Varicose Veins

Question 1

varicose veins?

Answer 1

dilated veins of the superficial venous system.

Question 2

Pathology

Answer 2

Blood from the superficial veins of the leg passes into the deep veins via perforator veins. Valves prevent the blood passing from deep to superficial veins. If they become incompetent there is venous hypertension and dilatation of the superficial veins.

Question 3

Risk Factors of Varicose veins

Answer 3

Prolonged standing
Obesity 
Pregnancy 
FHx 
OCP

Question 4

what % are primary and secondary

what is secondary causes?

Answer 4

95% primary
5% secondary

DVT, pelvic tumour

Question 5

Symptoms of Varicose veins

Answer 5

My legs are ugly
Pain cramps
Tingling
Heavinesss

Question 6

Signs of Varicose veins

Answer 6

Phlebitis (inflam of vein) Oedema

Severe:
Ulcers
Atrophie blanche (white scarring at site of healed ulcer

Question 7

Tx of Varicose veins

Conservative management?

Answer 7

Treat underlying cause
Avoid prolonged standing, elevate legs whenever possible.
Compression (stockings)
Lose weight
Regular walks (calf muscle action aids venous return)

Question 8

Tx of Varicose veins

NICE recommend specialist referral for VV if?

Answer 8

• severe impact on QoL
• bleeding
• pain
• ulceration

Question 9

2 types of Surgical intervention what are they?

Answer 9

Endovascular Treatment

• Radiofrequency ablation (catheter inserted into the vein and heated to destroy endothelium and close the vein.
• Endovenous laser ablation – same as previous but using laser.
• Injection scleropathy – using liquid or foam – both damage the endothelium to achieve occlusion of affected vein.

Surgery

avulsions (tearing away)
saphenofemoral ligation