Doppler Ultra Sound Scanning For Veins

Although some thread veins are an isolated problem and can be treated successfully with micro sclerotherapy, sometimes they are being fed by blood under higher pressure from larger reticular veins and unless these are treated first the thread veins may get worse. In fact they can undergo “matting”, where the thread veins not only extend but form a mass of very fine vessels which are impossible to treat. This is a disaster that can now be avoided with the introduction of ultra sound scanning at Court House Clinics.

Reticular veins are flat, usually visible vessels up to 4mm in diameter with a one way valve at the upper end where they join the deep vein system. It is the failure of this valve which allows blood to flow under pressure the wrong way down the leg. Now this flow can be detected using a hand held Doppler machine. The technology was created by Christian Doppler, a nineteenth century Austrian mathematician.

The Doppler machine emits high frequency ultrasound which bounces off the blood corpuscles and the reflected sound frequency depends on the direction of blood flow enabling incompetent veins to be identified with ease. This prevents misdiagnosis and ensures veins are treated in the correct way.

Consultations are available nationwide

Frequently Asked Questions

What causes varicose veins?
Varicose veins occur when the one way valves in the veins in the leg fail allowing blood under pressure to flow the wrong way. The veins are not designed to cope with this increased pressure so they enlarge and become prominent and more visible. Who gets varicose veins?
Venous disease is largely inherited. It affects men and women equally but starts earlier in women often beginning in pregnancy. It is not caused by standing for long periods but the symptoms may be increased. They are not related to weight, blood pressure or smoking, nor are they caused by crossing the legs.

What is Foam Sclerotherapy?
Injections to close off the veins have been used to treat varicose veins for decades but poor long term results meant that the technique fell out of favour. We now know that if the fluid is mixed with a gas such as air to form a foam the results of treatment are much improved. It is performed as an out-patient procedure so avoiding the inconvenience, discomfort and expense of an admission to hospital. It is painless and you can drive home and return to normal activities immediately afterwards.

How is Foam Sclerotherapy performed?
The cause of the varicose veins is identified by ultrasound examination. A cannula is inserted into the main vein and a small volume of foam injected. This may need to be done at three or four sites to completely fill the veins. The foam damages the lining of the vein wall. A firm stocking keeps the vein compressed while the walls stick to each other so closing the vein. The stocking must be worn continuously for at least a week.

What happens afterwards?
You will be able to drive home or back to work immediately. Painkillers are almost always unnecessary. The leg will be bandaged and a stocking applied. You will be asked to return for a follow up appointment when an ultrasound will be repeated to assess your progress. Further ultrasound checks are made at intervals to ensure that the vein remains closed.

Are there any complications?
No procedure is complication free but they are less than with surgery. In particular, bruising is less and Foam Sclerotherapy is virtually pain free so you can return to normal activities immediately. A light copper coloured skin staining over the treated vein can occur in up to 40% of legs which will fade over the year but may be permanent.

Is Sclerotherapy safe?
Yes. The solution has been used for years and as a foam only a very small amount is needed.

What are the alternatives?
Conventional surgery or Endovenous Laser therapy are also effective methods of treating incompetence of the main vein. However, both these techniques are more invasive and have complications although they are usually minor.

Will the veins come back?
With surgery recurrence can occur in about 10% of legs over 5 years. Foam Sclerotherapy is likely to be about the same.

Is Foam Sclerotherapy successful?
This treatment is not suitable in all cases, especially very large veins. It is particularly appropriate for recurrent veins that have been treated before.The vein is closed off in more than 90% of people. If not, the injections are repeated. After six months the vein remains closed in over three quarters of legs.