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How is ultrasound testing used to diagnose and treat vein problems?

The ultrasound is the most important diagnostic tool vein doctors have. As you may know, ultrasound machines work by generating harmless, painless, inaudible sound waves and emitting them into the body through an instrument placed on the skin (with gel in between). The sound waves reflected back are then detected. The location, delay and quality of the reflected sound waves are converted to an image on a monitor, which shows the structures in or under the skin.

To measure the actual blood flow inside the veins ultrasound machines also can do Doppler testing. You know how the sound of a train whistle or siren changes pitch as it passes you? That’s the Doppler effect, which is the change in a sound wave’s frequency after reflecting off a moving object. In our case, the sound waves reflect off of the blood cells. Doppler lets us measure the direction and velocity of blood flow.

When the Doppler information is visually layered on top of the ultrasound image, we have what we call “Duplex Ultrasound” which shows us the vein structures as well as the direction and flow of blood. This is the key to vein diagnosis.

The vast majority of leg vein ultrasound tests are done to detect dangerous blood clots in the veins. These tests are generally done with the patient lying down as the technologist or physician compresses the vein while watching the ultrasound image. Normal veins will compress while veins with clots will not.

Often, new patients come to us saying that they’ve already had normal ultrasound tests. But if those tests were for blood clots, they probably won’t detect the leaky valve problems that can show up as varicose veins. That’s why I always ask if the ultrasound was done lying down or standing up. It tells me whether or not they looked at valve function.

So how do we do it? When we do the test standing up, gravity naturally pulls the blood in your legs down. If your vein valves are normal, when we squeeze the calf, the blood will be pushed up by the squeeze and then, when released, the Doppler will detect no backflow because the one-way valves worked. If your valves are leaking, when the calf-squeeze is released, the Doppler will show a reverse blood flow (reflux) back down the vein.

Ultrasound imaging also has other important uses in vein treatment. When laser or RF ablations are performed, we use ultrasound to guide the procedure by showing the doctor exactly where to insert and position the fibers and where to inject the local anesthetic. When we perform sclerotherapy injections, we often use ultrasound to help us guide the needle into the vein and confirm effectiveness. That’s called “ultrasound-guided sclerotherapy” — as you might have guessed.

Finally, we use ultrasound to evaluate the effectiveness of prior treatments. It can tell us if there are any complications, or any additional veins needing treatments.

If you have vein problems, whether you’ve already had an ultrasound or not, you can arrange for a quick and easy consultation right now by calling 201-265-5300.

About us: There are 20 million Americans with vein problems that can seriously affect the quality of their lives. And as we age, they just get worse. As one of the few New Jersey medical practices committed exclusively to vein care, Advanced Vascular Vein Care is uniquely capable of alleviating those problems, whether they are medical or cosmetic. All treatments are non-surgical, usually covered by insurance, and delivered in an office setting. And we do it as it should be done – with compassion, excellence, affordability, convenience, and the personal touch. Call 201-265-5300 or visit AdvancedVascular.com for a quick and easy consultation.


 131 Madison Ave. 2nd Floor
 Morristown, NJ 07960
 (973) 540-9700


  89 Sparta Ave. Suite 270
 Sparta, NJ 07871
 (973) 540-9700

Pompton Plains

242 West Parkway
Pompton Plains, NJ 07444
(973) 540-9700


1086 Teaneck Road, Suite 4F1
Teaneck, NJ 07666
(201) 265-5300

Office Hours


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8:00 am-5:00 pm


8:00 am-5:00 pm


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  • "One of the most professional and accommodating office and doctors I have been to in a very long time. I saw Dr. Lee and found him to be very kind and knowledgeable. He diagnosed a blood clot, got me started on a blood thinner and I feel better than I have in months. Thank you, thank you, thank you!"
    Barbara B.
  • "Best vascular surgeons around Dr. Patel is the best"
    Cookie R.
  • "Dr.Lee is thee BEST Vascular Surgeon I EVER had in 42yrs! He is kind, compassionate, funny, and super honest! I really need the super honest part as his patient because I have been on dialysis for almost 20yrs time around and then dealing with end-stage renal failure since I was 13 and I was born with circle kidney so I need someone who is going to be upfront and honest with me and compassion at the same time and he is the ONLY surgeon to get three fistulas working on me! No one in 42 years has ever done that! He is the best surgeon I have ever had! Omg... and his staff is phenomenal !"
    Mercedes R.
  • "Dr. Patel placed my fistula in july of 2014 and I have had most of my maintenance fistulagrams done by Dr Raiz. Though whoever i have had have been great.The entire staff is wonderful . They are compassionate caring and professional. Would not go anywhere else."
    Sherry S.
  • "Dr Riaz, Dr Lee, and the entire Medical Staff at Advanced Vascular Associates are one of the most professional, knowledgeable, courteous, and caring Medical Teams that I've ever visited in my life! I have the greatest amount of respect for them, and trust that whatever the purpose of your visit is, you will leave knowing that you've been treated by the best! Thanks for taking good care of me (especially Rose)."
    Bruce B.
  • "My Dad had surgery for a AAA a year ago! He is 91 years young! Dr. Lee brings so much to the Operating Table!I have never been put more at ease than by Dr Lee. His reassurance and soft-spoken confidence made me rest easily during the Procedure. What a great Man!"
    Lisa V.
  • "Dr. James and the staff are the best. Very attentive and caring."
    Roseanne L.
  • "My first time there. Everyone was very nice and Dr. Patel was awesome! Would recommend to everyone."
    Helen A.
  • "Caring and professional nurses and staff. And special thanks to Dr. David Cohen. His expertise and compassionate level of treatment is beyond comparison."
    Edward B.
  • "The advanced vein care center headed by Dr. Cohen, my physician, is a superior center with caring hands. Each and every visit has been a comfort to me."
    Theresa P.
  • "Thank you for always doing your very best for Dad. We appreciate you always doing what was best for Dad and for always making him feel worthy of being treated as a breathing human being and not some ‘old sick man’."
    The Danielian family
  • "A note of thanks to you! I must say I have never been more pleased with the care and treatment rendered by you and your staff, as compared to countless other physicians and their somewhat lacking care and consideration for their patients’ time and well-being. I am doing fine and had very little discomfort!"
    Paula D.
  • "Thank you very much for the great attention and services offered not only to me, but also to my assistant. Your loving and caring is taken to heart."
    Gustavo G., D.M.D.