Vein diagnostics knows several methods to determine the type and severity of venous disease.
The goal of all these measures is to find a therapy that is fine-tuned to the individual.
In the case of so-called anamnesis the physician establishes during an interview a patient’s medical history with regard to his current ailment. With venous problems the patient is asked about earlier thromboses and inflammation of the veins. The physician further determines any tendency for water to collect in the legs. Women are also asked about pregnancy or whether they take hormonal contraception (the anti-baby pill). And one’s family history is of relevance: family related disease patterns provide information about a possible tendency towards varicose veins and vein problems.
This is then followed by the physician examining more closely the legs in different body positions, the reason being that varicose veins fill up totally when standing and this is not the case when lying down. Also the skin, especially around the ankle is checked very thoroughly. Should edema be suspected (water retention in tissue), the physician will press the swollen leg. If an indentation occurs, which only disappears slowly again, this indicates an edema.
2. Ultrasonic testing
Different kinds of equipment, primarily the Doppler ultra-sonography (a special kind of ultrasonic testing) are available to determine the patient’s medical condition. This method allows for the speed and direction of blood flow to be measured and obstructions or defective venous valves to be detected. By means of duplex and colour duplex sonography an additional ultrasound image of the blood vessels can be generated, which can provide more detailed information about the state and capability of the veins. This method is always used when thrombosis or an inflammation of the veins is suspected, other methods have not provided a clear image or when an operation is planned.
3. Light-reflection rheography
Photoplethysmography (also called light-reflection rheography, in short LRR) can be additionally used to determine the function of the venous system. The skin of the lower leg is irradiated in a specific area with infrared light and measurements are taken to determine how strongly the light is reflected. As the amount of reflected light is dependent on the amount of blood in the veins below, this examination provides evidence of how well the venous system is functioning.
During the examination the patient has to move his foot several times in a certain way as a result of which the veins under observation gradually empty. Then it is measured how long it takes till the veins are filled with blood again. Should it take longer than 25 seconds, everything is fine. Should the veins fill more quickly, this indicates venous insufficiency because the blood flows back through the damaged venous valves against the normal direction of blood flow.