Ultrasound is a key component to successful treatment in any minimally invasive procedure related to Chronic Venous Disease. It is used before the treatment, during the treatment and post-procedure to document success and rule out any complications. You will have several ultrasound exams as part of the standard of care and follow-up needed to track your results and the success of any treatment you may receive. Having a trained and credentialed sonographer, in addition to a doctor who understands the findings can really make the difference for a successful treatment and outcome for the patient. It is also important that the doctor you are seeing has invested in a high quality ultrasound system. As part of your ultrasound exam, the following anatomy will be carefully examined and documented:
- The Saphenofemoral Junction (SFJ) is studied, which includes the Deep Femoral Vein, Femoral Artery, and the Great Saphenous Vein (GSV), and any refluxing tributary or branches off the SFJ. Deep Vein Thrombosis (DVT) is then ruled out.
- A Valsalva maneuver is performed at the Saphenofemoral Junction to determine reflux at the Saphenofemoral Junction (SFJ). Valsalva will be explained to you at the time of your exam.
- Distal augmentation for Great Saphenous Vein below the junction is performed along the vein track, reflux is documented, and the Deep Vein is examined along the vein track.
- The Small Saphenous Vein (SSV) is examined with augmentation to determine reflux levels and DVT is ruled out at the Saphenopopliteal Junction (behind the knee crease). SSV is scanned down to the foot.
- Perforator Veins (communication veins) are examined and measured, and reflux studies are performed.
- Reflux is noted and charted and sent to the doctor for review.
- Deep Vein Thrombosis is noted and charted if present and doctor is notified as soon as possible. This is a very serious situation that needs immediate attention.
- Any abnormality that includes greater than +0.5 seconds of reflux or retrograde blood flow is charted and discussed with the doctor.
Once the ultrasound exam is completed, your ultrasound sonographer or doctor will use the photos taken from the ultrasound machine and “chart” them on forms that will likely be sent to your insurance carrier. This form, as well as the doctor’s “findings or impression” will be dictated through an Electronic Medical Charting system or EMR for short. The visual chart will list all areas of reflux for both legs in RED, at multiple levels, from a frontal view and a posterior view. We chart reflux greater than .5 seconds or as required by the insurance companies, vein size, and any issues related to blood clots in your superficial veins, deep veins, or issues with an artery if detected. This exam usually will take 30-45 minutes and must be accurate. This, again, is where the training and the credentials your doctor has, comes in to play.