varicose veins

Question 1

what are they

Answer 1

e dilated, tortuous, superficial veins that occur secondary to incompetent venous valves, allowing blood to flow back, away from the heart.

Question 2

most common location

Answer 2

great saphenous vein and small saphenous vein.

Question 3

a variety of skin changes may be seen

Answer 3

varicose eczema (also known as venous stasis)
haemosiderin deposition → hyperpigmentation
lipodermatosclerosis → hard/tight skin
atrophie blanche → hypopigmentation

Question 4

ivx

Answer 4

venous duplex ultrasound: this will demonstrate retrograde venous flow

Question 5

management

Answer 5

leg elevation, weight loss, regular exercise, graduated compression stockings

Question 6

reasons for referral to secondary care include

Answer 6

significant/troublesome lower limb symptoms e.g. pain, discomfort or swelling
previous bleeding from varicose veins
skin changes secondary to chronic venous insufficiency (e.g. pigmentation and eczema)
superficial thrombophlebitis
an active or healed venous leg ulcer

Question 7

possible treatments

Answer 7

ablation, sclerotherapy, surgery