Varicose Veins Flashcards
what are varicose veins?
dilated, elongated and torturous superficial veins due to increased intra-luminal pressure
what three things are required to get blood from the legs to the heart?
open veins
competent valves
calf muscle pump
two systems of lower limb veins
- superficial veins
2. deep veins
examples of superficial veins in the leg
long and short saphenous veins
examples of deep veins in the leg
tibial
popliteal
femoral
iliac
direction of blood flow in veins
superficial to deep via perforator veins
classification of varicose veins
- primary= incompetent valves in superficial veins
2. secondary= occurred due to another issue e.g. DVT, pregnancy, neoplasms, etc.
what should patients have before surgery?
duplex USS to show the anatomy
varicose veins presentation
pain thrombophlebitis bleeding chronic venous insufficiency venous hypertension venous ulcers
pain in varicose veins
dull ache
worse at the end of the day
prolonged standing
aspects of chronic venous insufficiency
irreversible skin damage including venous eczema, haemosiderin deposits and lipodematosclerosis
causes of venous hypertension
vein reflux
vein occlusion
abnormal calf pump
idea of management in varicose veins
disconnecting deep and superficial venous systems
non-interventional management for varicose veins
fitted support hosiery
graduated compression
ulcer prevention
when is compression contraindicated?
low ABPI
examples of minimally invasive surgery techniques for varicose veins
- foam sclerotherapy
- EVLT
- radiofrequency ablation
- clarivein
examples of sclerosants
sodium tetradecyl sulphate (fibrovein)
liquid fibrovein
how does foam sclerotherapy close varicose veins?
induces chemical thrombophlebitis
what is EVLT?
endovenous laser therapy - laser probe is passed up the affected vein and it is withdrawn slowing inducing a thermal thrombophlebitis
how does radiofrequency ablation cause occlusion of affected veins?
induces a thermal thrombophlebitis
what is clarivein?
prolonged probe is deployed which rotates within in the vein while injecting a sclerosant inducing a mechanical and chemical thrombophlebitis
which nerves are likely to be damaged in open varicose vein surgery?
saphenous nerve
sural nerve
classification of varicose veins
CEAP
