Medically reviewed by Mohamed T. Hassan, MD, DABVLM, RPVI, on April 21, 2025
People with leg pain, itching, swelling, or throbbing varicose veins may be tempted to head to the emergency room (ER), hoping for fast answers—and relief. This is completely understandable, as vein problems can be scary and uncomfortable. You may also worry if these symptoms indicate a blood clot or pulmonary embolism (PE).
However, these symptoms are more likely a result of chronic venous insufficiency (CVI). This is a progressive type of vein disease that emergency rooms are not set up to evaluate thoroughly.
That’s where Center for Vein Restoration, America’s largest physician-led vein center, comes in. We transform lives by delivering safe, customized outpatient care for leg pain and swelling. As the nation’s top varicose vein and spider vein treatment provider, we offer a wide range of gentle, minimally invasive options to help you feel confident and comfortable again.
To help us understand why an ER or hospital visit usually can’t correctly diagnose CVI and what you can do instead, we spoke with Dr. Mohamed T. Hassan. He is the lead physician at Center for Vein Restoration (CVR) vein clinic locations in Hoover, Alabama, and Trussville, Alabama. Dr. Hassan is dedicated to helping patients overcome venous insufficiency and other vein-related issues with state-of-the-art vein treatments and compassionate outpatient care.
✅To schedule a consultation with Dr. Hassan in Hoover, Alabama, CLICK HERE.
✅To schedule a consultation with Dr. Hassan in Trussville, Alabama, CLICK HERE.
✅ Don’t live near Trussville or Hoover, Alabama? Call 240-965-3915 to speak with a helpful Patient Services Representative or schedule your consultation online at one of our 110+ CVR vein clinics near you.
Emergency rooms are designed to treat urgent, life-threatening conditions. When you arrive with leg pain or swelling, their top priority is to rule out a blood clot in the deep veins of the leg, also known as deep vein thrombosis (DVT). According to NIH research, this is standard protocol because a DVT can travel to the lungs and cause a dangerous pulmonary embolism (PE).
If the ER ultrasound rules out a DVT, the care team typically concludes the visit. If symptoms persist, you may be told to follow up with a specialist. Why? The ER is not equipped to diagnose chronic venous insufficiency (CVI), a progressive condition that develops over time when vein valves no longer work properly.
So, even if you leave the ER with “no clot found,” that doesn’t mean your symptoms aren’t real or serious because the underlying cause—often CVI—wasn’t evaluated.
At Center for Vein Restoration (CVR), we offer a safe and efficient alternative to the long wait in the emergency room. CVR’s DVT rule-out service includes:
✔️Same-day evaluation and diagnosis of possible deep vein thrombosis
✔️Notification of results on the same day
✔️Immediate start of anticoagulation medication (if indicated)
✔️Long-term follow-up care until anticoagulation medicine can be stopped
To schedule a DVT rule-out appointment offered by Center for Restoration, call 877-SCAN-DVT (877-722-6388).
The following symptoms are signs of a medical emergency and should be evaluated in the emergency room or by calling 911. If you do not have these urgent symptoms but suspect a deep vein thrombosis (DVT), Center for Vein Restoration offers same-day DVT rule-out services to assess your condition quickly and safely.
Go to the ER immediately if you have signs of a DVT with severe symptoms:
Signs of a possible pulmonary embolism (PE):
Other emergency symptoms:
For less urgent DVT concerns, call CVR to schedule a same-day evaluation at 877-722-6388.
Not all ultrasounds are created equal. Here’s how:
The ER ultrasound is a quick and limited study performed to rule out DVT and primarily checks vein compressibility to determine if there is an obstructing blood clot. This scan typically takes 10–15 minutes and is done with the patient lying down. The problem is that this type of ultrasound does not assess for venous reflux, the backward flow of blood caused by valve failure—a hallmark of chronic venous insufficiency.
In other words, a fast ER scan is designed to catch clots, not detect vein valve issues. After your ER visit, you may still have pain, swelling, or visible varicose veins.
Why is this an important distinction?
Vascular Today explains that blood flows back to the heart through the veins with the help of tiny valves, muscle movement, and pressure changes in the body. When you’re standing, gravity makes it harder for blood to flow upward, so your body depends on the valves and muscles in your legs to push it back to the heart. Gravity isn't a factor when lying down; other pressure changes help the blood move. While duplex ultrasound can show some of what’s happening in the veins, it doesn’t capture the whole picture.
