Venous duplex ultrasound protocol for iliocaval disease

Venous duplex ultrasound imaging of the retroperitoneal iliac veins and vena cava has been slow to be adopted into everyday use; however, current ultrasound technology allows more depth of penetration with improved image resolution. Gray-scale, color flow, and pulsed wave Doppler modalities are ideal for evaluation of the femoral-iliocaval outflow tract. Additional tools, such as chroma tint, power Doppler, and penetration harmonics, are useful for image optimization. Duplex ultrasound using the techniques described here needs to be compared and correlated with intravascular ultrasound imaging in a formal study that also looks at clinical outcomes and quality of life measures.