[Measures and interpretation of venous flow in stress tests. Manual compression and Parana manoeuver. Dynamic reflux index and Pstakis index]

Reproducibility of venous flow measurements with Doppler velocimetry depends on the type of stress test used. The signification of the resulting index varies with the type of calculation used. The Paranà manoeuvre has three advantages: it is easy to perform; has good reproducibility and the stress test is hemodynamically similar to the real situation. Unlike volumetric measurements such as the Psatakis index, the dynamic back flow index can be used to evaluate the degree of incontinence. The Psatakis index does however allow detection and measurement of shunt effect. By calculating these two indices when performing the Paranà manoeuvre (isometric reflex contractions of the lower limbs in stationary standing position), the real hemodynamic conditions controlling deep vein function when walking can be evaluated more precisely.