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What does the venous reflux test check for?

My friend recently went to doctor and got something called a venous reflux test for her varicose veins. I have had varicose veins behind my knees for awhile, and am thinking of getting them checked out. If I already know that I have varicose veins, do I have to go get a venous reflux test? What does the venous reflux test check for? What would I do with my results from the venous reflux test?


Doctors Answers (6)

The evaluation for varicose veins starts with a physical examination of the apparent (visible surface) veins to help understand the anatomy and distribution of the vein problem. A duplex ultrasound exam is done to further visualize the anatomy, including segments of varicose veins that are not visible at the skin surface. The ultrasound can also measure blood flow and direction within a vein so sources of venous reflux (irregular venous flow causing vein congestion and enlargement) can be determined. Veins that have enlarged with reflux will need treatment of the entire problem and not limit treatment only to the most cosmetically visible segments of the varicose vein. By determining the underlying cause of the varicose vein such as a refluxing perforating vein or from a Saphenous trunk, and treating down to the source of the reflux, the results can be expected to be permanent. Factors such as future pregnancies, family genetics, amount of standing (usually job related), choice of shoes, and age you developed vein problems, can all affect whether you ever develop any new varicose leg veins.

Great question. While most people who present with varicose veins have venous reflux in one or more of the saphenous veins, many do not. These are called non-truncal, having no obvious origin. A ultrasound test (Doppler) can check for underlying causes especially in the presence of symptoms such as pain, heaviness, cramping/restlessness, and changes in the skin, especially in the ankles or ulceration. If symptoms are severe enough to affect your activities of daily living, sleep, work, exercise, sitting/standing at work, etc., you should be eligible for insurance coverage. You do need to wear hose for a period of time, elevate legs when achy, exercise, and take some sort of pain medication - such as an over the counter ibuprofen. If you have no symptoms or skin changes and are just concerned about appearance, it is considered cosmetic.

If you have varicose veins, a duplex ultrasound evaluation will guide you toward a treatment plan. Varicose veins are a lifelong issue, but can be well-maintained.

A properly performed lower extremity venous reflux exam evaluates all of the major veins of the lower extremity for evidence of failure of the one-way valves within the veins. As we get older, our veins will stretch and the valves will fail in some veins resulting in the backward flow of venous blood toward the feet when it should be flowing toward the heart. The veins in the legs are very complicated and vary quite a bit from person to person, so mapping of the veins and of the abnormal segments is essential for a clinician to understand the abnormalities and to decide the proper treatments for abnormal veins. Often, the most important problems cannot be visualized on the surface of the legs, and ultrasound is the ideal method to map these veins.

Great question. The reflux or backward flow in a vein that most doctors check for is the saphenous veins. These are the main surperficial veins that run just below the skin. They are usually not visible and they are the trunk of the tree which give off branches in the skin. The branch veins in the skin are the varicose veins you see. So when you go to the vein specialist he will test for reflux in varicose veins - and truly swollen varicose veins almost always have reflux - and for reflux in saphenous veins below the surface of the skin. If there is reflux in the saphenous veins, that will have to be treated before or with the varicose veins to get the best success.

Reflux means abnormal backward flow. In the veins, this means blood flows back down the leg and toward the surface instead of (inward and upward), causing spider and varicose veins to appear. All patients with leg veins should have a quick, painless CW-Doppler test for reflux to determine if there are deeper veins feeding the surface veins. When found, these saphenous veins are treated first after ultrasound mapping.

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