PURPOSE The aim of our pilot study is to consider if the new flow presentation of the V-flow allows an assessment of the valve morphology of the crosses with respect to an insufficiency . MATERIAL AND
METHODS We performed a total of 50 investigations in which we documented a complete valve closure at the so called``crosse"at the valve of the large saphenous vein, a delayed valve closure or an incomplete valve closure with consecutive insufficiency at the crosse . The valve function of the crosse is crucial for the development of varicosis . For our study we recorded age and gender of the patients . One patient in the study was suffering from Covid19 . For the examinations we used a 3-9 MHz probe and a high-end ultrasound device . The examination was performed in a lying position and under quiet conditions . Before examination we practiced inhalation and exhalation as well as``pressing"or coughing with the patients, which resulted in a physiological closure of the venous valves . To rule out thrombosis, we carried out compression sonography on the legs . During the examination we documented the B-scan, the Color-Coded Duplex Sonography, the HR-flow and the V-flow for 3 seconds at the estuary of the crosses and incorporated these parameters into our measurements . Via V-flow, vectors can be imaged by representing the flow of erythrocytes and visually indicate a possible insufficiency due to delayed or incomplete valve closure .
RESULTS 31 of 50 patients (age 19-81years) showed a complete valve closure of the crosses, while three patients suffered from thrombosis . In eight of the 50 study participants (age 45-79 years) a delayed valve closure could be diagnosed by V-flow within 1-2 seconds . None of them had a thrombosis, but six of them suffered from cancer . In eleven patients we derived an incomplete valve closure with insufficiency (age 51-88 years). With reflux it took> 2 seconds to close the valve . The patient with Covid19 also showed an incomplete valve closure with insufficiency . At the same time this patient showed a Covid19-associated deep vein thrombosis . Eight additional patients also had a thrombosis . Six of them suffered from cancer . Overall, the results were best visualized by V-Flow .
CONCLUSION The crosse as a significant venous structure can be well investigated by V-flow with respect to hemodynamic changes and a resulted reflux . Also associated changes close to the valve can be visualized well.