It is very important to evaluate the venous system and find the source of hypertension in order to solve varicose veins, eliminate the problem and minimize the possibility of recurrence.
The gold standard in diagnosis is "Doppler Ultrasonography".
Doppler. Ultrasonography is the most important tool in the diagnosis of varicose vein diseases. However, it should be done by experts in the field, the entire system should be evaluated as a whole, not a specific area, problematic areas that will require intervention should be determined, and it should be decided which treatment method is appropriate according to the vascular structure, the relationship of the vessel with other tissues, and the person's body structure.
Doppler Ultrasonography system can show us in detail. This evaluation must be performed by expert radiologists for diagnostic purposes in varicose veins. During this evaluation;
- The patient should be examined both lying down and standing.
- The entire vascular system, including the intra-abdominal area, should be scanned and evaluated.
- The superficial vein system in the leg (Great saphenous vein and Small saphenous vein), the deep vein system and the connecting veins between them should be examined one by one at each level.
- During this examination;
- Intravascular blood flow direction,
- Blood flow speed,
- Whether there is reverse flow,
- Whether the flow changes in various situations (maneuvers) ,
- Vein diameters at certain levels of the leg
- The condition of the valves should be stated precisely.
- The connection of the side branches and the varicose veins with the main veins. It must be determined whether there is a new or old clot in the vessel, its connection points, whether there is a perforator connection if it is not from the main vessel, or whether there are vascular anomalies.
- It should be checked at every level whether there is a new or old clot in the vessel.
Thus, the region or regions that create venous hypertension are clearly revealed.
In more advanced clinical findings;
- Wound, non-healing and recurrent ulcer,
- Past clot, vascular occlusions due to clot,
- Congenital abnormal vascular structures, (Hemangioma, Klippel Trenaunay Syndrome, etc.)
- Intra-abdominal vascular problems, (May-thurner Syndrome) , Nutcracker syndrome…)
- Varicose veins in the genital area (Pelvic Congestion Syndrome, etc.)
In such cases, further tests may be requested after Doppler ultrasonography evaluation:
- CT- Vein imaging with computerized tomography (venography)
- MR- Vein imaging with magnetic resonance imaging (venography)
- Vein imaging with angio (Conventional venography)
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