Guidelines by vascular territory
For each territory: the Italian reference document, the European guideline, the American one and the downloadable SVU and CSVS operating protocols. Links lead to the websites of the societies that publish them; some full texts require a journal subscription.
1Supra-aortic trunks, cerebral circulation and vasculitis
Carotid and vertebral arteries, transcranial Doppler, giant cell arteritis.
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SIDV 2025 guidelines — Assessment of the supra-aortic trunks (in Italian)
First part of the new Italian update dedicated specifically to carotid and vertebral duplex: examination method, velocity criteria and report structure.
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ESVS 2023 — Atherosclerotic Carotid and Vertebral Artery Disease
The reference European guideline: indications for screening, stenosis thresholds, timing of revascularisation and the role of duplex as first-line investigation.
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SNLG guideline — Extracranial carotid stenosis and occlusion (in Italian)
Italian guideline accredited by the National Guidelines System (SNLG): diagnosis, treatment and stroke prevention in carotid stenosis.
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SPREAD — Stroke: Italian guidelines, 8th edition (in Italian)
Chapter 12: diagnosis and treatment of carotid stenosis, NASCET criteria, timing and stroke management. Historical edition: for the current approach to carotid disease refer first to SICVE-SNLG 2021/2022 and ESVS 2023.
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AIUM Practice Parameter — Extracranial Cerebrovascular System
American standard for performing and documenting the examination: scanning planes, mandatory measurements and minimum report content.
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SVU PPG — Extracranial Cerebrovascular Duplex Ultrasound Evaluation
Downloadable operating protocol: scanning sequence, angle of insonation, mandatory sampling sites and reporting.
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CSVS — Extracranial Cerebrovascular Duplex Ultrasound Examination
British carotid scanning protocol, revised every three years; very practical in describing the examination sequence.
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SVU PPG — Intracranial Cerebrovascular Evaluation (TCD and TCDI)
Non-imaging transcranial Doppler and transcranial duplex: acoustic windows, sampling depths and vessel identification criteria.
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SVU PPG — Transcranial Doppler in Pediatric Patients with Sickle Cell Anemia
Stroke risk screening in children with sickle cell disease: mean velocity thresholds and frequency of follow-up.
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CSVS — Transcranial Doppler Scanning for Children with Sickle Cell Disease
British equivalent of the paediatric transcranial screening protocol.
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CSVS — Giant Cell Arteritis Duplex Ultrasound Examination
Protocol for ultrasound assessment of giant cell arteritis: halo sign, temporal and axillary arteries, compression sign.
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SICVE-SIAPAV guidelines — Systemic vasculitis (in Italian)
Italian diagnostic and therapeutic approach to large- and medium-vessel vasculitis.
2Lower-limb arteries
Peripheral arterial disease, chronic limb-threatening ischaemia, diabetic foot, ABI and pressure studies.
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2024 ESC Guidelines — Peripheral Arterial and Aortic Diseases (PAAD)
Unified European document on peripheral arterial and aortic disease: the most recent reference text for overall clinical management.
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ESVS 2024 — Asymptomatic Lower Limb PAD and Intermittent Claudication
Management of asymptomatic PAD and intermittent claudication: when to investigate, when to treat, what surveillance.
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2024 ACC/AHA Guideline — Lower Extremity Peripheral Artery Disease
American guideline with the diagnostic algorithm based on ABI, post-exercise ABI, TBI and imaging.
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IWGDF/ESVS/SVS 2023 — PAD in People with Diabetes and a Foot Ulcer
The reference for the diabetic foot: limitations of the ABI in calcified arteries and the role of TBI, toe pressures and TcPO2.
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ESVS 2020 — Acute Limb Ischaemia
Acute limb ischaemia: Rutherford classification, timing of intervention and the role of bedside Doppler.
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SICVE guidelines — Chronic occlusive disease of the lower limbs (in Italian)
Italian pre-SNLG edition, still useful for terminology and the structure of national diagnostic pathways.
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NICE CG147 — Peripheral arterial disease: diagnosis and management
Essential and very pragmatic British guideline on the diagnosis and management of PAD.
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AIUM Practice Parameter — Peripheral Arterial Ultrasound Examinations
Standard for performing peripheral arterial duplex with colour and spectral Doppler.
