Varicose Veins Flashcards
What are varicose veins? Which veins are most commonly affected
veins that become prominently elongated, dilated + tortuous
Superficial veins of lower limbs.
Describe the primary aetiology of varicose veins
Due to genetic/ developmental weakness in the vein wall
Results in increased elasticity, dilatation + valvular incompetence
Describe the secondary aetiology of varicose veins
Venous outflow obstruction: Pregnancy Pelvic malignancy, Ovarian cysts, Ascites, Lymphadenopathy, Retroperitoneal fibrosis Valve damage (e.g. after DVT) High flow (e.g. arteriovenous fistula)
List 5 risk factors for varicose veins
Age Female FH Caucasian Obesity
Describe the epidemiology of varicose veins
COMMON
Incidence increases with age
F > M
List 4 symptoms of varicose veins
Aching in the legs (worse at end of day/ after standing for long periods)
Swelling
Itching
Bleeding
List 6 signs of varicose veins
Ulceration Varicose eczema Haemosiderin staining Atrophie blanche Lipodermatosclerosis Oedema
What investigation is performed for varicose veins? Why?
Duplex ultrasound
Locates sites of incompetence or reflux
Allows exclusion of DVT
What conservative management can be used for varicose veins?
Exercise: improves skeletal muscle pump
Elevation of legs at rest
Support stockings
What management can be used for venous telangiectasia and reticular veins?
Laser sclerotherapy
Microinjection sclerotherapy
What Surgical management can be used for varicose veins?
Saphenofemoral ligation
Stripping of the long saphenous vein
List 5 complications of varicose veins
Venous pigmentation Eczema Lipodermatosclerosis Superficial thrombophlebitis Venous ulceration
List complications of treatment of varicose veins
Sclerotherapy: skin staining, local scarring
Surgery: haemorrhage, infection, recurrence, paraesthesia, peroneal nerve injury
What is the prognosis for varicose veins?
Slowly progressive
High recurrence
