Learn more about our modern diagnostic techniques for veins

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Venous disease diagnostics has continuously improved over the last years. Consequently, we have also continuously adjusted our diagnostic procedures and now, among a number of other methods, make use of the following to achieve the maximum of precision.

At this time, we are very happy to be able to introduce a completely new technique for displaying veins and arteries in our institute.

Three-dimensional sonography

• Through this innovative technique, we can now – in addition to our already extremely sensitive and comprehensive diagnostic procedures – display veins and arteries three-dimensionally and in a computerised image which can be turned and displayed from all sides, a feature which is otherwise only known in magnetic resonance imaging or CT.
• We can now display especially the problematic areas associated with varicose vein and vein surgery, like the transitional zone between the superficial truncal veins and the inner veins, or the intercommunicating (perforans) veins, more precisely and plastically than with any other imaging procedure.
• Thanks to the 3-D ultrasound sonography, we can plan our gentle mini-catheter procedure even better and discuss the findings with the patient both before and after the vein treatment.
• The images are transmitted wirelessly directly into our central computer and stored there in the patients' files so that they can be copied on CD or presented as a printed image for the patient.
• Since the procedure unfortunately still requires a very high investment, it will be many years before it will be used widely (through mark-downs). Through our extreme specialisation, however, we in our practise are already able to offer our patients this sensationally precise display along with the associated safety in planning a vein treatment and the especially precise diagnostic possibilities.

With these simple infrared images of the legs, we can discover veins which have fallen ill, that would have certainly been frequently missed using sonography alone and could otherwise only be presented reliably with "phlebography": a series of x-ray images performed under the simultaneous injection of a contrast medium.

Along with the new sonographic technique with a higher resolution than magnetic resonance imaging (here, understandably, in the soft tissue), we can thereby discover the roots of the illness more precisely – that is, the true sources of flow in the varicose veins - and consequently treat them more precisely and even more gently.

This is the case since the targeted elimination of pathological flow to the varicose veins serves to "drain" them without having to treat the varicose vessels themselves centimetre by centimetre: Naturally, that protects the tissues (e.g. also the surrounding and very important lymphatic vessels) and, at the same time, essentially makes the treatment more efficient.

Of course, this complex diagnostic procedure requires not only highly technical procedures, but also an experienced investigator who takes an ample amount of time to investigate: with us, all patients undergo a sonographic examination lasting up to 90 minutes, performed personally by Dr. Netzer. Since all catheter treatments are performed exclusively and personally by the director of the institute, Dr. Netzer, he can also access the progress personally to obtain an optimal picture of the patient and the illness, and simultaneously explain precisely (and clearly) which method from our broad "arsenal" of catheter techniques should be employed and at which site.

The "Rapid Cuff Inflator"

• An inflatable cuff is put around the leg to be examined, which is inflated by means of compressed air within a matter of seconds. Thereby the vessels are compressed and pressure is exerted on the veins. If a colour-coded Duplex sonography is now performed simultaneously, one can recognise precisely in which direction and at what intensity the blood flows in the veins, and one can determine very precisely which venous valves are defective.
• Because this process is standardised and independent of the examiner or the patient, it is much more precise and more meaningful than a Duplex sonography, during which the patient must increase the pressure in the veins by coughing or pressing.

The light reflection plethysmography

• With this procedure, one measures the capacity of an extremity to the increase or decrease of the blood volume and the velocity and dynamics of these processes. This provides us with important additional information about the function of the entire venous system of the extremity.
• This examination, too, can of course be carried out without contrast medium or punctures, is completely painless and places no burden to the patient.

Here, you can see two examination results from the same patient just before and only two days after the catheter treatment performed by us:

• the upper curve (prior to therapy) proceeds very flatly, almost without any downward belly: this is a sign for a very severe, pathological reflux of the veins extending downward (= incorrect direction)

• the curve below now demonstrates a very clear downward belly and shows very clearly that this pathological reflux has already been stopped entirely through the sclerosation of the afflicted veins

The thermography

• Hereby, the legs of the standing patient are photographed with a thermographic camera from the front and the back. Experience shows that chronically congested parts of the legs are often clearly hyperthermic.

As part of a scientific study on this topic, we want to learn whether the temperatures of the skin measured before and after the reconstruction of the venous system which has previously been in poor health differ, and thus may provide inferences with regard to the venous disease before surgery. During the study, our patients will suffer no additional financial expenses through this examination.