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When should one get a venous reflux exam?

And when is it unnecessary? I already know I have varicose veins, so what are the benefits of having a venous reflux exam?

The information provided by medical professionals in the Q&A is for informational purposes only, and is not a substitute for individualized medical advice, diagnosis or treatment by a qualified health care provider.

Answers


Replied on 9/11/2010

By: Vanish Vein and Laser Center  |  Dr. John Landi, FACS, RPVI, RPhS
Medical Director, Diplomate Am. Board of Phlebology

Naples, FL


Venous reflux exams should be done whenever there is a reason to evaluate the venous leg circulation. This can be due to a multitude of symptoms such as aching, cramping, swelling ,itching, heaviness , varicose or spider veins, a question of DVT or chronic venous stasis, ulcer or lymphedema. The benefits of the exam are many including making a diagnosis and giving the anatomy of the venous problem. A venous reflux exam is unnecessary if venous disease is not considered as the problem.


Replied on 11/27/2009

By: Heart and Vein Center  |  Rodolfo D. Farhy, MD, FACC, FAHA
Lathrup Village, MI


The venous reflux exam is necesary on any patient in whom therapy for varicose veins is being determine. The degree of reflux, the source of reflux, the anatomy and physiology of the venous system is quite different from patient to patient. The treatment plan is tailored to each patient based on that evaluation.


Replied on 11/25/2009

By: Vein Specialty Medical Clinic, Inc.  |  Khalil Fattahi M.D.
Board Certified, American Board of Phlebology

Campbell, CA


Ultrasound mapping and doppler reflux study of legs veins in indicated when:
Bulging Varicose veins are present whether or not a patient has pain, swelling, cramps, or lower calf and ankle itching, inflammation or ulceration. Also when there is hyperpigmentation (brownish discoloration) of skin of lower calf and ankles. Also many cases of unsightly reticular and spider veins, may be due to reflux disease in superficial veins of legs. In such cases also, even though there is no pain, ultrasound mapping and reflux study of legs veins must be done. Of course whenever, recurrence of varicose veins or symptoms of reflux in veins are present, ultrasound mapping and reflux studies
must be done. Therefore it is easy to understand that, ultrasound mapping has a major role in evaluation and treatment of different vein conditions (both painful, and cosmetic) of legs.


Replied on 11/25/2009

By: Miller Vein  |  Jeffrey H. Miller, M.D.
Steven K. Wang, M.D.
Michael E. Lulenski, M.D.
Zoe Deol, M.D.

Novi, MI


The venous ultrasound looks for the underlying cause of varicose veins which is reflux (a leaking vein). In terms of treatment it is better to treat both the underlying cause of the varicose veins as well as the varicosities. Thus, the venous reflux exam is very helpful.


Replied on 11/25/2009

By: Laser Vein Center  |  Thomas Wright, M.D., F.A.C.P., R.V.T.
O'Fallon, MO


If you have varicose veins which bulge, or other symptoms of venous insufficiency such as achy legs swelling in the legs or skin discoloration or ulceration then you should have a venous insufficiency ultrasound evaluation.

A venous reflux exam also evaluates the deep venous system making sure it is working properly and without insufficiency or thrombus (DVT). Venous reflux exams are necessary for all patients with suspected venous insufficiency and especially those that are being considered for vein procedures.


Replied on 11/25/2009

By: Vein Specialists  |  Joseph G. Magnant, M.D., F.A.C.S.
Fort Myers, FL


If you have varicose veins which bulge, or other symptoms of venous insufficiency such as achy legs swelling in the legs or skin discoloration or ulceration then you should have a venous insufficiency ultrasound evaluation. This exam will identify which veins are leaking and determine whether endovenous ablation is indicated.



Replied on 11/25/2009

By: Angelo N. Makris MD   |  Angelo N. Makris, M.D. Interventional Radiology Center
Oak Brook, IL


Venous Reflux exams act as a "roadmap" of your veins. Although you have visual varicose veins, it is important to determine from where they are arising because this is the vein that needs to be ablated. Also, a venous reflux exam evaluates the deep venous system making sure it is working properly and without insufficiency or thrombus (DVT). Venous reflux exams are necessary for all patients with suspected venous insufficiency and especially those that are being considered for vein procedures.


Replied on 11/25/2009

By: Innovative Vein  |  Paul Cheatum, M.D.
Wichita, KS


The exam is to determine what larger vessels are causing the varicosities that you can see. That exam gives the physician the information necessary to determine the best way to treat the whole problem.


Replied on 11/25/2009

By: VeinSolutions - Edina  |  
Edina, MN


If you also have pain, swelling, burning or itching sensations in you legs it would be advisable to have a venous reflux ultrasound. This study looks for reflux and incompetent valves in your veins. It will help determine what procedures you are a candidate for.


