DVT ultrasound

Background

• Non-compressible vein may be mistaken for an artery, leading to a false negative result
• An artery may be mistaken for a non-compressible vein, leading to a false positive result

Leg Vein Anatomy

Significant risk of PE:

• Common femoral vein
• (Superficial) femoral vein
  • (Superficial) femoral vein is part of the deep system, not the superficial system as the name suggests!
• Popliteal veins

Technique

1. Select transducer
   • Linear array vascular probe 6–10 MHz
   • 6–8cm width ideal (for larger patients, consider abdominal probe)
2. Compression
   • Compress vein with transducer (probe transverse to vein)
   • Touching of anterior and posterior walls = normal
   • No touching with pressures sufficient to deform the artery = likely DVT
3. Common Femoral Vein
   • Patient positioning
     • Reverse trendelenberg or semi-sitting with 30 degrees of hip flexion
     • Mild external rotation (30 degrees) hip
   • Probe at medial inguinal crease
   • Apply compression every centimeter
   • Continue distal to 1-2cm beyond bifurcation of the common femoral vein (into superficial and deep branches)
4. Popliteal vein
   • Patient positioning
     • Prone, decubitus position, or seated on edge of gurney
     • Knee flexed 10–30 degree
     • Reverse trendelenberg
   • 12cm superior, to 5cm inferior to the popliteal crease
     • Vein usually superficial to artery

See Also

• Ultrasound (Main)
• DVT (Deep Venous Thrombosis)
• Paget-Schroetter Syndrome

Source

Sonoguide.com