Your surgeon will ask you many questions about the development of your leg problems. He will also ask you about your general health. Treatment options will be discussed and will include both non-surgical and surgical treatments. The risks and benefits of surgical treatment will be discussed according to the degree of damage to your leg. Serious complications rarely occur without treatment and the ultimate decision will be yours.

Doppler

Clinic investigations will include a doppler examination. This is a hand-held device that is non-invasive. It allows the surgeon to listen to and assess the way in which the veins are working. The surgeon may ask you to help perform a number of moves to help in this process. This technique should be considered as providing preliminary information only. It is not 100% accurate and this will vary amongst operators. It will however give the surgeon an understanding of where the problems may lie and how best to proceed.


Duplex ultrasound

The definitive test to examine your veins is the duplex scan. It allows the operator to identify precisely where the refluxing veins are within your legs. It will also clarify that the rest of the vein network is normal or whether there has been a previous thrombosis or injury that may influence the decision to offer surgical treatment. Duplex offers the best technique of accurately localising the abnormalities and hence targeting treatment. This is the only way to ensure that the best possible treatment is being offered. Unfortunately not all surgeons utilise this routinely but in my own practice this is standard.



Other investigations

Pending the results of the duplex other investigations may prove necessary although this is rare. Injection of a dye into the veins whilst taking an xray (venography) can provide further information on the anatomy of the vein network. Other investigations (magnetic resonance imaging, photoplethysmography) remain largely research tools in academic institutions.