Is there a more comprehensive scan that can detect vein function in addition to obstruction? We’re glad you asked.
A venous reflux study, known as a Duplex ultrasonography (DUS), is a specialized vascular ultrasound designed to assess the function of the veins, explicitly looking for valve failure and backward blood flow (reflux). This test, performed in a comfortable office setting at all Center for Vein Restoration vein clinic locations, examines the patient standing, allowing the ultrasoundographer to assess reflux properly.
A study reported by the National Library of Medicine (NIH) titled “Duplex ultrasound in the assessment of lower extremity venous insufficiency” highlights that a high-quality reflux scan—performed by a trained sonographer in a standing or upright position—can accurately identify where valves are failing, how blood is flowing backward, and which veins are affected.
Because of its accuracy, duplex ultrasound is the primary tool vein specialists rely on to plan the best treatment for varicose veins and venous insufficiency.
Another big difference is who performs and interprets the exam. ER and hospital sonographers are typically general ultrasongographers and are only trained to quickly assess for life-threatening conditions such as DVTs and vascular occlusions. Their focus is not on evaluating reflux or venous valve dysfunction.
At Center for Vein Restoration, your scan is typically done by a registered vascular technologist (RVT), an ultrasound expert focused on blood vessels. These technicians (and the vein doctors supervising them) are vein experts who perform reflux studies every day. They know how to find even subtle signs of vein disease. The equipment and settings are optimized to detect slow, reverse blood flow. If one vein segment shows something borderline, they’ll spend extra time investigating, ensuring nothing is overlooked. This level of attention is hard to get in a busy ER where the goal is to triage and treat quickly.
Time in the ER is limited, affecting how thoroughly your leg veins can be evaluated. A standard ER ultrasound to rule out a blood clot (DVT) is typically done in 10–15 minutes and focuses only on major deep veins. In contrast, a venous reflux study at a vein center takes 30–60 minutes and includes a detailed evaluation of both deep and superficial veins.
This longer, more comprehensive exam is essential for accurately diagnosing chronic venous insufficiency (CVI) and creating an effective vein treatment plan.
Vein specialists like Dr. Mohamed T. Hassan are specially trained to diagnose and treat chronic vein conditions, such as varicose veins and venous insufficiency. At a CVR vein center, your care goes beyond a basic ultrasound—you receive a complete evaluation that connects your symptoms with detailed imaging to uncover the root cause of your discomfort. Dr. Hassan uses this information to create a personalized treatment plan tailored to your needs. Unlike the ER, which focuses on ruling out immediate threats, a vein expert is dedicated to finding and treating the underlying vein problem.
Call 240-965-3915 to speak with a Patient Services Representative or schedule your consultation online at a CVR near you today.
CVR accepts many insurances, including Aetna, Amerigroup, Anthem, Blue Cross/Blue Shield, Cigna, MultiPlan, Medicaid, Medicare, and more.
Beyond accuracy, cost and convenience are major reasons to avoid the ER for chronic vein issues. Per Debt.org, ER visits often come with high fees and can cost up to 10 times more than a visit to a vein specialist. Reflux studies are far more affordable at a dedicated vein center like Center for Vein Restoration—typically around $150–$400—and are often covered by insurance.
Plus, you'll skip the long waits and rushed exams of the ER and instead receive focused, comfortable care from a team specializing in vein problems.
Unless you truly think you have an emergency, you can save time, money, and stress by going straight to a Center for Vein Restoration vein clinic for chronic leg issues. By avoiding unnecessary ER visits, you reduce hefty medical bills and get a more accurate diagnosis for conditions like venous insufficiency.
Think of it this way: you wouldn’t go to an ER for a chronic skin rash – you’d see a dermatologist. Similarly, for chronic vein issues, see a vein expert. You’ll receive a comprehensive evaluation in one place at a dedicated vein center. If CVI is confirmed, you can start treatment immediately with the same team. This continuity of care leads to better outcomes and happier patients.
At Center for Vein Restoration, our goal is to relieve your symptoms and improve your leg health so you can return to living life without constant discomfort.
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