Medically reviewed by
Dr. Eva Rzucidlo
McLeod Vascular Associates
Parents are well aware of the power of ultrasound testing to see their developing baby in utero. “Vascular specialists also use ultrasound technology to see problems developing in your veins,” says McLeod Vascular Surgeon Dr. Eva Rzucidlo. “One of the most fortunate developments of the last several decades has been the advance of non-invasive testing for vascular problems – both for arterial and vein problems.”
The ultrasound technology that is available today allows a very precise anatomic definition of the vein system. Vascular specialists can see the veins very clearly and can assess them from a functional point of view, evaluating which way the blood is flowing in the veins and if the valves inside the veins are working as they should.
It’s also possible to observe blood flow from an area remote from the problem. For instance, if there’s a problem with the veins in the pelvis, it may not be easily visible. A surgeon can determine how the blood is flowing in that area by looking at how the blood is flowing in the nearby groin area or in the upper thigh.
Ultrasound is a very sophisticated tool that enables a surgeon to diagnose almost any problem in circulation through the veins, and it helps guide the treatment. It can also help determine how serious the patient’s condition is so the care team can follow them after treatment to ensure they are healing properly and that they don’t require further testing or therapies.
Many problems in the veins are related to our lifestyle, such as sitting or standing for prolonged periods of time or being overweight. These issues need to be addressed. People with arterial conditions should not stand or sit for long periods. Instead, they should recline and keep their legs elevated when possible.
External compression helps counteract the increased pressure coming from the inside of the vein. An appropriate compression stocking is good; in fact, it’s probably the best non-invasive, nonsurgical measure to help prevent or improve symptoms if they do exist. It’s almost impossible to heal open wounds without compression stockings, and vascular specialists often insist that patients wear them. In most cases, they prevent any need for further invasive treatments.
Among the more invasive treatments offered are simple injections. Veins can be injected with special medication that can improve the appearance or make it disappear completely. Larger veins can be injected to help them shrink or disappear over time.
There are other procedures to relieve the cause of the increased blood pressure in the small branches of veins in the legs. The most common is an endovenous ablation, where a small catheter is introduced into one of the larger superficial veins using ultrasound images to guide it. Using a laser or a microwave-type radiofrequency, heat is created to burn the vein from the inside.
Newer techniques use a special medication glue introduced through a specialized catheter, narrowing the vein to reduce the pressure on the lower parts of the leg. The goal of all treatments is to reduce pressure from the blood flowing the wrong way in the veins.
Ten to 15 years ago, there were also a number of open surgical procedures, where some larger veins were simply removed. Even today, that is occasionally necessary. If the cause of the increased pressure in the vein is eliminated but varicose veins remain, they can be removed through small incisions with specialized instruments.
To learn more, find a Vascular Surgeon near you.