Varicose Veins

Question 1

Why do varicose veins occur?

Answer 1

Due to valvular incompetence.

Question 2

Where do varicose veins most commonly occur?

Answer 2

At the saphenofemoral junction. Blood backs up into the superficial veins (great and small saphenous veins are part of the superficial system, femoral vein is part of deep system).

Question 3

What are the signs of varicose veins?

Answer 3

Bulging veins.
Leg swelling.
Skin colour and texture changes.
Venous ulcers.
Eczema.

Question 4

What skin colour and texture changes can occur with varicose veins?

Answer 4

Haemosiderin.

Atrophy blanche.

Question 5

What are the risk factors for varicose veins?

Answer 5

Standing for long periods of time.
Obesity.
Pregnancy.
FHx.
Contraceptive pill.

Question 6

What lifestyle advice can be offered to people suffering from varicose veins?

Answer 6

Referral cannot be for cosmetic reasons alone.

Lose weight, take short walks, elevate legs, avoid standing, support stockings.

Question 7

Other than lifestyle changes, how can varicose veins be managed?

Answer 7

Radiofrequency ablation (catheter inserted and heated up).
Injection sclerotherapy (foam injected that damages endothelium).
Surgery (can ligate or strip).