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Hossam El Benawi: Is Ultrasound Alone Enough to Diagnose CVI?
Apr 4, 2026, 16:06

Hossam El Benawi: Is Ultrasound Alone Enough to Diagnose CVI?

Hossam El Benawi, Senior Clinical Research Fellow of Cardiovascular Medicine at Mayo Clinic, shared a post on LinkedIn about a recent article he and his colleagues co – authored, adding:

“Is ultrasound alone enough to diagnose chronic venous insufficiency (CVI)?

Our data suggest it may fall short.

In 839 patients (1478 limbs), photoplethysmography (PG) consistently outperformed ultrasound (US) in detecting venous incompetence and identifying severe disease.

CVI severity was classified by CEAP score.

Severe CVI: 32.3% of limbs

US detection: 67.4% overall, 75.3% in severe CVI

PG detection: 72.9% overall, 88.5% in severe CVI

In machine learning models PG outperformed US parameters in predicting severe CVI (AUROC: 0.82 vs 0.65).

Limiting PG data to incompetence and obstruction parameters modestly reduced performance but remained higher than US (logistic regression AUROC 0.72). (Figure 1)

Takeaway:

A quantitative, whole – limb hemodynamic assessment with PG may better stratify CVI severity – and improve prognostic insight – than ultrasound alone.”

Title: Plethysmography compared to ultrasound for the evaluation of chronic venous insufficiency

Authors: Hossam Elbenawi, David Liedl, Thom Rooke, Ana I Casanegra, Paul Wennberg, Gina K Hesley, Robert McBane, Damon E Houghton

Read the Full Article on Vascular Medicine

Hossam El Benawi

Find more posts fromĀ Hossam El Benawi on Hemostasis Today.