The Importance of Venous Duplex in Evaluation

The proper evaluation of a patient with varicose veins includes a thorough and detailed ultrasound examination of the involved leg(s). But why is this necessary?

The visual inspection of the leg with varicose veins can give doctors a general idea of the pattern of venous insufficiency. We can suspect, for example, that the great saphenous vein in the thigh is not functioning properly and unable to resist the force of gravity. If this is true, then reflux (backflow) in the vein will lead to high pressures being passed to the skin level, in turn causing varicose veins. In a scenario such as this, VNUS Closure is an ideal option to eliminate the source of the elevated venous pressure.

However, there are cases that involve other patterns of reflux, for which alternative treatments may be needed.

The venous ultrasound, also known as duplex scan, allows our registered vascular technicians (RVT) to look deeper in the leg, showing in great detail the cause of each patient's varicose veins. Treatments are based on the duplex scans, as are insurance authorizations for treatments. Luckily, most treatment of varicose veins is recognized as "medically necessary" by the insurance companies, as long as certain ultrasound criteria are met.

It may be difficult for a patient to know if a certain vascular lab is "high quality". There are nationally recognized accrediting organizations, such as ICAVL, that can give you greater confidence that the study is being done according to accepted criteria.

In sum, venous duplex is an essential part of any evaluation of patients with varicose veins. Be sure that you undergo a good quality exam before embarking on a treatment plan.