Varicose Veins Flashcards
define varicose veins?
veins that become prominently elongated, dilated, and tortuous, most commonly thesuperficial veinsof the lower limbs.
what are the primary causes of varicose veins?
Due to genetic or developmental weakness in the vein wall
Results inincreased elasticity, dilatation and valvular incompetence
what are the secondary causes of varicose veins?
o Due to venous outflow obstruction • Pregnancy • Pelvic malignancy • Ovarian cysts • Ascites • Lymphadenopathy • Retroperitoneal fibrosis o Due to valve damage (e.g. after DVT) o Due to high flow (e.g. arteriovenous fistula)
risk factors for varicose veins?
o Age o Female o Family history o Caucasian o Obesity
epidemiology of varicose veins?
• COMMON
• Incidence increases with
age
• more common in women than men
presenting symptoms of varicose veins?
- Patients may complain about the cosmetic appearance
- Aching in the legs (worse after standing)
- Swelling
- Itching
- Bleeding
- Infection
- Ulceration
what position should one inspect varicose veins?
- on standing
what might one feel on palpation of varicose veins?
- might feel fascial defects along the veins
- cough impulse might be felt on the saphenofemoral junction
- Tap test on the saphenofemoral junction
what will the Trendelenburg Testshow?
- Allows localization of the sites of valvular incompetence
- Leg is elevated and the veins are emptied
- A hand is placed over the saphenofemoral junction
- When the leg is placed back down the filling of the veins is observed before and after the hand is released from the junction
- A Doppler ultrasound can be used to show saphenofemoral incompetence
what are signs on examination of venous insufficiency?
o Varicose eczema o Haemosiderin staining o Atrophie blanche o Lipodermatosclerosis o Oedema o Ulceration
Investigations for varicose veins?
• Duplex Ultrasound
- this locates incompetence
- allows exclusion of DVT
what is a conservative management plan for varicose veins?
o Exercise - improves skeletal muscle pump
o Elevation of legs at rest
o Support stockings
the management plan for venous telangiectasia
o Laser sclerotherapy
o Microinjection sclerotherapy
what is the surgical plan for varicose veins?
o Saphenofemoral ligation(tying veins together)
o Stripping of the long saphenous vein
o Avulsion of varicosities
Identify possible complications of varicose veins?
- Venous pigmentation
- Eczema
- Lipodermatosclerosis
- Superficial thrombophlebitis
- Venous ulceration
