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Jan Sloves: Iliocaval Duplex Ultrasound as a Decision-Making Tool

Jan Sloves/LinkedIn

Apr 29, 2026, 13:14

Jan Sloves: Iliocaval Duplex Ultrasound as a Decision-Making Tool

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

“If your iliocaval duplex says there’s a significant lesion… how often are you right?

In our vascular labs, iliocaval duplex has become the hemodynamic gatekeeper for venous outflow obstruction.

When we call a significant iliac or IVC lesion on duplex, whether native disease or in-stent restenosis, IVUS confirms a treatable lesion in about 95% of cases.

Because of that, in many patients we move directly from duplex to venogram and then IVUS with intent to treat.

CT/MR venography?

Reserved for select cases with highly complex anatomy and redo interventions.

That experience doesn’t exactly line up with older publications suggesting iliocaval duplex is ‘unreliable’ for iliac stenosis…or with current practice patterns that still lean heavily on cross-sectional imaging before referral.

At the same time, newer data using optimized iliocaval imaging protocols with diameter measurements and strict hemodynamic criteria & velocity ratios show strong agreement between duplex and IVUS.

So, the real question becomes: is the issue the modality… or the way we’re performing it?

Because in a high-functioning vascular lab with a standardized protocol and experienced vascular technologists – iliocaval duplex may be far more accurate and clinically actionable than it’s often given credit for.

Curious what you’re seeing in your lab:

What’s your duplex : IVUS correlation for iliocaval lesions (native and ISR)?
Are certain lesion types throwing things off (acute DVT, compression, long-segments with fibrosis, CTO, ISR or mass effect)?
Are you consistently identifying acute DVT, compressed vein segments, CTO, or recanalization patterns before IVUS?
Are you comfortable going duplex : venogram/IVUS directly, or still relying on cross-sectional imaging first?

Is your lab still heavily dependent on CT/MR because duplex ‘isn’t reliable’?

That’s usually not a technology problem – it’s a protocol and performance problem.

Is your lab dealing with inconsistent duplex performance and interpretation gaps?

If so, I can help optimize your studies into decision-ready data.

If you want to elevate your technique and your lab’s performance, schedule a discovery call with me by activating the link or message me.

Su bscribe to the only newsletter built for vascular pros.”

Proceed to the video attached to the post.

Other posts featuring Jan Sloves on Hemostasis Today.