Varicose Veins

Question 1

What are varicose veins?

Answer 1

Long, tortuous and dilated veins of the superficial venous system.

Question 2

Explain the pathology of varicose veins.

Answer 2

Blood from superficial veins of the leg passes into deep veins via perforator veins usually.
Valves prevent blood from passing from deep to superficial usually.

If these valves become incompetent there is venous hypertension and dilation of the superficial veins leading to varicose veins.

Question 3

Risk factors of varicose veins.

Answer 3

Prolonged standing

Obesity

Pregnancy

FH

COCP

Question 4

Causes of varicose veins.

Answer 4

Primary mechanical factors usually (95%)

It can be secondary to obstruction, arteriovenous malformation, overactive muscle pumps or congenital.

Question 5

Symptoms of varicose veins.

Answer 5

“My legs are ugly”

Pain

Cramps

Tingling

Heaviness

Restless legs

Question 6

Signs of varicose veins.

Answer 6

Oedema

Eczema

Ulcers

Haemosiderin

Haemorrhage

Phlebitis

Lipodermatosclerosis

Question 7

Management of varicose veins.

Answer 7

Treat any underlying cause

Education to avoid prolonged standing, elevate legs as frequent as possible. Support stockings, lose weight, regular walks.

Endovascular treatment such as;
Radiofrequency ablation
Endovenous laser ablation
Injection sclerotherapy

Surgery

Question 8

When should varicose veins be referred to a specialist?

Answer 8

When there is bleeding, pain, ulceration, superficial thrombophlebitis or a severe impact on quality of life.