Pretreatment Assessment

The examination should always begin with a complete medical history. Data concerning family and personal venous history, symptoms, clinical findings, and previous venous treatments are collected. Comorbidities, allergies, and pharmacologic history must be documented.2 The BMI is calculated from the patient's height and weight and should be recorded.

The patient should be examined in a standing position to demonstrate patterns of teleangiectasias, reticular veins, and varicose veins.5 Cold light transillumination of the skin (vein light) may be used to identify reticular veins, and a handheld Doppler device can verify the presence of reflux in some superficial veins as a screening examination.5 Thus the three levels of pathologic veins are evaluated. Telangi-ectasias in the skin are visually inspected, reticular veins are transilluminated with the vein light, and varicosities and the saphenous veins are examined with ultrasound. Clinical data should be integrated into the CEAP classification.6,7

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