How are Varicose Veins Diagnosed?

Written By Tony Carabasi III, MD, FACS
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Varicose veins are a common problem for adults in the U.S., affecting both men and women as they reach the later years of their lives. While you may be all too familiar with the sight of those bulging vessels, you may not realize that varicose veins are often a sign of an underlying vein condition known as chronic venous insufficiency or CVI. In addition to the appearance of varicose veins, CVI can lead to uncomfortable symptoms that can impact your quality of life. The good news is CVI is a relatively easy condition to diagnose and treat today, giving you freedom from the embarrassment and pain of varicose veins without throwing a major monkey wrench into your daily routine.

Why do Varicose Veins Occur?
Varicose veins are often a visible byproduct of an underlying vein condition known as chronic venous insufficiency or CVI. CVI occurs when certain veins of the body wear out or become damaged. More specifically, small valves inside the vessels wear out, preventing blood from flowing as efficiently back to the heart. This problem typically occurs in the veins of the lower legs, since these vessels have the challenging task of pushing blood back up the body against gravity to the heart.

When the veins don’t work as well, blood can reflux back into the vessel. This can lead to weakening of swelling of the vein. Eventually, varicosity can occur, which is evidenced by bulging veins that protrude above the surface of the skin and snake up the leg. Other symptoms of CVI include swelling of the leg, painful cramping, fatigue, and skin changes.

Choosing a Doctor
When you are suffering from the cosmetic embarrassment and physical discomfort of varicose veins, the right doctor can make all the difference in an accurate diagnosis and most effective treatment. Vein specialists work with vein conditions every day and usually have the state-of-the-art equipment and expert staff to address your vein condition. Physicians like Dr. Carabasi at Center for Vein Restoration have ample experience in vascular surgery to manage a wide range of vein disorders.

In addition to the surgeon that will be making your diagnosis and performing your treatment, staff at clinics like Center for Vein Restoration are usually some of the best in vascular medicine. These technicians and assistants, like the surgeon they work with, spend all of their time diagnosing and managing vein conditions. Their vast experience and expertise ensure you receive the highest level of care throughout your diagnosis and treatment process.

The Diagnostic Process
Pinpointing the cause of varicose veins is often a three-step process:

Medical History
A full medical history will be taken, which includes possible vein and clotting disorders you have experienced in the past. In addition, your surgeon will likely want to know whether anyone in your family has a history of blood clots or varicose veins. This is the time to give your physician a full rundown of the symptoms you are currently experiencing, including pain, swelling, skin irritation and fatigue in your legs.

Physical Examination
The physical examination usually follows the medical history, in which your physician will examine your legs for signs of swelling and varicosity. Most physical exams are performed with the patient standing up, since this gives the doctor a better idea of blood flow and makes some symptoms more obvious. Your physician may also check your legs for tender areas of skin or signs of skin discoloration that could indicate tissue damage and breakdown of the skin in the area of the varicosity.

Doppler Ultrasound
A vital step in diagnosing your problem will be the Doppler ultrasound exam. This may be done before or after the examination depending on your symptoms. The ultrasound is also the “gate keeper” for your insurance carrier and will their specific require medical criteria to be met – and demonstrated with that ultrasound for your carrier to consider covering any treatment. Doppler ultrasound is a painless procedure that uses sound waves to create an image of the vessel and the blood flow inside. The diagnostic tool is very useful in pinpointing the cause of varicose veins, as well as ruling out other serious vein disorders. A thorough venous exam for functional review performed by a registered vascular technologist (RVT) will take about an hour for both legs.

During the Doppler ultrasound, a special gel is placed on the handheld applicator used to conduct the examination. Known as the “transducer” this applicator is used to direct high frequency sound waves to the specific vein to be examined. The test will show how efficiently blood is moving inside the vessel or if any reflux is occurring that would indicate CVI is present.

“Ruling Out” Other Issues
In addition to pinpointing the cause of a vein condition, Doppler ultrasound can be used to rule out other issues, particularly a condition known as deep vein thrombosis or DVT. DVT occurs when a blood clot forms in a deep vein of the body, often the leg. This blood clot may form without any noticeable symptoms, although some patients may experience pain, swelling or skin tenderness in the area of the clot.

If the clot breaks free from its original location, it can travel to the lungs where it can lead to a pulmonary embolism. A pulmonary embolism is a potentially life-threatening condition that requires immediate medical treatment. It is far better to identify DVT before a pulmonary embolism occurs, in order to manage the condition and prevent a more serious event.

Prescribing Treatment
Once the cause of varicose veins can be identified and other conditions are ruled out, treatment for the vein condition can be prescribed. Dr. Carabasi offers a variety of vein treatments that allow him to customize treatment to the unique needs of each of his patients. All of his treatments are minimally-invasive and can be performed on an outpatient basis right in his office. Patients usually return to their daily activities as soon as treatment is finished.

If the cause of the varicose veins is accurately identified through the diagnostic examination, patients may qualify for insurance coverage for at least a portion of their vein treatment. The staff at Center for Vein Restoration can help you determine if insurance coverage is possible for your treatment. To learn more about diagnosing and treating vein disorders including varicose veins, contact Center for Vein Restoration.

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