Lower Limb Venous Insufficiency Ultrasound

Blood is returned from the muscles in your legs back to your heart via the deep and superficial veins in your legs. The deep veins are the large veins which do the majority of the work. The superficial veins will also help the deep veins in returning the blood from the leg to the heart although they aren’t essential in the process.

The veins work with the muscles in your legs to move the blood back to your heart. When you walk the calf muscle pumps the blood upwards and out of your legs. The one way valves inside the vein then stop the blood from draining back down the vein.

Unfortunately for some people the valves inside the veins can stop working resulting in the back-flow of blood towards the feet which is called venous insufficiency or incompetence. Most commonly it is the superficial veins which become incompetent. Because the veins are closer to the surface you can often see the bluish varicose veins in the skin surface, gradually over time they tend to bulge at the skin surface. These are known as varicose veins.

Symptoms of varicose veins are varied, for many people it is a cosmetic concern. Some people can have veins which ache, or are painful or itchy, particularly after prolonged standing. For others however, symptoms may progress and become severe; skin changes can occur and this causes the skin to become stained a red/brown colour typically around the ankle and lower leg. Oedema is also common, this is when the leg becomes overloaded with fluid and swells up. Over time as venous congestion worsens, and if it isn’t managed, this can lead to the development of venous ulcers; this is wounds with broken skin that are very slow to heal.

The vascular sonographer will perform an ultrasound scan with you standing up. It is only possible check the function of the valves in the veins when you are standing because we need gravity to make the valves function. They will start in your groin and follow the veins in the thigh and calf. In order to see where the valves are working the sonographer will have to squeeze your leg to force the blood through the veins. If the blood drains back down the vein then this means the valves are not working.

After the scan the sonographer will draw a diagram of the veins in your legs and mark where they are working and not working. This will allow Dr Theivendran to determine the optimal treatment to improve your symptoms.