Diagnosis
The earlier a disease of the veins is identified and treated, the lower the risk of complications.
To determine the type and severity of a disease of the veins, specific precautionary examinations indicate the condition of the veins or the form of disease that may be present. Modern vein diagnostic techniques also provide a starting point for determining an appropriate form of treatment.
The specialist starts the examination by obtaining the patient's medical history. In addition to previous thromboses and vein inflammations, disease patterns within the patient's immediate family indicate a possible susceptibility to varicose veins and other venous diseases.
After taking the medical history, the doctor takes a closer look at the legs with the patient in various positions because varicose veins usually bulge out when the patient is standing up and disappear when he or she is lying down. The specialist now has an initial impression of the problem and can apply various procedures to reach a more precise diagnosis, if necessary.
The most widely used technique employs a Doppler ultrasound, which allows the doctor to determine whether the blood in the vein is moving towards the sound probe or away from it.
In this way, it is possible to ascertain the speed at which the blood is flowing through the vein, and to determine whether it is flowing towards the heart only, or is also flowing back towards the feet.
An enhancement of this method is duplex and color duplex sonography, which maps blood flow but also creates an ultrasound image of the blood vessels to provide even more detailed information about the condition and sufficiency of the veins.
Light reflection rheography (also known as photoplethysmography) is another standard procedure that allows doctors to detect a disruption in normal vein function.
An x-ray examination of the veins using a contrast medium (venography) reveals the shape and appearance of the veins, as well as the functioning of the valves and the direction of blood flow. Venography is only used in exceptional cases in addition to a duplex ultrasound for diagnostic and surgical planning purposes.
