During your initial consultation with Dr. Rosen, a very thorough medical history will be obtained. That, coupled with a focused physical exam, will allow the doctor to determine the utility of performing an ultrasound exam. The ultrasound is a painless test that allows you to see both the form and function of your lower extremity veins. A detailed “map” of your leg veins can be generated. In addition, the ultrasound allows Dr. Rosen to listen for reflux, or wrong-way flow past incompetent vein valves. As mentioned in the section regarding spider & varicose veins, lower extremity valve incompetence is what can ultimately lead to spider and varicose veins.
The goal of treating problematic superficial veins that have improper flow is to reroute the blood to properly functioning veins. It may be helpful to picture lower extremity veins as having larger “trunks” and smaller “branches”. The general approach is to address issues with larger trunks first and then treat the smaller branches. In the superficial venous system, the larger trunks are the saphenous veins. The typical culprit veins where valve incompetence can occur are the Great & Small saphenous veins. The Great saphenous vein courses from the inner (medial) ankle area, up through the inner leg and thigh and ultimately joinins with a deep vein near the crease in the groin. The Small saphenous vein runs vertically at the back of the calf (think of it as having the same orientation as those lines in silk stockings).
At the end of your ultrasound examination, a tailor-made course of treatment can be designed to address your particular vein problems. Dr. Rosen generally spends an hour with each patient during the initial consultation. It is the perfect time for you to have any questions answered and for discussions regarding treatment options.