Venous Reflux Exam

Updated on: February 6, 2017

A venous reflux exam (a.k.a. duplex venous ultrasound) is a non-invasive diagnostic tool used to evaluate vein function, check for venous reflux (blood flow in the wrong direction) and ensure there are no blood clots, blockages or other vein-related conditions. It is used as a future roadmap for your physician to treat the underlying cause of varicose veins, which is known as venous insufficiency.

Normally, veins in your legs carry blood upward towards your heart. With venous insufficiency, blood pools in your veins causing a wide variety of symptoms including varicose veins. Unlike CT scans or MRIs, ultrasounds are very operator dependent. If you want to know when you shouldn’t trust your ultrasound results read on!

Venous Reflux Exam: What to Expect

A venous reflux exam is performed with a handheld ultrasound “wand” on legs. The reflection of sound waves is used to create images that will allow the physician to view veins and valves and determine the movement and direction of blood.

First, you lay on a table while the vascular technologist applies a conductive gel and passes the wand over the area of interest. Since gravity plays a big part in venous insufficiency, after assessment of your veins is performed supine (lying down), you will need to stand up for evaluation of reflux. This is the critical part of the exam. Your ultrasound technologist will squeeze and release your calf (sometimes with an automatic cuff). If you have venous insufficiency, this maneuver will provoke blood to travel towards your foot, which is easily detected by ultrasound. Your exam generally takes between 40 minutes and one hour if both legs are evaluated.

This exam is typically conducted as part of a varicose vein evaluation. It’s important for you to understand that this test is completely painless! A venous reflux examination is a non-invasive study that does not require a recovery period. You can return to normal daily activities with no downtime or aftercare. If there is any downside to this exam it is that the ultrasound gel tends to stick around despite your best efforts to wash off with a towel. The good news is that you can get rid of the residual after your next shower.

Venous Reflux Exam: Frequently Asked Questions

What are the advantages of a venous reflux exam over other similar procedures?

Venous reflux exams using ultrasound are less invasive than venography, arteriography and other diagnostic tools.

Who is a candidate for a venous reflux exam?

Candidates for venous reflux exams include patients who have been clinically diagnosed with venous reflux or venous valvular insufficiency in the past, or who are experiencing related symptoms, such as skin discoloration, feelings of heaviness or pain in the legs, chronic swelling, varicose veins or venous ulcers.

When can I expect results?

If you go to a dedicated vein specialist you will obtain your results immediately. Otherwise, your doctor will receive the results from your venous reflux exam within a few days and will then be able to formulate a treatment plan depending on the results.

What are the risks?

There are no risks or complications associated with this simple, non-invasive examination procedure. Some people will feel seasick during the standing part of the exam. This is easily remedied by lying down.

Do insurance companies cover the venous reflux exam?

Because venous reflux exams are used to diagnose a medical condition, or to confirm a clinical suspicion of your physician, this exam is usually covered by medical insurance companies, other than copays or deductibles.

How much does a venous reflux exam cost?

The cost of a venous reflux examination will vary depending on geographical location, provider fees, insurance coverage and where the test is performed, such as in an imaging center or in a physician’s office.

When should I not trust the results of my ultrasound?

Drum roll please. If your venous ultrasound is performed specifically for evaluation of venous insufficiency, part of the exam must get performed while standing! Otherwise you will receive a “false negative” which is a test that is falsely interpreted as normal despite the fact it should be abnormal. At that point run away and get a second opinion!

Updated February 3, 2017

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