms. It assesses blood flow and vein structure to check for any abnormalities such as blood clots or venous insufficiency.

Purpose

The procedure addresses conditions like deep vein thrombosis (DVT), varicose veins, and chronic venous insufficiency. It aims to detect blood clots, assess blood flow, and evaluate the functionality of valves in the veins, ensuring they are functioning properly.

Indications

• Swelling in the legs or arms
• Pain or tenderness in the extremities
• Varicose veins
• History or suspicion of blood clots (DVT)
• Skin discoloration or ulcers on the legs
• Screening for venous insufficiency

Preparation

• No special fasting or preparation is required.
• Wear comfortable clothing; you may be asked to change into a gown.
• Inform the healthcare provider about any medications or underlying conditions.

Procedure Description

1. You will lie down on an examination table.
2. A water-based gel will be applied to the skin over the veins being examined.
3. A transducer (a small handheld device) is moved over the skin, emitting sound waves that create images of the veins.
4. The technician may apply gentle pressure (compression) to the veins or ask you to perform certain maneuvers (e.g., deep breathing, leg movements) to assess blood flow and vein response.
5. The images are displayed on a monitor and analyzed by the technician and a radiologist.

Duration

Typically, the procedure takes about 30-60 minutes.

Setting

The procedure is performed in an outpatient clinic, radiology department, or vascular clinic.

Personnel

• Registered vascular technologist (RVT)
• Radiologist or vascular specialist
• Occasionally, a nurse or medical assistant

Risks and Complications

• Minimal risks as the procedure is non-invasive.
• Rare complications include minor skin irritation from the gel or slight discomfort during compression.

Benefits

• Provides detailed images of vein structure and blood flow.
• Helps in the diagnosis and management of conditions like DVT and venous insufficiency.
• Non-invasive and painless with no radiation exposure.
• Immediate results that aid in prompt decision-making for treatment plans.

Recovery

• No downtime required; you can resume normal activities immediately.
• Follow any specific instructions provided by your healthcare provider.
• Attend follow-up appointments if requested to discuss results.

Alternatives

• Magnetic Resonance Venography (MRV): More detailed but expensive and requires contrast dye.
• CT Venography: Involves radiation and contrast dye, used in more complex cases.
• Physical examination and symptom assessment: Less precise, often used in conjunction with imaging tests.

Patient Experience

• You might feel slight pressure during the compression and maneuvers but generally no pain.
• The gel may feel cool and a bit messy.
• Relax and remain still during the procedure to ensure accurate results.
• After the procedure, you can clean off the gel and go about your normal activities.
• Any discomfort is minor and temporary, typically resolved right after the scan.