I am a 25-year-old male who has been diagnosed with varicose veins in my both legs. I went to two reputed radiologists in my town and as per their reports, all my junctions are competent except one incompetent branch of great saphenous vein. My vascular surgeon, on the other hand, says my saphenofemoral junction is incompetent. Who should I believe?
You need to obtain the actual duplex ultrasound reports from all three physicians and review what is documented. If there are conflicting reports, you need to consult with a physician who is an expert ultrasonographer or who works with an RVT (Registered Vascular Technician) who is an expert ultrasonographer. In any event, are these 3 physicians recommending different treatment courses or are they all recommending the same - if any - treatment?
Published on Jul 11, 2012
If you have varicose veins then there has to be a source for the veins. The most common source are incompetent valves. A duplex scan is only as good as the person doing it and the person interpreting it. You most probably do have valvular insufficiency.
Published on Jul 11, 2012
Did any of the doctors do your venous exam while you were standing? The one who did the exam standing would probably be more correct.
Published on Jul 11, 2012
You need to go to a ICAVL facility or an equivalent certified vascular lab for a definite diagnosis.
Published on Jul 11, 2012
Hmm, that is a tough one. Were the studies performed the same way? Were you standing upright when they assessed the saphenofemoral junction with the radiologist? If not, it is possible that reflux was missed. When there is discrepancy you should ask the other doctor for an explanation. If you are not satisfied, seek a third opinion.
Published on Jul 11, 2012
Did the vascular surgeon do an ultrasound?
Published on Jul 11, 2012
Dear Sir,
There are different forms of treatment for venous disease. A reasonable place to start would be to get copies of all your studies and get another opinion. Make sure that whomever you see for the additional opinion is accredited and qualified.
Published on Jul 11, 2012
The testing of the valves should be done in the standing position and should be visible to you when done properly. The MD doing the test should be able to show you the reflux. I show all my patients the reflux because of the amount of fraud in this area of medicine that I have witnessed. Simple test.
Published on Jul 11, 2012
Let me ask you these questions before we can come up with a good plan:
1. Do you have venous insufficiency or venous disease symptoms like leg pain or discomfort, heavy legs, swelling, burning sensations, or you have any signs of discolorations, venous eczema,etc?
2. Are most of your concerns are cosmetic?
If possible, get both venous mappings from both doctors and compare them. One of the most important factors that some people might forget is that the venous mapping needs to be done in standing position since it tends to be more accurate.
Please gather all these information and I think you can come up with a better answer.
Published on Jul 11, 2012
I would believe the radiologists. Try to address the smaller vein, for doing so can improve your symptoms, which should be your first concern not the presence or absence of junctional incompetence.
Published on Jul 11, 2012