Varicose veins Flashcards
What are varicose veins?
tortuous dilated segments of veins associated with valvular incompetence
What do varicose veins arise from?
incompetent valves which permit blood flow from deep venous systems to the superficial venous system causing venous hypertension and dilatation
What causes 98% of varicose veins?
idiopathic
What can cause the other 2% of varicose veins?
DVT, pelvic masses, arteriovenous malformations
What are the risk factors for varicose veins?
prolonged standing, obesity, pregnancy, family history
What are the symptoms of varicose veins?
unsightly visible veins or discolouration of the skin, pain, aching, swelling, itching, leading to skin changed, ulceration, thrombophlebitis or bleeding
What would be present on examination of varicose veins?
varicosities will be present in the course of the great and or short saphenous veins, may also have venous insufficiency
What are the clinical features of venous insufficiency?
oedema, varicose eczema, thrombophlebitis, ulcers, haemosiderin skin staining, lipodermatoscerlosis or atrophie blanche
What is a saphena varix?
dilatation of the saphenous vein at the saphenofemoral junction in the groin, it displays a cough impulse so may be mistaken for a femoral hernia- duplex ultrasound to confirm
What is the CEAP classification?
Clinical features, aEtiology, anatomical, pathophysiology
What are the investigations for varicose veins?
Duplex ultrasound assessing valve incompetence at the great.short saphenous veins and any perforators
What is the non-invasive management for varicose veins?
patient education, weight loss, prolonged standing, increase exercise, compression stockings if interventional treatment not appropriate
When should surgery be done for varicose veins?
symptomatic, lower limb skin changes, superficial vein thrombosis, venous leg ulcer
What are the treatment options for varicose veins?
Vein ligation, stripping and avulsion, foam sclerotherapy or Thermal ablation
What are the complications of varicose veins?
worsen overtime, from surgery can get haemorrhage, thrombophlebitis, DVT, disease recurrence and nerve damage
