Ace the RPVI 2026 Exam – Navigate Your Path to Vascular Victory!

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How can an examiner be certain a vein is thrombosed on duplex examination?

The vein collapses during compression

The adjacent artery collapses or snaps when pressure is applied but the vein remains visible

Compression findings are key in identifying venous thrombosis on duplex. In an acutely thrombosed vein, the intraluminal clot makes the vein noncompressible—so when you apply gentle pressure with the transducer, the vein stays visible and does not collapse, while a nearby artery (which is not thrombosed) will compress or “snap” under the same pressure. This contrasting response—noncompressible vein with a compressible artery—is a classic sign of a thrombus. If the vein collapses with pressure, that argues against thrombosis, and persistent flow on color or continuous Doppler in all segments would also suggest patency or partial thrombosis rather than a complete acute blockage.

The vein shows continuous holographic Doppler signals

Color Doppler shows persistent flow in all segments

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