According to the research of Dr. Paul van Bemmelen and his colleagues, a valve closure time exceeding 0.5 sec is consistent with clinically significant valvular incompetence. You must be certain that the patient is in a pronounced reverse Trendelenberg ( > 15 degrees lower than heart), or better yet, upright with weight bearing on the opposite leg, when the study is performed. The majority of variables related to Valsalva maneuvers, etc., can be overcome by using the cuff inflation-deflation techniques described in his papers.

Marsha M. Neumyer, BS, RVT, FSVU, FAIUM
International Director
Vascular Diagnostic Educational Services
Vascular Resource Associates
Harrisburg, PA
Phone/Fax: (717) 564-5907
Email: [log in to unmask]
Website: www.vasculared.com
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