Varicose Veins Flashcards
Define Varicose Veins
Subcutaneous, permanently dilated veins 3mm or more in diameter when measure in standing position
Aetiology of Varicose Veins
Primary cause unknown
Venous valve incompetence most common
Previous DVT + genetics
Progesterone + oestrogen
Risk factors of Varicose Veins
Increasing age Family history Female sex Increasing no. Of births VT Occupation with prolonged standing Obesity
Epidemiology of Varicose Veins
Prevalence higher in industrialised countries and more developed regions
Prevalence increases with age
Risk of development if both parents are affected is 90%
Symptoms of Varicose Veins
Dilate tortuous veins Leg fatigue or aching with prolonged standing, relieved by elevation Leg cramps, usually nocturnal Restless legs Itching Ankle swelling Ulceration Bleeding from varices
Signs of Varicose Veins
Dilated tortuous veins Haemosiderin deposition Corona phlebectatica (multiple fine vein branches) Lipodermatosclerosis Ankle swelling
Investigations for Varicose Veins
Duplex ultrasound -
Valve closure time >0.5s indicative of reflux
Valve closure time >1s indicative of reflux in deep system
Management for Varicose Veins
Conservative: compression with stockings | frequent leg elevation | physiotherapist | manual lymphatic drainage | avoid long periods of standing and sitting and heat
Pain and swelling (symptomatic):
Vein ablation
1. Endogenous thermal ablation (Laser + radiofrequency)
2. Chemical ablation (sclerotherapy)
3. Open surgery with partial or complete vein removal
Complications of Varicose Veins
Chronic venous insufficiency Haemorrhage Venous ulceration Lipodermatosclerosis Haemosiderin deposition
Prognosis of Varicose Veins
Resolution in >95% of patients
New ones are very likely to occur with time - progressive diseases
