Tests for Veins - Duplex Ultrasound

Duplex Ultrasound started to appear in the UK in the mid 1980s. Throughout the 1990s, many vein surgeons used to argue whether Duplex Ultrasound was needed at all before varicose vein surgery - and whether it should only be used in patients who had recurrent varicose veins.

This was surprising as even in 1986, research had shown that planning varicose veins surgery without a Duplex Ultrasound led to the wrong operation being performed in about one in three cases.

So clear was the evidence that in 1998, Mark Whiteley instituted a programme that ensured every one of his patients had a Duplex Ultrasound before surgery, making sure that the correct surgery was planned for them. He also introduced a new concept, at the time, that every patient should also have Duplex Ultrasound DURING the operation.

The idea of this was to make sure that the correct veins were being treated and the treatment was successful. This was revolutionary at that time and many people argued against the idea - saying it made the surgery too expensive or tied up resources by having the Duplex Ultrasound in theatre rather than working elsewhere.

However, by the mid 2000s, no vein expert anywhere would treat varicose veins without a Duplex Ultrasound to plan the treatment - and no vein expert could achieve the results that are now expected without having a Duplex Ultrasound in theatre, guiding the treatments.

Mark Whiteley talks about testing for Varicose Veins

What is Duplex Ultrasound?

Duplex Ultrasound is a combination of 2 tests. The first is Ultrasound.

Most people are aware of what an ultrasound is. Almost every woman who gets pregnant has an ultrasound and many other people need ultrasound scans of parts of their bodies.

Ultrasound is non-invasive - this means that gel is placed on the skin and an ultrasound probe is passed over the skin. Ultrasound is beamed into the tissue and echoes are received - reflected from bone, muscle, fat and other surfaces. A computer in the ultrasound machine then turns this information into a black and white picture. This is why ultrasound is often called "Grey Scale Ultrasound".

The second test is a Doppler Ultrasound. Doppler is the name of Christian Doppler, a man who first described the phenomenon seen with moving objects. The same way that an ambulance siren changes note as it passes you, ultrasound can tell if there is anything is moving on the ultrasound picture.

Using the Doppler theory, a Duplex Ultrasound can show blood moving on an Ultrasound picture. It not only shows the direction of flow - but also the speed of flow.

For vein surgery, we need to know which way blood is flowing. In normal veins, blood flows upwards towards the heart. If a vein is blocked, there is no flow. If the vein isn't working (i.e. the valves aren't working) blood flows back the wrong way, giving all of the problems that varicose veins and venous reflux can cause.

All of these abnormalities are best picked up by Duplex Ultrasound.

Mark Whiteley talks about how long a Duplex Ultrasound test takes

Duplex Ultrasound:

  • is perfectly safe
  • uses no needles or drugs
  • doesn't use x-rays or any harmful radiation
  • is done as an out-patient

You can see more about Duplex Ultrasonography and the reports we can obtain using it.

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