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SVU PPG — Lower Extremity Arterial Duplex Evaluation
Duplex protocol for the lower-limb arterial axis: sampling points, stenosis criteria and velocity ratios.
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SVU PPG — Lower Extremity Arterial Segmental Physiologic Evaluation
Segmental pressure studies and plethysmographic waveforms: technique, normal values and interpretation.
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CSVS — Arterial Duplex Assessment (lower and upper limbs)
British arterial duplex protocol for the limbs, with the complete operating sequence.
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CSVS — ABPI Measurement
How to measure the ankle-brachial index correctly: position, cuffs, probe, common errors.
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CSVS — Peripheral Arterial Doppler Waveform Terminology
Shared terminology for arterial Doppler waveforms: how to describe monophasic, biphasic and triphasic without ambiguity in the report.
3Lower-limb veins
Reflux and varicose veins, deep and superficial vein thrombosis, vein mapping, pelvic veins.
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ESVS 2022 — Chronic Venous Disease of the Lower Limbs
European guideline on chronic venous disease: reference standard for ultrasound diagnosis of reflux and indications for treatment.
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ESVS 2021 — Management of Venous Thrombosis
DVT, superficial vein thrombosis and thrombosis at unusual sites: ultrasound diagnosis, duration of therapy and follow-up.
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SVS/AVF/AVLS 2022 — Varicose Veins, Part I: Duplex Scanning
The most useful part for the reporting clinician: it is entirely devoted to duplex scanning and the treatment of superficial truncal reflux.
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SVS/AVF/AVLS 2023 — Varicose Veins, Part II
Second part of the American recommendations on varicose veins: tributaries, recurrence and management of complications.
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2025 SCAI Clinical Practice Guidelines — Chronic Venous Disease
Recent interventional document on chronic venous disease, useful for comparing approaches.
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UIP Consensus — Duplex Ultrasound of the Veins, Part I: Basic Principles
The worldwide methodological consensus on venous duplex: patient position, provocation manoeuvres and definition of pathological reflux.
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UIP Consensus — Duplex Ultrasound of the Veins, Part II: Anatomy
Official venous anatomical nomenclature: the terminology to use in the report to be understood everywhere.
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UIP Consensus — Duplex Investigation after Treatment for Varicose Veins
Ultrasound follow-up after treatment: definitions of occlusion, recanalisation, neovascularisation and recurrence.
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Management of Chronic Venous Disorders — Guidelines, Part I
Evidence-graded systematic review on chronic venous disease; part one.
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Management of Chronic Venous Disorders — Guidelines, Part II
Part two, with ample space for instrumental diagnosis and therapy.
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AIUM/ACR/SPR/SRU — Peripheral Venous Ultrasound Examination
2024 revision of the American standard for the peripheral venous examination: compression, colour, Doppler and documentation.
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SVU PPG — Lower Extremity Venous Duplex Evaluation
Protocol for ultrasound diagnosis of DVT: compression intervals, mandatory segments, criteria for acute and chronic thrombus.
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SVU PPG — Lower Extremity Venous Insufficiency Evaluation
Reflux study in the standing position: manoeuvres, threshold times and mapping of escape points.
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SVU PPG — Lower Extremity Vein Mapping
Mapping of the great and small saphenous veins for bypass: diameters, depth and usable segments.
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SVU PPG — Transabdominal Pelvic Venous Duplex Evaluation
Pelvic congestion and gonadal reflux: transabdominal approach, criteria for dilatation and reflux.
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CSVS — Lower Limb Venous Duplex for Venous Incompetence
British protocol for the study of superficial and deep venous incompetence.
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CSVS — Upper and Lower Limb Venous Duplex Assessment for DVT
Single protocol for DVT assessment in the lower and upper limbs.
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NICE CG168 — Varicose veins in the legs
British criteria for specialist referral and indications for treating varicose veins.
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SIF-SICVE Phlebology guidelines (in Italian)
Italian reference for clinical phlebology, including the ultrasound diagnostic part.
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Guidelines of the Collegio Italiano di Flebologia (in Italian)
Diagnosis and treatment of venous and lymphatic diseases according to the Collegio Italiano di Flebologia.
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SIAPAV care pathway for deep vein thrombosis (in Italian)
Italian DVT management pathway, from clinical suspicion to ultrasound follow-up.
4Abdominal aorta and iliac arteries
Abdominal aortic aneurysm, screening, surveillance and follow-up after EVAR.
