3: Varicose Veins Flashcards
Define varicose veins
Dilated and tortuous superficial veins
In which gender are tortuous veins more common
Females
What causes 95% of varicose veins
Primary mechanical dysfunction
What are other rarer causes of varicose veins
Obstruction: pelvis tumour, foetus, DVT
AV malformation
Over-active calf muscles
Give 5 risk factors of varicose veins
- Prolonged standing
- Pregnancy
- Obesity
- FH
- COCP
What are 5 symptoms of varicose veins
- Aching
- Non-aesthetic
- Cramps
- Heaviness
- Tingling
What are 4 signs of varicose veins
- Oedema
- Venous ulcers
- Venous eczema
- Atrophie blanchie
- Lipodermatosclerosis
- Phlebitis
What is atrophie blanche
Healing of previous ulcer w/white scar
What is lipodermatosclerosis
Fibrosis of subcutaneous fat caused by chronic inflammation
What classification system is used for varicose veins
C.E.A.P
What is the C.E.A.P classification
Clinical Classification (signs)
Etiology
Anatomical distribution of reflux
Pathophysiology (Reflux or obstruction)
Explain flow through superficial venous system
Normally blood from superficial venous system drains into the deep via perforator veins, saphenofemoral junction and saphenopopliteal junction
What is the role of valves
Valves prevent flow from deep system back to the superficial system
If valves become incompetent what happens
If valves become incompetence or individual has venous HTN which causes dilation of superficial veins - blood flows from deep to superficial system
How are varicose veins investigated
Duplex US
What is first-line for managing varicose veins
Lifestyle: weight loss and exercise
What is second-line for varicose veins
Compression stockings
What is third-line for varicose veins
Surgery:
- Radiofrequency ablation
- Endovenous laser ablation (EVLA)
- Sclerotherapy
What is a trendelenberg proceudure
Sapheno-femoral ligation
How does lipodermosclerosis present
hardened, red-brown skin around ankle
How does thrombophlebitis present
tender, erythematous veins
