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In my experience I have found that trying to be precise in grading
venous reflux is of little significance. We have evolved into three
categories: no reflux, mild reflux (less than 1 sec), and positive for
reflux. The main thing is "is reflux present? Yes or no" and if so, "is
it deep or superficial".  If reflux is < 1 sec the physician has to make
his/her decision based on the clinical assessment.  

It is also important to determine if a reflux is localized or involves a
larger segment of the vessel.  A localized mild reflux between two
valves is not likely to be of importance (assuming you have also
assessed the superficial veins), but if the entire vessel length is
incompetent then that obviously has a higher likelihood of being of
clinical significance. 

Bonnie L. Johnson RDMS, RVT, FSVU

Stanford University Medical Center

Director, Vascular Laboratory Services

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-----Original Message-----
From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of Needham,
Terry
Sent: Wednesday, April 12, 2006 8:32 AM
To: [log in to unmask]
Subject: Re: valvular incompetence

Sorry this delayed.  Nicos Labropoulos has published that normal flow
reversal times are:

	<1s at common fem level
	<0.5s at popliteal and all levels superficial
	<0.35s for perforators

Labropoulos N. J Vasc Surg. Feb 2003; 38:4.
 
Terry Needham
Heart & Vascular
Erlanger Health System
423-778-5839
PLEASE  NOTE MY NEW EMAIL ADDRESS
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-----Original Message-----
From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of Chris
Willis
Sent: Friday, March 31, 2006 9:59 AM
To: [log in to unmask]
Subject: valvular incompetence

I was wondering if I can get everybody's input regarding valvular
reflux.
There is some confusion regarding reflux criteria.  I am especially 
interested in the sustained time period that is considered reflux.  I am

hearing anything greater than a second up to 3 seconds.  I am also being

asked by the vascular physicians if the patient's reflux is mild,
moderate 
and severe.  Is there any criteria out there that can answere this?
Your input is appreciated.
Thanks
Chris Willis RVT
Bangor, Maine

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