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ESVS 2024 — Abdominal Aorto-Iliac Artery Aneurysms
The reference European guideline: intervention thresholds, ultrasound surveillance intervals by diameter band and measurement criteria.
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SNLG guideline — Infrarenal aortic aneurysm disease (in Italian)
Accredited Italian version: prevention, diagnosis and treatment of AAA, with the national screening programme.
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SNLG guideline — Thoracic and thoracoabdominal aortic disease (in Italian)
Completes the picture of the aorta for the thoracic and thoracoabdominal segments.
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SVU PPG — Screening for Abdominal Aortic Aneurysms (AAA)
Screening protocol: measurement planes, leading-edge criteria and content of the screening report.
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SVU PPG — Abdominal Aortoiliac Duplex Evaluation
Complete duplex study of the aorto-iliac axis, including stenoses and occlusions.
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CSVS — Endovascular Aneurysm Repair (EVAR) Duplex Ultrasound
Ultrasound surveillance after EVAR: search for endoleaks, sac measurement and timing of follow-up.
5Visceral and renal vessels
Mesenteric arteries, coeliac trunk, renal arteries and renovascular hypertension.
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ESVS 2025 — Diseases of the Mesenteric and Renal Arteries and Veins
The most recent European guideline on the visceral and renal territory: ultrasound diagnostic criteria, indications for treatment and follow-up.
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SICVE-SIRM guidelines — Visceral and renal artery aneurysms (in Italian)
Joint Italian vascular surgery–radiology document on splanchnic and renal aneurysms and pseudoaneurysms.
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SVU PPG — Mesenteric/Splanchnic Artery Duplex Imaging
Protocol for chronic mesenteric ischaemia: patient preparation, PSV thresholds for the coeliac trunk and superior mesenteric artery.
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SVU PPG — Renal Artery Duplex Imaging
Renal artery study: RAR, resistive index, acceleration time and criteria for significant stenosis.
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CSVS — Mesenteric Artery Duplex Assessment
British protocol for mesenteric studies, with the fasting and post-prandial sequence.
6Upper limbs, TOS and haemodialysis access
Upper-limb arteries and veins, thoracic outlet syndrome, mapping and surveillance of AV fistulas.
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SVU PPG — Evaluation of Hemodialysis Access
Vascular access surveillance: volume flow, criteria for anastomotic and needling-segment stenosis, warning signs.
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SVU PPG — Upper Extremity Vein Mapping (pre-fistula and pre-bypass)
Pre-creation mapping: minimum cephalic and basilic diameters, depth, distance from the skin and central patency.
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CSVS — Pre Arterio-Venous Fistula Duplex Assessment
British pre-fistula assessment: arm arteries and veins, reactivity test and suitability criteria.
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CSVS — Post Fistula and Dialysis Access Graft Assessment
Follow-up of native fistulas and prosthetic grafts after creation.
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SVU PPG — Upper Extremity Arterial Duplex Evaluation
Upper-limb arterial duplex, from the subclavian artery to the palmar arches.
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SVU PPG — Upper Extremity Arterial Segmental (TOS and cold immersion)
Positional manoeuvres for thoracic outlet syndrome and cold testing in Raynaud's phenomenon.
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SVU PPG — Upper Extremity Venous Duplex Evaluation
Upper-limb venous thrombosis, including catheter-related forms and Paget-Schroetter syndrome.
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SVU PPG — Radial Artery Assessment for Coronary Artery Bypass
Assessment of the radial artery as a conduit: diameter, calcification and ulnar compensation.
7Venous thromboembolism and antithrombotic therapy
Across all territories: diagnosis and treatment of VTE, prophylaxis, DOACs and periprocedural management.
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NICE NG158 — Venous thromboembolic diseases
Complete diagnostic pathway for DVT and pulmonary embolism, combining clinical score, D-dimer and ultrasound.
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ASH 2020 — Treatment of Deep Vein Thrombosis and Pulmonary Embolism
Treatment of VTE according to the American Society of Hematology: choice of drug, duration and special cases.
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ASH 2018 — Diagnosis of Venous Thromboembolism
Diagnostic strategies by pre-test probability, and the place of compression ultrasound.
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ASH 2018 — Prophylaxis for Hospitalized and Nonhospitalized Medical Patients
Prophylaxis in hospitalised and non-hospitalised medical patients.
