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Jan Sloves: What Every Vascular Specialist Should Be Looking For

Jan Sloves/LinkedIn

Dec 6, 2025, 06:23

Jan Sloves: What Every Vascular Specialist Should Be Looking For

Jan Sloves, President and Consultant at Vascular Imaging Professionals LLC, shared on LinkedIn:

“Duplex Ultrasound and Pelvic Escape Points: What Every Vascular Specialist Should Be Looking For

One critical – and often overlooked – part of a comprehensive venous exam is evaluating the internal iliac veins.

These vessels are usually very well visualized, and when you detect reversal of flow, it should immediately raise a red flag. In many cases, this finding points to a left common iliac vein obstruction – and that’s when your diagnostic mindset needs to shift:

How is this flow crossing the pelvic floor?
Where are the pelvic escape points?

With the patient standing and using a linear transducer, you can leverage hydrostatic pressure and a gentle Valsalva maneuver to reveal pelvic floor–lower limb connections.

When done properly, this technique is extremely sensitive and correlates closely with venography.

A great example:

Bilateral obturator vein reflux exiting the pelvic floor, with flow tracking through the vulvar region into the lower extremities.

Even if you’re still gaining comfort with pelvic venous imaging, incorporating just this portion of the exam is an excellent first step — and it can dramatically improve your ability to identify meaningful pelvic escape pathways.

Better technique. Better detection. Better outcomes.

Want to go deeper?

Join our private community, Ultrasound Unlocked, for case-based learning, advanced techniques, and weekly expert insights.

Request access here.

Let’s elevate the standard of vascular ultrasound together!

Have a great rest of your day!
Jan”

Jan Sloves