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This article blends current evidence with the author\u2019s perspective to review the principles, strengths, and limitations of VExUS and to outline the emerging concept of extended VExUS (eVExUS). VExUS has practical limitations when standard windows are inaccessible or unreliable, such as in patients with cirrhosis, advanced kidney disease, or difficult body habitus. The eVExUS approach addresses these challenges by incorporating additional venous Doppler assessments, including the internal jugular, superior vena cava, femoral, and splenic veins, as well as grayscale-based internal jugular measurements to estimate right atrial pressure when inferior vena cava imaging is suboptimal. While eVExUS offers a more adaptable, individualized strategy, its clinical adoption is still in the early stages. Further studies are required to validate eVExUS, link its findings to patient outcomes, and inform the development of tailored imaging protocols for diverse patient populations.<\/jats:p>","DOI":"10.4330\/wjc.v18.i1.112636","type":"journal-article","created":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T01:35:26Z","timestamp":1768440926000},"source":"Crossref","is-referenced-by-count":4,"title":["Extended venous excess ultrasound: A promising addition to point-of-care ultrasound-based venous congestion assessment"],"prefix":"10.4330","volume":"18","author":[{"given":"Abhilash","family":"Koratala","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2060","published-online":{"date-parts":[[2026,1,26]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.02.058"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1097\/SHK.0000000000001381"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000004617"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehad195"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.6061\/clinics\/2021\/e1924"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1093\/eurjhf\/hfq118"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.05.068"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.13118"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2024.154809"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1111\/joim.20049"},{"key":"B11","unstructured":"Blind men and an elephant. 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