Varicose Veins

Question 1

What are varicose veins?

Answer 1

• Dilated, often palpable subcutaneous veins with reversed blood flow
• Commonly found in legs

Question 2

What is the pathophysiology of varicose veins?

Answer 2

• Incompetent valves, which permit blood flow from deep venous system to the superficial venous system (At sapheno-femoral junction and sapheno-popliteal junction)
• Results in venous hypertension and dilatation of the superficial venous system

Question 3

What are the causes of varicose veins?

Answer 3

1. Primary idiopathic

2.Secondary:
>DVT
>Pelvic masses: pregnancy, uterine fibroids, ovarian mass
>Ateriovenous malformations

Question 4

What are the risk factors for varicose veins?

Answer 4

• Prolonged standing
• Obesity
• pregnancy
• Family history

Question 5

What is the presentation of varicose vein?

Answer 5

• 1st usually present with ‘cosmetic issues’ unsightly visible veins
• Worsening = aching or itching
• Varicoseal eczema
• Complications: skin changes, ulceration, thrombophlebitis

Question 6

What is the management of varicose veins?

Answer 6

• Advice and reassurance
• Lifestyle: weight loss, exercise
• Compression hosiery
• Interventional treatment: endothermal ablation, foam sclerotherapy and surgery