Provocation manoeuvres for the duplex ultrasound diagnosis of varicose veins

Summary

In contrast to the arteries, spontaneous flow in the leg veins is not sufficient for good diagnosis. Therefore, provocation manoeuvres are used to induce blood flow. Breathing and the Valsalva manoeuvre are classically used. Over the past few years, dynamic manoeuvres and manoeuvres closer to physiological conditions have been developed, such as the Paraná manoeuvre, in which the patient is pushed slightly forward in order to activate the gastrocnemius muscles, the Wunstorf manoeuvre, in which the forefoot is raised, or the orthostatic manoeuvre, in which the patient is placed in the supine position and then raised upright again in order to test the closure of the valves. All of these procedures are presented and compared with each other.

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Keywords

Varicose veins - Duplex ultrasonography - Provocation manoeuvre - Manual compression of the calf - Wunstorf manoeuvre

• Literatur

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