Ultrasound assessment for chronic venous insufficiency: introducing an evidence-based clinical guideline for sonographers

Chronic venous disease (CVD) is a prevalent vascular disease. Duplex ultrasound (US) is considered the first-choice imaging modality for evaluating venous anatomy and hemodynamics in patients with CVD. In Australia and New Zealand, chronic venous insufficiency (CVI), often referred to as venous insufficiency (VI) scans, is primarily performed by medical sonographers. Currently, inconsistency in the performance and reporting of CVI ultrasound presents a challenge, and a practical solution to this dilemma is a clinical guideline to assist sonographers in making appropriate, consistent, and evidence-based decisions throughout the scanning and reporting process. The aim of this article is to introduce a new guideline for sonographers on how to perform duplex US assessment for CVD, to provide a brief overview of its development and the methodology used, to explain its contents, and outline how it can be effectively used clinically to promote standardized practices and maintain the integrity of duplex US examinations. This guideline fills a critical gap by offering clear, evidence-informed recommendations and general guidance on scanning techniques, interpretation, and reporting of sonographic findings.