Imaging Studies

Duplex ultrasonography is the diagnostic method of choice for diagnosing venous disease. A thorough workup is warranted in the presence of symptoms such as aching, cramps, fatigue and swelling of the lower limbs, along with a positive family history of varicose veins; in the presence of varicose veins, and in patients who have a cutaneous manifestation of an underlying venous disease (stasis dermatitis, stasis ulcers, lipodermatosclerosis, atrophie blanche).

Duplex ultrasonography is the most frequently used investigation for the diagnosis and management of chronic venous disease (both deep and superficial) in the lower extremities. It should demonstrate both the anatomical patterns of veins and abnormalities of venous blood flow in the limbs (functional impairment). Duplex ultrasonography has largely replaced handheld nonimaging (continuous wave [CW]) audible Doppler instruments to assess venous disease and confirm clinical impressions.^[9]For more information, see Radiology article Deep Venous Thrombosis, Lower Extremity.

Other Tests

Other available functional tests for venous disease include photoplethysmography and air plethysmography.

Treatment & Management

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Kahle B, Leng K. Efficacy of sclerotherapy in varicose veins-- prospective, blinded, placebo-controlled study. Dermatol Surg. 2004 May. 30(5):723-8; discussion 728. [QxMD MEDLINE Link].
Tisi PV, Beverley C, Rees A. Injection sclerotherapy for varicose veins. Cochrane Database of Systematic Reviews. 2006. Issue 4, Art. No.: CD001732. DOI: 10.1002/14651858.CD001732.pub2.:1372.
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Media Gallery

Telangiectasias.
Reticular veins.
Venulectasias.
Venulectasias after sclerotherapy treatment.

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Author

Samer Alaiti, MD, RVT, RPVI, FACP Medical Director, Miracle Mile Medical Center for Dermatology and Cosmetic Surgery, Inc

Samer Alaiti, MD, RVT, RPVI, FACP is a member of the following medical societies: American Academy of Dermatology, American College of Phlebology, American College of Physicians-American Society of Internal Medicine, American Society for Dermatologic Surgery, American Society for Laser Medicine and Surgery

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Mark E Krugman, MD Assistant Professor of Plastic Surgery, Clinical Professor of Otolaryngology-Head and Neck Surgery, University of California at Irvine School of Medicine

Mark E Krugman, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Surgeons, American Society of Plastic Surgeons, American Academy of Facial Plastic and Reconstructive Surgery, American Society for Aesthetic Plastic Surgery, American Society for Laser Medicine and Surgery

Disclosure: Nothing to disclose.

Chief Editor

Jorge I de la Torre, MD, FACS Professor of Surgery and Physical Medicine and Rehabilitation, Chief, Division of Plastic Surgery, Residency Program Director, University of Alabama at Birmingham School of Medicine; Director, Center for Advanced Surgical Aesthetics

Jorge I de la Torre, MD, FACS is a member of the following medical societies: American Burn Association, American College of Surgeons, American Medical Association, American Society for Laser Medicine and Surgery, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, American Society for Reconstructive Microsurgery, Association for Academic Surgery, Medical Association of the State of Alabama

Disclosure: Nothing to disclose.

Additional Contributors

Shahin Javaheri, MD Chief, Department of Plastic Surgery, Martinez Veterans Affairs Outpatient Clinic; Consulting Staff, Advanced Aesthetic Plastic & Reconstructive Surgery

Shahin Javaheri, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Society of Plastic Surgeons

Disclosure: Nothing to disclose.

Acknowledgements

The authors and editors of Medscape Drugs & Diseases gratefully acknowledge the contributions of previous authors Laurence Z Rosenberg, MD; Jorge I de la Torre, MD, FACS; Gary D Monheit, MD; and John D Kayal, MD; to the development and writing of this article.

Sclerotherapy Workup

Imaging Studies

Other Tests

References

Tables

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