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What kind of examinations are done for varicose veins?

This question was asked in Largo, Florida and has 5 answer(s) as of 01/16/2013.
How are vein doctors able to concretely diagnose varicose veins so that they are sure that this is the problem as opposed to anything else?


Doctors Answers (5)

First off, pick the right doctor. Make sure you "vein doctor" is well trained and experienced in the diagnosis and treatment of venous disease. Ask about their training, board certification and experience in treating venous disease. If you chose the right physician; with the aide of good duplex ultrasound, they should have no problem telling you if your symptoms are related to your varicose veins.

The test that is done to diagnose the problem with varicose veins is a duplex ultrasound. This test examines the vein that causes varicose veins. The exam specifically examines the function of the valves within the vein. If the vein valve inside the greater saphenous vein is not closing properly then there is venous valvular reflux. The valve does not work properly and blood flow is in the wrong direction(down the leg) leading to dilated varicose veins. If the vein stays open too long greater then 0.5 seconds the it has to be repaired or the patient will end up with varicose veins.

A thorough examination to diagnose varicose veins involves three parts: patient medical history, especially as it pertains to problems with the legs, a physical examination in the standing position, and a color duplex venous ultrasound. A properly performed venous ultrasound by a vein specialist is extremely important for several reasons. First, ultrasound "sees" below the surface to identify abnormalities in deeper veins. Second, it helps to "map" the abnormal veins and is important in determining a treatment plan. Finally, detailed ultrasound information is necessary to submit to insurance companies to get approval to treat varicose veins and the underlying condition called chronic venous insufficiency (also called venous reflux). Ultrasound can also check for evidence of deep venous thrombosis (DVT), a potentially fatal condition if left untreated.

An ultrasound examination in the most non-invasive and cost effective way to definitively diagnosis varicose veins. First the ultrasound is able to image the area under the skin that is in question and determine if it is a vein, lymph node, cyst or something else. Next if it is a vein, the ultrasound can determine the direction of blood flow in veins. Blood should only flow one direction back towards the heart when traveling through the legs. In a healthy vein the blood is pushed up to the heart and as it starts to fall back due to gravity the valves in the vein close tight. This keeps the blood from falling until it gets pushed up again due to either a heart beat or the calf muscles contracting. If the valves do not close correctly, the blood leaks through the damaged valve. This creates increased back pressure which causes the vein to expand into what we notice as a varicose vein. If an ultrasound exam shows blood flow in both a forward and backwards direction it is definitive proof that the valves within the veins are not closing correctly and helps determine the best course of treatment.

The gold standard for evaluation of vein anatomy? (size, shape, and location) and function (venous flow and the direction of flow) is with a detailed duplex ultrasound evaluation usually done in the office. The ultrasound studies help to determine the degree and location of poorly functioning veins? (due to venous incompetence and reflux) as well as in helping to develop a treatment plan or treatment options.

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