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After confirming the patient has adequate venous outflow and diameters measuring ≥2.5 mm, the sonographer should proceed to confirm and assess for presence of perforator(s).

Perforator Follow the cephalic or basilic vein distally to where it meets the median cubital as shown in Figure 7.

Figure 7 – Perforator Measurement

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The sonographer should assess for a perforating vein that communicates between the deep and superficial veins, while paying close attention to carefully measure the perforator longitudinally to assess and confirm it is ≥2 mm in diameter and is not tortuous (Figure 8).

Figure 8 – Assessing for a Perforating Vein That Communicates, Meets Criteria for Size, and Is Not Tortuous

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