Diagnosis Varicose Veins
Ultrasound, Doppler and angiography
Phlebology – 2008
It would seem that there is nothing easier than to detect varicose veins in the legs. Suffice it once carefully inspect the feet and you can see the extended and twisted veins. But that's not enough. A simple inspection can not determine the state of deep vein leg and hip (they just can not see with the naked eye), and that is very important for the correct choice of treatment, the condition of valves, veins and perforating veins.
So, one of the first diagnostic examination of varicose veins is. On examination, the doctor can see the enlarged, twisted veins, blood clots, skin color to assess the state of his legs, the presence or absence of edema.
In the diagnosis of varicose veins is very important to find out what kind of varicose veins: primary or secondary, which develops on the background of postthrombotic syndrome. And for this it is important to know the condition of the surface terrain, and especially the deep veins, the condition of valves of veins, perforating veins of the state.
For all this had been used so-called BCF (bintovye) samples (somewhere they are used now). This is an absolutely safe method of diagnosis, for his conduct only an elastic (or even normal) bandage. The essence of these samples is that the doctor puts a bandage on a certain area of foot and controls the nature of the fullness of varicose veins.
For example, if you put a bandage on the area of the upper thigh, after raising his leg, and then delete it, then we can assess the patency of deep veins and perforating veins valve condition. If the vein after application of bandage moderately fallen down, it means that the deep veins are passable. If varicose veins have been extended, and remain, this means that the deep veins impassable. The most common cause is thrombosis.
When applying the bandage in the upper leg, and at the bottom to the abandonment of "window" assessed the state of valves of perforating veins. If this box "swelled" vein, this section has the insufficiency of perforating vein valves.
There are other sample BCF. However, their value in recent years has dropped substantially, as there are other, more accurate methods of diagnosis. In addition, these tests take time.
Ultrasound and Doppler
Today, the main diagnostic method for varicose veins is ultrasound. Ultrasound diagnosis and Doppler allows the physician to the vein "in the slice." A Doppler ultrasound can assess the nature of blood flow, the presence of reverse flow, the consistency of valves of perforating veins, deep vein patency and the presence of deep venous thrombosis.
The method of ultrasound – is the safest and most cost-effective diagnostic method in the diagnosis of many diseases, including diseases of the veins.
Doppler ultrasound – a method based on ultrasound, which allows us to estimate the motion of body fluids. Such environments include, above all, the blood in the vessels.
There are several types of Doppler ultrasound:
- Color Doppler ultrasound – a method of diagnosing the nature of the vascular blood flow. Thus, depending on the direction of blood flow, it is painted on the screen in red or blue.
- Power Doppler – a diagnosis of vascular blood flow. Depending on the speed of blood flow in the vessel, it is stained a bright yellow color, with a slower speed is close to the color red. This method of Doppler, roughly speaking, allows you to see if there is blood flow in the vessel. It does not assess the nature of the direction of blood flow.
- Pulse-wave Doppler ultrasound – a method of research, which allows us to estimate the velocity of blood flow in vessels.
- Duplex Doppler ultrasound – a method in which the two methods simultaneously Doppler: B-mode and color Doppler sonography.
- Triplex Doppler ultrasound – a method which uses three Doppler methods simultaneously: B-mode, color Doppler and pulsed-wave Doppler.
Ultrasonic method of diagnosis – the most important method of diagnosis of varicose veins. Its advantage is that it is noninvasive, it is his conduct requires no intervention – no needle insertion or injection of any drugs.
With ultrasound the doctor reveals the presence of perfonatnyh veins and notes those areas with a marker. This is done to make it easier for the surgeon to search for these veins, which are needed to tie in the treatment of secondary varicose veins (r. Ie, postthrombotic syndrome).
Angiography – an x-ray is a diagnostic method of blood vessels. It consists of introducing into the vessel a special solution – a radiopaque solution and then made an X-ray. Thus, angigrafiya allows the doctor to see the status of vessels, their course, the diameter of the lumen, the presence of blood clots.
Angiography is called venous phlebography. When venography radiopaque dye is injected into a vein to the patient. To date, the value of phlebography decreased slightly, due to the fact that there were modern ultrasonic diagnostic methods.
In addition, the method is not without venography and special disadvantages, among which the most important – is the introduction into the blood to the patient of allergenic substances. Therefore, prior to venography performed allergy test to determine the sensitivity of the patient for this contrast agent.
The method of venography is currently used only on special indications, when Doppler diagnostic methods do not allow to identify some ososbennosti venous system of the lower extremity.
Other methods of diagnosis of venous diseases, such as plethysmography, flebomanometriya, flebostsintigrafiya, three-dimensional computed tomography, etc. used much less frequently, mainly in the case of diagnosis of certain complications of varicose veins and the lack of informativeness of ultrasonic methods.
Varicose veins – a new gentle method of treatment in Germany
SURGICAL DIVISION CB 6 RZD – MOSCOW
ISSUE application for treatment
Examination and treatment in GERMANY – Institute "DIAGNOSTIX"
AID IN THE TREATMENT –
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