Varicose veins Flashcards
Define varicose veins
Tortuous and dilated veins of the superficial venous systems (often legs)
NOT ALWAYS VISIBLE
Aetiology and risk factors for varicose veins
Causative (very linked)-previous DVT, genetic links
associated-age, gender, pregnancy. prolonged standing, obesity, fam history, the pill
valve issue causes-primary-congenital valve absence (super rare)
Secondary-obstruction, DVT, hypertension, constipation, overactive muscle pumps (cyclists)
Blood from superficial veins go to deep veins-at Sappho femoral and Sappho polieayeal. valve prevent back flow-if bad-hypertension and dilated and blood pools down
Epidiemology of varicose veins
Higher in developed countries
around 15% for men and 25% for women
increase prevalence with age
big link of family history
Symptoms of varicose veins
“my legs are ugly”-visible tortuous veins
Pain, cramps, tingling, heavy legs and restless legs
very non distinct
classic presentation-not in the morning, worse after day of standing
later-ulceration, bleeding, ankle swelling
Signs of varicose veins
visible toutous veins
Oedema, eczema,
ulcers, Atrophie blanche (white scar over ulcer)
Lipodermatosclerosis (skin hardned from fibrosis)
COUGH impulse at saphenofemoral junction
can also tap on VV and palpate from transmitted impulse
Auscultate for bruits
Trendeleburg test-assess SFJ–
Investigations of varicose veins
Duplex ultrasound-assess valve closure time-0.5 is usually and
Management of varicose veins
Treat underlying causes
Education-avoid prolonged standing, stockings, lose weight and regular walks
endovascular treatment-Radiofrequency ablation-catheter in vein and closes vein
Endovenous laser ablation-same with laser
Slecotherapy-foam/liquid sclerosant is injected and occlude the veins
Surgery-depends of the veins- (saphenofemoral ligation), stripping–remove the veins
Complications of varicose veins
Chronic venous insufficiency-common-
rarer-venous ulcers, haemorrhage, lipodermasclerosis, heamosiderin deposition (leaky capillaries)
