Phlebography

This test requires the injection of a contrast material into a foot vein in order to make the venous path visible and determine its morphology or permeability. This test is painful, costly and must be done in a radiology laboratory. The equipment is cumbersome.
This method is hardly used any more for an evaluation of the varicose veins of the lower extremities. It is used on rare occasions for the exploration of deep venal networks, for the evaluation of certain phlebitis, sequels of phlebitis and congenital anomalies.

The Döppler

Based on ultrasound technology, the Doppler is a simple, cheap and totally pain-free test.
A hand-held transducer is placed on the skin over the veins being tested; the ultrasound waves bounce off the blood flow and allow two parameters to be measured:
- the direction of the blood flow in the vein (toward the heart in a normal vein, toward the feet in a varicose vein)
- the speed of the blood flow (slower in a varicose or obstructed vein).
The information comes out in a graph form without actual pictures of the vessel.

The Duplex Döppler Scan

This machine allows the combination of "dynamic" information given by the Doppler with ultrasound pictures.
The information recorded is comprehensive:
- anatomic localization of superficial and deep venal networks
- vein diameters
- extent of enlargements
- functioning of the valves
- permeability of the vessels explored
- quality of the vein wall...

The Color Duplex Scan :

The most recent vascular imaging ultrasound method is the colour-Duplex-scan, which makes it possible to directly visualise the blood flow. Changes in light and colour give information on the speed and direction of the blood flow. This test can be done in the office of an angiologist, is totally pain-free, cheap and easy to replicate. It gives (in hands familiar with the method) extremely reliable information on the state of the deep and surface venous system as well on the state of the arterial system.

In fact:

Any varicose vein evaluation requires a Duplex Scan

- To confirm or rule out the presence of varicose veins
- To locate the varicose veins with precision
- To determine the nature of these varicose veins
- To appreciate the importance and consequences of a bad valve
- To determine the best treatment to follow
- To verify the state of the deep venous system before removing superficial varicose veins
- To monitor the evolution of the venous insufficiencies