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ASH/ISTH 2025 — VTE in Pediatric Patients
Update on venous thromboembolism in children.
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CHEST 2021 — Antithrombotic Therapy for VTE Disease (second update)
Update of the CHEST recommendations, the long-standing reference for antithrombotic therapy.
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CHEST 2024 — Compendium and Review of Guidelines 2012-2021
Reasoned summary of ten years of CHEST recommendations: convenient as a single reference.
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2019 ESC/ERS — Acute Pulmonary Embolism
Diagnosis and risk stratification in acute pulmonary embolism.
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2024 ESC/EACTS — Atrial Fibrillation (AF-CARE)
Atrial fibrillation: relevant to the management of anticoagulation in vascular patients.
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SNLG guidelines for the prophylaxis of venous thromboembolism (in Italian)
Historical Italian document on VTE prophylaxis in different clinical settings.
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Diagnosis and treatment of DVT in general practice (in Italian)
Italian intersocietal guide designed for primary care, useful for understanding who refers the patient for duplex ultrasound and why.
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Guidelines for the diagnosis and treatment of DVT (in Italian)
Historical Italian intersocietal document, still cited for the structure of the diagnostic pathway.
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Intersocietal recommendations on laboratory tests for DOACs (in Italian)
When and how to measure the effect of direct oral anticoagulants.
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FCSA recommendations — Oral anticoagulation, surgery and invasive procedures (in Italian)
Periprocedural management of anticoagulants: interruption, bridging and resumption.
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SIMG-FCSA consensus on prescribing oral anticoagulant therapy (in Italian)
Practical document for general practice on the correct prescription and management of oral anticoagulation.
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AIFA Note 97 — Oral anticoagulants in non-valvular atrial fibrillation (in Italian)
Italian regulatory reference on reimbursement by the National Health Service; update in force from 9 July 2026.
8Compression, venoactive drugs, lymphoedema and malformations
What to recommend after the report: compression therapy, venoactive drugs, lymphology and vascular anomalies.
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Indications for medical compression stockings in venous and lymphatic disorders
International consensus on indications for compression stockings, by compression class and clinical picture.
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Risks and contraindications of medical compression treatment
The other side of the coin: absolute and relative contraindications to compression, often overlooked in the report.
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Compression therapy after invasive treatment of superficial veins
How much compression and for how long after sclerotherapy, endovenous laser and surgery.
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Clinical Guidelines on Compression Therapy in Venous Diseases
Recent summary by an international panel on compression therapy in venous disease.
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The role of venoactive compounds in the treatment of chronic venous disease
Review of venoactive drugs and their place in chronic venous disease.
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Venoactive drugs: critical appraisal and comparison with international guidelines
Critical comparison of the recommendations of different societies on venoactive drugs.
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Delphi consensus on venoactive nutraceuticals — SIAPAV position statement (in Italian)
Cautious Italian position on the role of venoactive nutraceuticals in chronic venous disease.
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SIF-SICVE Phlebolymphology guidelines (in Italian)
Italian reference that brings together the venous and lymphatic parts.
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IUA-ISVI Consensus — Diagnostic guidelines of Chronic Lymphedema of the limbs
Differential diagnosis of limb lymphoedema, often raised precisely when the venous duplex is negative.
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IUA-ISVI Consensus — Vascular Anomalies: Malformations and Hemangiomas
Classification and diagnostic work-up of vascular malformations and haemangiomas.
9Methodology, report structure and laboratory quality
How to write the report and how to keep the accuracy of the vascular laboratory under control.
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Operating procedures for vascular diagnostic investigations (in Italian)
The Italian document closest to a reporting manual: examination procedures and report templates for each territory.
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SIDV-GIUV Guidelines for vascular diagnostic procedures
English version of the SIDV procedures, useful for citing them in international settings.
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SVU — Professional Performance Guidelines (index of the 20 protocols)
Index page from which all SVU operating protocols can be downloaded free of charge, territory by territory.
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CSVS — Vascular Science Guidelines (index of the 12 protocols)
Index of downloadable British protocols, revised every three years.
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SVU PPG — Quality Assurance for Accuracy of Examinations
How to validate your own velocity criteria and measure laboratory accuracy: the prerequisite for every threshold used in the report.
