Varicose Veins + Venous Insufficiency Flashcards
what are varicose veins
torturous dilated segments of veins associated with valvular incompetence
how do varicose veins form
incompetent valves allow blood flow from deep venous system to superficial venous system
- results in venous HTN + dilatation of superficial venous system
risk factors for varicose veins
prolonged standing
obesity
pregnancy
family hx
presentation of varicose veins
cosmetically unappealing dilated superficial veins
aching / dragging sensation in legs
itch – varicose eczema
investigation of varicose veins
duplex USS to assess valve incompetence
criteria for surgical treatment of varicose veins
symptomatic primary/recurrent varicose veins
lower limb skin changes e.g. varicose eczema
superficial vein thrombosis
venous leg ulcer
surgical options for varicose veins
thermal ablation
sclerotherapy
vein ligation + stripping
non-surgical management of varicose veins
avoid prolonged standing
weight loss
increase exercise - promotes calf muscle action
difference between varicose veins and venous insufficiency
varicose veins affect superficial venous system
venous insufficiency affects deep venous system
what causes primary venous insufficiency
underlying defect in vein wall or valve
- congenital, connective tissue disorders
what causes secondary venous insufficiency
defects occur secondary to damage
- due to DVT, trauma, outflow obstruction, post-phlebitis
presentation of venous insufficiency
chronically swollen lower limbs
aching
venous claudication - bursting pain on walking, relieved with leg elevation
skin changes: varicose eczema, haemosidrin staining, thrombophlebitis, lipodermatosclerosis
where would leg ulcers be located in venous insufficiency
medial malleoli
1st line investigation of venous insufficiency
doppler USS to assess extent of venous reflux
management of venous insufficiency
compression stockings + analgesia
