Varicose Veins—How to Investigate

Varicose veins (VVs) are dilated, enlarged, and tortuous superficial veins that most commonly occur in the lower extremities. Lower-extremity VVs result from intravenous reflux of blood, in turn due to vein wall dilatation and valvular incompetence of superficial veins. The VVs are classified as per CEAP classification. It is important to find the anatomical extent and etiology-pathophysiology of VVs. A set of investigations are required to exactly know the type of VVs. It is especially important to know which system, superficial, deep, or perforators, is involved. Though color duplex scanning is the gold standard for the diagnosis of VVs, sometimes, other investigations come into play for arriving at a diagnosis especially if the deep venous system is involved and in cases of recurrent disease. This paper discusses the systematic investigational plan for the diagnosis of the VVs in suspected cases.