Scientific societies in the vascular field
Who writes the guidelines cited above. For each society, one line on what it produces that is useful to the reporting clinician.
Italy
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SIDV-GIUV — Italian Society of Vascular Diagnostics
The only Italian society dedicated specifically to vascular ultrasound diagnostics. It publishes the Operating procedures for vascular diagnostic investigations, with reporting templates.
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SICVE — Italian Society of Vascular and Endovascular Surgery
Produces the Italian SNLG-ISS accredited guidelines on carotid disease, abdominal aorta, thoracic aorta and visceral aneurysms.
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SIAPAV — Italian Society of Angiology and Vascular Pathology
The reference society for Italian angiology: guidelines, care pathways and position statements.
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SIF — Italian Society of Phlebology
Co-author with SICVE of the Italian Phlebology and Phlebolymphology guidelines.
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CIF — Collegio Italiano di Flebologia
Guidelines on chronic venous insufficiency, venous ulcer, thrombosis and lymphoedema, with a strong duplex component.
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SIUMB — Italian Society of Ultrasound in Medicine and Biology
National network of basic and advanced Ultrasound Schools with hands-on training: the most structured route in Italy for training in ultrasound.
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SIECVI — Italian Society of Echocardiography and Cardiovascular Imaging
Operator certification and laboratory accreditation pathways for cardiovascular imaging.
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SISET — Italian Society for the Study of Haemostasis and Thrombosis
Intersocietal recommendations on DOACs and laboratory diagnostics: relevant to the DVT pathway after duplex.
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FCSA — Federation of Thrombosis Centres (Italy)
Operating recommendations on oral anticoagulation and DOACs, periprocedural management and the network of anticoagulation clinics.
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SIRM — Italian Society of Medical and Interventional Radiology
Ultrasound study section; co-signatory with SICVE of the guideline on visceral and renal aneurysms.
Europe
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ESVS — European Society for Vascular Surgery
Publishes the European Clinical Practice Guidelines on carotid disease, PAD, abdominal aorta, chronic venous disease and venous thrombosis, in EJVES.
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ESVM — European Society of Vascular Medicine
Federates national vascular medicine societies; guidelines on PAD, compression and antithrombotic therapy.
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EFSUMB — European Federation of Societies for Ultrasound in Medicine and Biology
Federates 29 national societies with about 20,000 members; publishes European guidelines and recommendations on ultrasound.
International and worldwide
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UIP — Union Internationale de Phlebologie
Author of the consensus documents that are the worldwide methodological standard for venous duplex: Basic Principles, Anatomy and follow-up after treatment.
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WFUMB — World Federation for Ultrasound in Medicine and Biology
World federation of ultrasound societies, of which EFSUMB is the largest member.
United States
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SVU — Society for Vascular Ultrasound
Founded in 1977, it is the only professional society entirely dedicated to non-invasive vascular ultrasound. More than 5,700 members; it publishes the Journal for Vascular Ultrasound and the 20 operating protocols, downloadable free of charge.
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AIUM — American Institute of Ultrasound in Medicine
Publishes the Practice Parameters that define the standard for performing and reporting venous, arterial and carotid ultrasound, often with ACR, SPR and SRU.
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SVS — Society for Vascular Surgery
Co-author of the SVS/AVF/AVLS guidelines on varicose veins, whose Part I is entirely devoted to duplex scanning.
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AVF — American Venous Forum
Co-author of the varicose vein guidelines and of the document on compression after invasive treatment.
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AVLS — American Vein & Lymphatic Society
The largest US association of professionals dedicated to venous and lymphatic disease.
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ASE — Circulation & Vascular Ultrasound Council
Council of the American Society of Echocardiography dedicated to vascular and circulation ultrasound.
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SRU — Society of Radiologists in Ultrasound
Organises multidisciplinary consensus conferences (including the 2003 one on carotid criteria) and co-signs the practice parameters.
United Kingdom, Ireland and other countries
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CSVS — The College and Society for Clinical Vascular Science
Formerly the SVT of Great Britain and Ireland: the scientific and educational society of Clinical Vascular Scientists. It publishes 12 scanning protocols, runs the AVS professional accreditation and provides CPD. Together with the SVU it is the worldwide reference for vascular ultrasound practitioners.
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BMUS — British Medical Ultrasound Society
British guidelines, training resources and public information on ultrasound, including the vascular part.
