5
Laboratory Evaluation
➤ We suggest laboratory evaluation for thrombophilia for patients with a
history of recurrent venous thrombosis and chronic recurrent venous
leg ulcers. (2-C)
Arterial Testing
➤ We recommend arterial pulse examination and measurement of ankle-
brachial index on all patients with venous leg ulcer. (1-B)
Microcirculation Assessment
➤ We suggest against routine microcirculation assessment of venous
leg ulcers but suggest selective consideration as an adjunctive
assessment for monitoring of advanced wound therapy. (2-C)
Venous Duplex Ultrasound
➤ We recommend comprehensive venous duplex ultrasound examination
of the lower extremity in all patients with suspected venous leg ulcer.
(1-B)
Venous Plethysmography
➤ We suggest selective use of venous plethysmography in the evaluation
of patients with suspected venous leg ulcer if venous duplex ultrasound
does not provide definitive diagnostic information. (2-B)
Venous Imaging
➤ We suggest selective computed tomography venography, magnetic
resonance venography, contrast venography, and/or intravascular
ultrasound in patients with suspected venous leg ulceration if
additional advanced venous diagnosis is required for thrombotic or
nonthrombotic iliac vein obstruction or for operative planning before
open or endovenous interventions. (2-C)
Venous Disease Classification
➤ We recommend that all patients with venous leg ulcer be classified
on the basis of venous disease classification assessment, including
clinical CEAP, revised Venous Clinical Severity Score, and venous
disease-specific quality of life assessment. (BP)
Venous Procedural Outcome Assessment
➤ We recommend venous procedural outcome assessment including
reporting of anatomic success, venous hemodynamic success,
procedure-related minor and major complications, and impact on
venous leg ulcer healing. (BP)
