Video: Varicose Veins: Scan First, Treatment Second

If you have varicose veins, the best treatment is not decided just by looking at the veins on the surface. It should start with an ultrasound scan. That's because visible varicose veins are often only the end result. The real problem may be deeper, where valves inside the veins are not working properly and blood is flowing backwards. This is called venous reflux.

Now, two people can have veins that look very similar from the outside, but their scan findings may be completely different. One person may be suitable for endovenous therapy such as laser, radiofrequency, glue or foam. Another may need a completely different approach. And sometimes the scan shows that the visible veins aren't the main problem at all.

That is why I do not like choosing treatment based only on photographs or appearance. The question is not just how do we remove the veins. The better question is: where is the reflux coming from, and what treatment matches the scan? So if you are considering treatment for varicose veins, make sure the plan is guided by a proper vascular ultrasound. Tomorrow I'll talk about what happens during a peripheral arterial disease or circulation assessment.