Varicose Veins Flashcards
What are varicose veins?
Varicose veins are dilated, tortuous superficial veins, usually in the legs, caused by venous valve incompetence and blood pooling.
Which veins are most commonly affected by varicose veins?
The great saphenous vein and its tributaries are most commonly affected.
What is the main cause of varicose veins?
The main cause is venous valve incompetence, leading to venous reflux and increased pressure in superficial veins.
What are the risk factors for developing varicose veins?
Risk factors include advanced age, female sex, pregnancy, obesity, prolonged standing, family history, and previous deep vein thrombosis (DVT).
What are the typical symptoms of varicose veins?
Symptoms include aching, heaviness, swelling, itching, and discomfort in the legs, which may worsen after prolonged standing.
What are some complications of untreated varicose veins?
Complications include venous ulcers, thrombophlebitis, bleeding, and chronic venous insufficiency.
What are the typical signs of varicose veins on clinical examination?
Signs include visibly dilated, tortuous veins, swelling, skin changes (e.g., hyperpigmentation, eczema), and, in severe cases, venous ulcers.
What is the pathophysiology of varicose veins?
Weakness or damage to venous valves leads to reflux, increased venous pressure, and vein dilation, which can progress to further valve dysfunction and pooling of blood in the veins.
What investigations are used to assess varicose veins?
Duplex ultrasound is the investigation of choice to assess vein anatomy, valve competence, and reflux.
What is the clinical significance of a venous ulcer?
Venous ulcers are a sign of advanced chronic venous insufficiency and typically occur around the medial malleolus.
What lifestyle modifications can help manage varicose veins?
Lifestyle changes include weight loss, regular exercise, leg elevation, and avoiding prolonged standing or sitting.
What is the role of compression therapy in varicose veins?
Compression stockings improve venous return, reduce swelling, and alleviate symptoms, especially in mild to moderate cases.
What are the conservative management options for varicose veins?
Conservative options include lifestyle changes, compression stockings, and leg elevation to manage symptoms and prevent progression.
What are the medical management options for varicose veins?
Medical options may include topical treatments for skin symptoms (e.g., emollients, steroid creams for eczema) and anticoagulants if thrombophlebitis occurs.
What are the main surgical treatment options for varicose veins?
Surgical options include endothermal ablation (e.g., radiofrequency or laser), foam sclerotherapy, and surgical vein stripping or phlebectomy.
What is endothermal ablation, and how is it used in varicose vein treatment?
Endothermal ablation uses heat to seal off incompetent veins, promoting blood flow through healthier veins.
What is foam sclerotherapy, and when is it used?
Foam sclerotherapy involves injecting a sclerosing agent into the vein to cause fibrosis and closure. It is typically used for smaller or residual veins.
What is surgical vein stripping?
Surgical vein stripping involves removing the affected vein through small incisions, often reserved for severe or recurrent varicose veins.
What are the indications for surgical treatment of varicose veins?
Indications include symptomatic varicose veins, recurrent superficial thrombophlebitis, skin changes, venous ulcers, and patient preference for cosmetic reasons.
What are the potential complications of varicose vein surgery?
Complications include infection, bruising, nerve injury, deep vein thrombosis (DVT), and recurrence of varicose veins.
What is the role of duplex ultrasound in varicose vein treatment?
Duplex ultrasound is used to map vein anatomy, identify incompetent valves, and guide treatment planning, such as targeting veins for ablation or sclerotherapy.
What are the key differential diagnoses for varicose veins?
Differential diagnoses include deep vein thrombosis (DVT), chronic venous insufficiency, lymphoedema, and lipodermatosclerosis.
How does pregnancy contribute to varicose vein development?
Pregnancy increases venous pressure due to hormonal changes, increased blood volume, and pressure from the growing uterus, all of which can lead to valve incompetence and vein dilation.
What lifestyle advice can help prevent varicose veins?
Advice includes maintaining a healthy weight, exercising regularly, avoiding prolonged standing or sitting, and elevating the legs when resting.
What is the prognosis for patients with varicose veins after treatment?
Prognosis is generally good, with most patients experiencing symptom relief and improved quality of life, but recurrence can occur, particularly if risk factors are not addressed.
