Varicose Veins

Question 1

What is the underlying aetiology of varicose veins?

Answer 1

1. Blood from superficial veins of leg pass into deep veins at saphenofemoral and saphenopopliteal junctions.
2. Valves prevent blood passing from deep to superficial veins.
3. If they become incompetent, there is venous HTN and dilation of superficial veins.

Question 2

What are the risk factors for varicose veins?

Answer 2

Prolonged standing, obesity, pregnancy, FHx, COCP.

Question 3

What is this a presentation of?
‘Ugly legs’, pain, cramps, tingling, heaviness, restless legs. Oedema, eczema, ulcers, hemosiderin, lipodermatosclerosis.

Answer 3

Varicose veins

Question 4

When should you refer suspected varicose veins and what is the treatment?

Answer 4

1. Refer if - bleeding, pain, ulceration, or ‘severe impact on quality of life’
2. Avoid prolonged standing, elevate legs, stocking, lose weight, walk often (aid venous return).
3. Radiofrequency ablation
4. Endovenous laser ablation