Diagnostic Tests

To establish whether there is insufficiency of valves in the veins of the leg, an ultrasound will be performed. Venous insufficiency is an abnormal circulatory condition, with decreased return of blood from the leg veins up to the heart and pooling of blood in the veins. Normally, stop valves in the vein close to keep blood from flowing downward with gravity. When the valves in the vein become weak and don’t close properly, they allow blood to flow backward, or reflux. Varicose veins are prominent veins that have lost their valve effectiveness and, as a result of dilation under pressure, become elongated, rope-like, bulged and thickened.

The most common underlying cause of varicose veins is reflux within the greater saphenous vein in the thigh, which leads to blood pooling in the veins below, and causing enlarged veins visible in the leg.

This is why screening for valvular incompetence is necessary. For a patient to be considered for the EVLT procedure they must have valvular incompetence of the greater saphenous vein at the level of the saphenofemoral junction. This is where the greater saphenous vein (a superficial vein) joins into the deep venous system. When the valvular structure is incompetent at this site, varicosities of the leg are usually more prominent.

The test usually takes about an hour to an hour-and-a-half and are specifically performed to diagnose valvular incompetence or venous reflux disease, although they are comprehensive tests and also rule out deep vein thrombosis and superficial vein
thrombosis.