More Questions on Venous Reflux Exams

When are venous reflux exams helpful? (12 answers)
I have a few varicose veins on my legs, which I'd like to have removed. My doctor suggested I might have a venous reflux exam, as well. I already know I have varicose veins, so why would I need an exam? Also, how are the venous exams performed?

Is it common for two specialists to see two different things in an ultrasound? (12 answers)
I had an ultrasound done and was told I have deep vein reflux, but when I went to Mayo they found nothing other than a small superficial vein. I have leg pain in my calves, shins and upper legs. There is no swelling, but there is mild leg discoloration. Is it common for an interventional radiologist and a vascular doctor to see two different things in an ultrasound? Any suggestions as to what my condition may be?

Can very mild reflux cause lots of pain in the legs? (12 answers)
I've had two separate venous ultrasounds done at two different clinics. Neither showed much reflux, yet symptoms still persist. Can very mild reflux cause lots of pain in legs or is this typically only seen in people with a more significant amount of reflux? Are there other problems that could be causing symptoms similar to vascular/vein issues?

Does a venous Doppler exam also check for arterial dieseases? (12 answers)
I know there is vein disease and arterial diseases that can cause leg pain. When someone has a duplex ultrasound done are the arteries and veins both checked for issues?

Can I file an appeal if my insurance company refuses to cover my vein surgery? (12 answers)
I pay $1,000 a month for my insurance policy with BCBS, yet they will not cover ANY of my vein issues. I am in terrible pain all the time, my knee and calf are very swollen and it's affecting my walk. I have been diagnosed with venous reflux. Can I appeal the insurance company's decision? If so, how do I do that?

Shouldn't I be able to see varicose veins on the surface of my leg? (11 answers)
If I have varicose veins that can be treated, shouldn't I be able to see them on the surface of my leg? Or, can you have refluxing veins that aren't obvious to the eye?

Can Hemosiderin staining be removed? (11 answers)
I was told when I was 42 that I have PAD and leaking valves in my lower legs causing Hemosiderin staining. Is there anything that can be done to remove the staining from my legs?

Are Venus reflux exams painful? (11 answers)
Does either version of the exam hurt? What should I be prepared for?

Should I get a Venous Reflux Exam for my spider veins? (11 answers)
I have a lot of spider veins on my legs, but no pain and no visible varicose veins. However, if I get bruised it takes months to heal and my feet are always cold, even in the summer. Should I get a reflux exam to find out what's going on?

Is the Venous Refulx Exam the proper vein problem detection method? (10 answers)
I was wondering what test can be performed to detect which veins in the pelvis are refluxing. I am having a hysterectomy and have been told if we know which veins are refluxing they can be taken care of during the hysterectomy surgery.

Is the correcting reflux veins an urgent procedure?? (10 answers)
My vein mapping test showed reflux and weak veins. The test was done because of pain in leg and varicose veins. I had a DVT in that leg 2 yrs ago. Is the procedure to correct this urgent? Can it be delayed or not done at all?

Large varicose vein (10 answers)
Would a large varicose vein on the side of my leg get better with weight loss? Would it disappear or get smaller?

Can pain and swelling in ankles be from varicose veins? (10 answers)
I have varicose veins. For the past two months I have had severe pain and swelling in my ankles. I have no arthritis. Can the pain and swelling be from the varicose veins? Am to have a venous reflux exam next week.

Are there Venous Reflux Exams for DVI? (9 answers)
Recent ultrasound: left leg reflux 3.7 sec in femoral, and 5.2 in GSV, Rt leg 1.4 sec in common femoral 4 sec in femoral. Another showed popliteal left leg. I am 47, BMI 19 & I exercise. I have spider veins but no varicose veins yet. Treatment options?

Are there any contraindications to having the VNUS Closure procedure done when diagnosed with both superficial and deep venous reflux? (9 answers)
I had an ultrasound of veins in my legs and apparently have both superficial and deep venous reflux. Since I have deep reflux as well, is the VNUS Closure procedure still adviseable? What if the deep vein does not get better? How will blood flow out?

Do I need vein treatment for venous reflux at age 24? (9 answers)
I am 24 years old, and I have spider veins and visible blue veins behind knees on both legs. Ultrasound showed 0.4 sec reflux in GSV right leg. Some doctors told me this is normal, but is it normal? And, if not, is it dangerous or weird for my age? I am scared and confused. Can you offer any advice?

what can I do to reduce varicose veins in my wife's legs? (9 answers)
Would elevating her legs to my shoulders while lying in bed and massaging her legs from ankles to thighs help at all?

