The heaviness you feel in your legs, the swelling that increases at the end of the day, the cramps that strike at night, or those purple/blue vein networks appearing on the skin surface… Varicose veins are not just an aesthetic concern but a progressive vascular disease that must be taken seriously. However, most of our patients fall into the misconception of thinking those prominent veins seen on the skin surface are the disease “itself”. Yet, what we see on the skin is merely the tip of the iceberg; the real problem is the valve insufficiency in the main venous (vein) system that feeds those veins and is located deep within the skin.
Today, there are highly modern and comfortable “non surgical” methods in varicose vein treatment, such as laser, radiofrequency, foam, or adhesive (glue). But even if you use the most advanced technology in the world, any intervention performed without correctly identifying the “root cause” of the problem will lead to the disease recurring (relapsing) shortly after. This is exactly where the most critical, indispensable stage of our varicose vein treatment philosophy in our clinic comes into play as a Surgeon (Cardiovascular Surgeon): Venous Mapping.
In this guide, we detail with a surgical perspective what the venous mapping procedure, which is the key to success in varicose vein treatment, is, why it differs from a standard ultrasound, and how it shapes a “tailor made” treatment plan specific to you.
What is Venous Mapping (Detailed Color Doppler Ultrasound)?
Venous mapping is the process of examining the superficial and deep vein (venous) system in the legs, the direction of blood flow, and the condition of the intravascular valves millimetrically with a high resolution Color Doppler Ultrasound device.
This process is more like a detailed “sketch” or “architectural plan” of your legs rather than a simple imaging. Thanks to the mapping process:
- Whether there is a leak (reflux/venous insufficiency) in the intravascular valves that ensure the one way flow of blood to the heart,
- Exactly in which vein segment the leak begins and where it ends,
- Whether there is a trace of a previously hidden clot (DVT) in the deep vein system,
- The connection pathways (perforator veins) between the capillaries or varices (large varicose veins) visible on the skin and the main vein inside are clearly identified.
Why is Mapping with a Surgical Vision of “Vital” Importance?
A surgeon does not enter a surgery or medical procedure blindly. Just as an engineer cannot perform restoration without seeing the load bearing columns of a building, we cardiovascular surgeons do not plan varicose vein treatment without mapping the venous system of your leg.
- Treating the Root Cause: It is very easy to apply foam (sclerotherapy) or laser directly to the fine capillary veins on the skin surface. However, if there is a leak in the main vein inside (for example, the Great Saphenous Vein) feeding those capillaries, even if you close the vein on the surface, the disease will erupt from somewhere else within a few months. Mapping shows us the main point where we need to “drain the swamp”.
- “Tailor Made” Planning: Every patient’s vascular structure is different from one another, just like a fingerprint. A standard, “same treatment for everyone” (fabrication) approach goes against our surgical discipline. Based on your mapping results, whether laser, radiofrequency, medical adhesive (glue), or just foam treatment will be applied is decided entirely specifically for you.
What is the Difference Between Venous Mapping and Standard Ultrasound?
Our patients usually apply to our clinic with an ultrasound report they had taken previously elsewhere. However, a standard radiological ultrasound is not sufficient to plan varicose vein treatment. The biggest differences of venous mapping are:
- Obligation to be Done Standing: Standard ultrasounds are usually taken while the patient is lying on a stretcher. However, varicose veins are a disease related to gravity! When you lie down, the pressure in the veins drops, the leak (reflux) in the valves is hidden, and the vein diameters appear normal. In our clinic, venous mapping is absolutely and strictly done while the patient is standing. The true performance of the vein is measured while under the influence of gravity.
- Testing Blood Flow with Maneuvers: During mapping, the patient is asked to bear down (Valsalva maneuver) or contract their calf muscles. In this way, how well the vein valves can withstand pressure is measured and the leak duration is calculated in seconds.
- Drawing the Map: After the examination, your doctor literally draws the vascular anatomy of your leg, the leak points, and the areas to be intervened on a piece of paper as a “map”.
