Facial relationships, new nomenclature, variations.
Article Sonographic anatomy of the lower extremity superficial veins
Variations and knowledge in anatomy are most important
it needs expertise and experience...
Very interesting question! The most confusing is information exchange between person who performs DU and person who will treat the VV. If surgeon performs the DU by himself (optimal variant), to my opinion the most confusing issue becomes the diagnosis (criteria) of PATHOLOGICAL incompetence of perforating veins on the leg. Another difficult situation is identification of source of reflux in patients with VV caused by pelvic congestion syndrome.
Yes, regarding information exchange, we do think that the person treateing the patient (surgeon) should perform the Duplex himself and the skin mapping before the operation: it is the optimal way to transmit the whole anatomical and hemodynamical data...
Information exchange between the person who performs the procedure and person who performs the DU is probably the most important. We should unify the nomenclature and anatomic knowledge as soon as possible. I believe diagnostic part which is quite variable is more important than the treatment part which is more or less straightforward. Guideline set forth by UIP are very important but, there are still issues to be standardized such as accessories and aplasia/hypoplasia of the great saphenous veins. Role of -treatment of- perforators in the alleviation of patients' symptoms is still a dilemna.
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