Are venous reflux exams required before varicose vein treatment? (9 answers)
Do I need to have a venous reflux exam before endovenous ablation procedures? I have very obvious varicose veins on one leg, and already know i want to have them treated with ELA.

Will a Venous Reflux Exam tell me if I have venous insufficiency? (9 answers)
I can see that I have varicose veins. Are all varicose vein sufferers diagnosed with venous insufficiency? How are these two conditions related?

I have no varicose veins, but should I get a Venous Reflux Exam? (9 answers)
Ever since my last pregnancy (1 year ago) I have had aching and heaviness in my lower legs, but no visible varicose veins at all. Should I get a venous reflux exam to find out what's going on, or is the discomfort likely caused my something else?

Where can I get a Venous Reflux Exam? (8 answers)
I have a few visible varicose veins, and general heaviness. I think I may need a Venous Reflux Exam. Can they be performed at a general practitioner's office, or should I go to a vein specialist or a hospital?

What can a Venous Reflux Exam tell me? (8 answers)
How does this treatment measure my veins effectiveness?

Will I have swollen legs for life? (8 answers)
In April I had a blood clot in my thigh, behind my knee and in my calf. I had another really bad calf cramp, so my doctor sent me for another doppler, which showed I had developed another clot in my calf. He said that I would have swelling for life. Is he right?

My ultrasound showed no reflux, so why am I experiencing a lot of pain? (8 answers)
Compression stockings seem to help some, but there are days where I am not sure. I have classic vein symptoms, such as pain in the calves and the back of the upper thigh. However, after a duplex ultrasound at Mayo Clinic, no reflux was found. I was in a standing position during the exam. If no reflux was found, should I be experiencing so much pain? I have to sit down and elevate my legs constantly, as it's hard to stand up.

Is it common to have an exam that show deep vein reflux but no superficial varicose veins or swelling? (8 answers)
Having had two separate exams done, one showed deep vein reflux and one showed nothing. I have no superficial varicose veins and no swelling, but do have pain in my legs and burning in my feet on and off. Any suggestions in terms of the next steps I should take? I am confused. Thx.

Is a MRI contrast safe when you have reflux in the femoral deep vein? (8 answers)
I have had swelling above the knee for 3 months. An ultrasound found no deep vein thrombosis (DVT), just reflux in the femoral deep vein. The doctor told me to have a MRI of the left leg with contrast, but I read that the dye can cause clotting. What are the risks of doing a MRI contrast when you have reflux in the femoral deep vein? Is the MRI safe?

Why is a duplex ultrasound necessary before vein treatment? (7 answers)
An in-office hand-held Doppler ultrasound found bilateral venous reflux. Despite wearing compression stockings, I have significant pain each night after work (sitting, standing for long periods). Why is a duplex ultrasound essential before any treatment? Thank you.

When is swelling above the knee a concern? (7 answers)
I have swelling above the left knee, which was noticed 3 months ago. I had an ultrasound that revealed no deep vein thrombosis (DVT), just vein reflux and stasis. I've been wearing compression stockings, but the swelling is still there. I'm worried. Should I have further testing?

Are Venous Reflux Exams also used for wound care? (7 answers)
I have a slow-healing wound on my foot and my wound care center specialist recommended some vascular testing. Are the same venous reflux exams used to evaluate legs with varicose veins also used in people with non healing wounds?

Does grade 1 Venous Reflux need to be treated with EVLT? (7 answers)
I was recently diagnosed with Venous insufficiency of 0.7s. My understanding is that this is grade 1 venous reflux. Does this need to be treated with EVLT? Will it get worse if left untreated?

DVT and issues afterwards. (6 answers)
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Can severe reflux in common femoral vein be caused by obstruction in the pelvic veins? (6 answers)
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Why would my greater saphenous vein and the veins in the back of my thighs bulge if my ultrasound was normal and no reflux was found? (6 answers)
I am thin and have had prominent calf veins for years without pain. I began working out and now my greater saphenous vein and the veins in the back of my thighs bulge. I have pain in my legs that I feel is due to these veins. My ultrasound was normal and no reflux was found. What's going on?

Are venous reflux ultrasounds more accurate if performed while standing up? Is venous color duplex ultrasound diff from venous reflux ultrasound? (6 answers)
All of my ultrasounds have been done while lying down. I am concerned that the test results may not be as accurate because of that. Can you clarify whether it is best to have a venous reflux exam performed when lying down or standing?

Does consuming caffeine cause less venous reflux to be found on an ultrasound? (6 answers)
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Can a leaking leg vein cause me to have irregular periods and affect my fertility? (5 answers)
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What are the types of venous reflux exams? (5 answers)
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Can you help me understand my venous reflux exam? (3 answers)
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I've been diagnosed with meralgia paresthetica, could chronic DVT cause this? (2 answers)
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