Clinical and duplex ultrasound evaluation of lower extremities varicose veins - a practical guideline

Vasa. 2017 Aug;46(5):325-336. doi: 10.1024/0301-1526/a000635. Epub 2017 Apr 27.


Lower extremities varicose veins are among the most frequent diseases in the general population. They can cause complaints with a deterioration of the quality of life and are associated with potentially threatening clinical conditions such as chronic venous ulceration, haemorrhage from ruptured varicose veins, and venous thromboembolism. An accurate diagnostic work-up is crucial to confirm the presence and the extension of the venous problem, in order to obtain an optimal management of the condition. In the past years, great efforts have been made to reach an international consensus on the terminology, the symptomatology, the classification, and the duplex ultrasound examination of lower extremities varicose veins. Mainly guided by these consensus documents, the present article describes the diagnostic work-up of lower extremities varicose veins, based on a careful medical history, physical examination, and duplex ultrasound examination.

Keywords: Varicose veins; chronic venous disease; duplex ultrasound; venous reflux.

Publication types

  • Review

MeSH terms

  • Chronic Disease
  • Humans
  • Lower Extremity / blood supply*
  • Predictive Value of Tests
  • Prognosis
  • Regional Blood Flow
  • Reproducibility of Results
  • Ultrasonography, Doppler, Duplex*
  • Varicose Veins / diagnostic imaging*
  • Varicose Veins / physiopathology
  • Varicose Veins / therapy
  • Veins / diagnostic imaging*
  • Veins / physiopathology