Investigation of varicose veinsInvestigation begins with a thorough clinical assessment of symptoms and signs.
The hand held doppler (similar to that used to listen to the babies heart during pregnancy) is used to establish the sites of leaky valves ("reflux") between deep and superficial veins. At these site blood flows the wrong way giving rise to varicose veins further down the leg. The commonest sites of leaky valves are in the groin (the saphenofemoral junction), behind the knee (the saphenopopliteal junction) and in the midthigh/calf (perforators).
Modern treatment of varicose veins relies on the use of a colour duplex ultrasound machine to create a "road map" of leaky veins in the leg. Information from the scan can also help the surgeon decide which type of treatment is most suitable for the patient.