At our center the evaluation begins with a comprehensive consultation and physical examination. It is important to know the prior family history, occupation as well as other conditions our patients might suffer from that may be impacting their current venous disease.
Every patient is thoroughly evaluated then with a duplex ultrasound where we can determine the presence of deep venous as well as superficial venous problems. Prior deep venous thrombosis that are in a chronic state are often times noted for he first time on the ultrasound evaluation.
Special attention is paid to the evaluation of venous insufficiency. By the ultrasound image the back flow of blood into the legs was the patient is standing up can be determined. This establishes the diagnosis. The size of the major veins are measured and a road map of the venous system is defined for future procedures is needed.
Not uncommonly patients with simple spider veins have been evaluated after suboptimal results with sclerotherapy and noted to have significant superficial venous insufficiency. Once this issue has been treated the results of the treatment for the spider veins has been much more satisfactory and longer lasting.