Frequently Asked Questions (FAQ) About Venous Mapping
We transparently clear the question marks in your mind about how the process works and how it affects treatment planning:
1. Is venous mapping a painful or aching procedure? Absolutely not. This procedure is a radiological imaging method performed entirely over the skin with ultrasound gel and a probe. No needles are inserted into your body, no medication is given, and no radiation (X rays) is received. It is an extremely comfortable and zero pain process that can be safely performed even on pregnant women.
2. How long does the procedure take? Is any preparation required beforehand? A detailed venous mapping of both legs usually takes between 30 to 45 minutes, depending on the complexity of your vascular structure. You do not need to fast or stop the medications you are using before the procedure. It is sufficient to wear comfortable clothes (shorts, etc.) or use the disposable patient gowns given to you in our clinic so that the examination can be done comfortably.
3. Can we start treatment directly with an ultrasound report I had taken at another hospital? Due to our surgical principle, it is healthiest for the physician who will perform the intervention to see the vascular map with their own eyes. Ultrasound results brought from outside, usually taken “lying down” and consisting only of a written report, do not provide sufficient anatomical detail (vein depth, distance to surrounding nerves, diameter, etc.) to plan a surgical procedure. The secret to success is the eye that makes the diagnosis and the hand that applies the treatment working in the same coordination.
4. I only have capillary varicose veins, is mapping still mandatory? Yes, it is mandatory. Although those fine red/purple capillaries in the shape of a spider web often look innocent, they can be a harbinger of a hidden venous insufficiency lying beneath them. If there is a leak in the main vein and we apply needle treatment (sclerotherapy) only to the capillaries on the surface without mapping, those capillaries will return by increasing even more shortly after.
5. Can treatment be started immediately after mapping is done? This is entirely your preference and depends on the availability of our clinic. As soon as the mapping process is finished, the extent of your disease becomes clear and the most appropriate treatment method is explained to you by Op. Dr. Nebiye Tüfekçi Varer. If necessary, your treatment can be planned and applied immediately on the same day with non surgical methods (laser, adhesive, foam, etc.).
Kartal Venous Mapping Doctors and Varicose Vein Treatment Prices
One of the issues our patients who apply to the Op. Dr. Nebiye Tüfekçi Varer clinic with a varicose vein complaint wonder about most is how examination, mapping, and treatment prices are determined. In accordance with our medical ethics rules and the Ministry of Health guidelines, it is not legally appropriate for us to share a clear and standard price list on digital platforms or our website. However, the transparent dynamics behind the pricing policy are as follows:
- Stage of the Disease and Anatomical Condition: Although varicose veins seem like a single disease, they are at a different level in each patient. While some only have superficial capillaries, in others the main vein (Saphenous vein) may have completely failed, its diameter may have expanded greatly, or it may carry an advanced risk of clotting (thrombophlebitis). This is exactly why the mapping process is necessary; the treatment cost is determined based on the stage of the disease.
- Treatment Method and Material to be Used: After the venous map is extracted, the most appropriate “tailor made” method for that map is selected. The costs of different technologies such as closing the vein from the inside with a laser (EVLA), using medical adhesive (Glue), or foam sclerotherapy accompanied by ultrasound are naturally different from each other.
- Surgeon’s Expertise: Varicose vein treatment is not a simple aesthetic cosmetic procedure, but a serious medical procedure that falls into the field of cardiovascular surgery. The planning of your treatment, the correct execution of mapping, and the application of modern methods (laser/cannula applications) without complications are directly proportional to the experience of the Surgeon performing the procedure.
You are no longer obliged to carry that heavy burden in your legs, wake up with cramps, or hesitate to wear skirts or shorts. Varicose veins are a disease that can be treated extremely comfortably and permanently with today’s technology when the root cause is correctly identified.
As the Op. Dr. Nebiye Tüfekçi Varer clinic, we are here to flawlessly extract the “architectural plan” of your disease and start that safe treatment protocol completely specific to you. You can contact our clinic immediately to discover the true health map of your legs and for free preliminary consultation/examination details. Healthy, lightened, and aesthetic steps are very close to you.
