Gray scale and color duplex ultrasound of great saphenous vein valve. Note closure of the valve leaflets during the valsalva maneuver.
Iliac vein compression may cause pelvic venous congestion.
64 year old male, type 1 diabetes, with a prior femoral to politeal bypass graft and a subsequent poplileal to tibial bypass graft.
Nutcracker syndrome is one of the causes of secondary pelvic congestion syndrome.