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Venous Insufficiency Testing

Chronic venous insufficiency happens when your legs do not allow blood to flow back up to your heart. Blood may pool in your legs, which is known as venous reflux disease or venous insufficiency/vein disease.  This is typically a result of leaky vein valves in specific veins, or prior incidents of clotting in these veins. Your interventional radiologist may recommend venous insufficiency testing because of varicose veins, leg swelling, pain, leg discoloration or ulcer/wound formation.

Venous Insufficiency Testing is a two-part exam.  The first part of the exam uses ultrasound to visualize the veins of the legs to determine whether the veins are open and blood is flowing.  The second part of the exam involves applying pressure to the lower leg or placing the leg in a standing position while obtaining ultrasound imaging of the vein.  This allows you to determine the direction of the flow of blood and helps you determine, indirectly, if the valves in your veins are working properly.

Venous insufficiency frequently manifests itself in the form of leg pain, leg heaviness, leg discoloration or varicose veins.  Nearly one in four adults have dark leg veins that appear to be “popping out.”  This condition is called varicose veins. These symptoms require vein treatment planning. Other symptoms of chronic venous insufficiency may include swelling in your legs or ankles, a tight feeling in your calves or itchy, painful legs, pain when walking that stops when you rest, open sores on the legs (leg ulcers), leg cramps or spasms, or an uncomfortable urge to move your legs (restless leg syndrome).

Left untreated, venous insufficiency or venous reflux can cause more serious complications like ulcers, bleeding, and a life-threatening condition called Deep Vein Thrombosis (DVT).

Risk factors for venous insufficiency include:

  • Being overweight
  • Being pregnant
  • Having a family history of vein problems
  • Having previous blood clots, injury, or damage to your legs

Rarer causes of venous insufficiency can include conditions such as pelvic congestion syndrome, or inferior vena cava atresia—an uncommon condition where the individual is born without the major abdominal vein (the inferior vena cava) resulting in leg swelling. Alternatively, it can also be seen less commonly in long term blockage of the major abdominal vein due to prior blood clots, scarring or filter placement.

Treatment will depend on your symptoms, age, and general health. First the reason for the venous insufficiency needs to be determined.  Often the first step is an exam for venous insufficiency. During the exam, you will lay face-up or on your stomach on a moveable exam table.  Warm gel will be placed over different areas of the leg in question.  The ultrasound probe is then gently passed back and forth on your skin over the area and sound waves are used to create an image on the screen.

Why choose Fairfax Vascular Center?

While an ultrasound is a simple exam, there are many factors that go into successful imaging and interpretation.  These range from high-quality, updated ultrasound machines, experienced ultrasound technologists and experienced vascular and interventional radiologists.  These factors are particularly important when making more challenging venous diagnoses such as May-Thurner Syndrome and some of the other causes mentioned above.

While good imaging is important, the appropriate and successful interpretation of those images may be just as important, if not more, in correctly directing your treatment for the best possible outcomes.  At Fairfax Vascular Center our interventional radiologists have some of the largest combined experience in interpreting examinations for diagnosis of venous insufficiency, as well as unparalleled regional experience in treating both simple as well as complex and rare causes of venous insufficiency.  We work closely with our patients from their initial clinic visit through imaging and, if needed, treatment and follow-up.  This insures the best possible long-term outcomes for our patients and provides for seamless, coordinated care.

Geographically, we are among the most experienced dedicated vascular specialists for diagnostic imaging related to the vascular system and vascular disease.  Thanks to our rigorous emphasis on quality of imaging and interpretation, we are able to provide our patients with the utmost in experience and care.

Have a discussion with your physician to determine if a venous insufficiency ultrasound is an appropriate part of your work up.

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