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ASA — Australasian Sonographers Association
More than 8,000 members, over 70% of sonographers in Australasia; a broad range of continuing education.
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Sonography Canada
About 7,500 members; manages Canadian national credentials, including the vascular one (CRVS).
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SVU Southeast Asia
Regional chapter of the SVU for Southeast Asia.
Operator certification and laboratory accreditation
Who certifies the people who perform the examination and who accredits the facility where it is performed. In Italy there is not yet a pathway equivalent to the US RVT or the British AVS.
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ARDMS — RVT (Registered Vascular Technologist)
The worldwide reference credential for vascular ultrasound: SPI exam plus the VT specialty exam. Required for IAC laboratory accreditation.
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CCI — RVS (Registered Vascular Specialist)
Alternative credential to the RVT, issued by Cardiovascular Credentialing International.
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ARRT — Vascular Sonography (VS)
Post-primary pathway of the American Registry of Radiologic Technologists for vascular sonography.
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IAC — Intersocietal Accreditation Commission, Vascular Testing
Defines the standards of the vascular laboratory: the SVS/AVF/AVLS guidelines require duplex to be performed in an IAC- or ACR-accredited laboratory.
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CSVS — AVS (Accredited Vascular Scientist)
British professional accreditation with written exams, a practical assessment and a public register: the closest European equivalent to the RVT.
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IQIPS — Improving Quality in Physiological Services (UKAS)
UKAS standard for the accreditation of physiological services, including the vascular laboratory: the British equivalent of IAC accreditation.
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AHCS — Academy for Healthcare Science
Professional register of UK healthcare scientists; publishes the Good Scientific Practice code adopted by the CSVS.
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CASE — Consortium for the Accreditation of Sonographic Education
Accredits ultrasound training courses in the United Kingdom, including vascular modules.
Scientific journals
Where the guidelines listed on this page are originally published.
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European Journal of Vascular and Endovascular Surgery (EJVES)
The ESVS journal: this is where the European Clinical Practice Guidelines are published.
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Journal of Vascular Surgery: Venous and Lymphatic Disorders
Publishes the SVS/AVF/AVLS guidelines on varicose veins and much of the recent venous literature.
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Journal for Vascular Ultrasound (JVU)
Quarterly journal of the SVU: the only journal entirely dedicated to vascular ultrasound, with CME questions attached to many articles.
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Phlebology — The Journal of Venous Disease
Published the Rabe and Partsch consensus documents on indications for and contraindications to compression.
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International Angiology
Published the Nicolaides guidelines on chronic venous disease and the English version of the SIDV procedures.
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Annals of Vascular Surgery
General vascular surgery journal; hosts international consensus documents such as the 2024 one on compression.
Training, forums and community
Structured training pathways and spaces for discussion among those who perform the examination every day. Private groups require a membership request.
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SIUMB Ultrasound Schools
National network of accredited schools with supervised practical training: the reference structured pathway in Italy.
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ABC Vascular
Accredited courses on carotid and lower-limb venous ultrasound, built on practical videos and cases.
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Esonography — Vascular Ultrasound Registry Review
E-learning built specifically to prepare for the RVT vascular exam.
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GCUS — Gulfcoast Ultrasound Institute
Blended courses, online plus hands-on, on peripheral vascular ultrasound and ARDMS registry review.
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123sonography
FocusClass and MasterClass on cardiac, abdominal and point-of-care ultrasound.
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SVU UConnect — Open Forum
The SVU professional forum: cases, protocols, equipment and coding. The most qualified worldwide on vascular ultrasound; full access requires membership.
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CSVS — Public register of Accredited Vascular Scientists
Public search of accredited AVS: useful for identifying contacts and centres in the United Kingdom and Ireland.
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Vascular Technologists (Facebook group)
About 28,000 members: the largest and most specialised group for vascular technologists and sonographers, covering cases, protocols and velocity criteria.
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Ecografia in Medicina Generale (Facebook group, in Italian)
The most active Italian community on outpatient clinical ultrasound, including vascular.
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FLEBOLINFOLOGIA (Facebook group, in Italian)
Italian group with an explicit phlebology focus.
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r/VascularSurgery
Clinical discussion of vascular surgery on Reddit, active for more than ten years.
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r/Sonographers
Professional space for sonographers: cases, continuing education and work issues. Patient questions are not allowed.
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