HOW ARE VARICOSE VEINS DIAGNOSED?
The presence of varicose veins is confirmed with a simple physical examination. The patient usually seeks medical advice with a pre-established self-diagnosis.
Nevertheless, it is very important to determine what sort of varicose veins we are dealing with, what territories are involved, and the indemnity of the deep venous system.
The venous system is composed of reticular veins and superficial dilatations or telangiectasias. When these structures become dilated they become quite evident to direct visual inspection. The use of the Echo-Doppler is essential to determine the characteristics and parameters of the condition by measuring the type and extension of the affected vein very accurately in each patient.
An Echo-Doppler examination is required in any patient suffering from varicose veins and will help us define:
- The patency and valvular function of the deep system
- Reflux in the saphenofemoral junction
- The calibre and circumference of perforating veins
Two typesof varicose veins are generally accepted:
A. Cases in which the saphenous vein, its draining valves or perforating veins are affected causing the dilatation of large venous trunks situated in the superficial muscle fascia. These varicose veins are considered severe and cause significant hemodynamic disruption, severe symptoms and possible complications.
B. Cases in which there is only mild dilatation of reticular veins and superficial dermal plexus (telangiectasias). Due to their small calibre and scanty flow, these veins do not affect return circulation as badly and are considered a merely aesthetic problem.
