Are there any concerns about venous insufficiency or deep vein thrombosis in a patient with patent and thrombosis-free deep and superficial veins, and no evidence of reflux, who underwent a nonsurgical planning test in the reverse Trendelenburg position?

No Significant Concerns Identified

Based on this venous duplex ultrasound report, there are no concerning findings for either deep vein thrombosis or clinically significant venous insufficiency. 1

Deep Vein Thrombosis Assessment

Your ultrasound effectively rules out DVT with the following reassuring findings:

• All deep veins are patent and compressible bilaterally - The American College of Chest Physicians guidelines establish that compression ultrasound demonstrating patent, compressible veins in the common femoral, femoral, and popliteal segments reliably excludes proximal DVT 2

• No evidence of thrombosis in any visualized segment - Both proximal deep veins and superficial veins (great saphenous, anterior accessory saphenous, small saphenous) show no thrombus 1

• Normal spectral waveforms - The presence of normal Doppler flow patterns further confirms absence of obstruction 2

Venous Insufficiency Assessment

The study also demonstrates no significant venous reflux disease:

• No reflux in deep venous system - The American Family Physician guidelines define clinically significant reflux as retrograde flow >500 milliseconds in superficial/deep calf veins and >1000 milliseconds in femoropopliteal veins; your study shows no reflux meeting these criteria 2

• No reflux in major superficial veins - The great saphenous, anterior accessory saphenous, and small saphenous veins all demonstrate competent valves without pathologic reflux 2

Anatomic Variant Noted

The only noteworthy finding is an anatomic variant on the right side:

• Right small saphenous vein continues as a thigh extension (PTE vein) rather than terminating at the saphenopopliteal junction - This is a common anatomic variant present in approximately 20-30% of individuals and is not pathologic 2

• This variant does not indicate disease and requires no intervention 2

Clinical Implications

No treatment or further testing is indicated based on these results. 1 The study was performed for nonsurgical planning purposes and provides a complete baseline assessment showing:

• Normal deep venous patency bilaterally
• Competent venous valves throughout
• No evidence of current or prior thrombosis
• No hemodynamically significant reflux

If symptoms develop in the future (leg swelling, pain, skin changes), clinical correlation would be appropriate, but the current study provides no evidence of venous pathology requiring intervention 2, 1