What is new in duplex scanning of the venous system?

The diagnosis and treatment of chronic venous disease has undergone a quantum leap forward in recent decades. In many ways, the venous system is now considered more complex than the arterial system. This is a result of the advances in understanding due to improvements in duplex ultrasound equipment, diagnostic techniques, and communication standards as they relate to findings in anatomy, pathology, and hemodynamics. Currently, it is self-evident that duplex ultrasound has become the gold standard for diagnosis of the venous system providing anatomic and functional information. Mapping techniques, understanding of superficial reflux, and other factors that affect duplex ultrasound findings are presented. These factors and techniques can affect diagnostic results and therefore have significant impact on the planning and approach to treatment of primary and recurrent venous insufficiency.