Vascular: Deep Venous Insufficiency Flashcards

1
Q

Outline the pathophysiology of deep venous insufficiency

A

failure of the venous system, characterised by valvular reflux, venous HTN and obstruction

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2
Q

What is the aetiology of deep venous insufficiency?

A

Primary = underlying defect to vein wall or valvular component, includes congenital defects and connective tissue disorders

Secondary = result from damage, including post-thrombotic disease, post-phlebitic disease, venous outflow obstruction, and trauma

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3
Q

What are the risk factors for deep venous insufficiency?

A

Increasing age

Female

Pregnancy

Previous DVT or phlebitis

Obesity

Smoking

Occupation with periods of long standing

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4
Q

What are the symptoms of deep venous insufficiency?

A

Chronically swollen lower limbs

Aching

Pruritic

Pain

Varicose eczema (dry and scaly skin)

Thrombophlebitis (inflam of a vein)

Haemosiderin skin staining

Lipodermatosclerosis (inflam of subcutaneous fat)

Atrophie blanche (ivory-coloured stellate scars on the legs)

Varying degree of dependent pedal oedema

Venous ulcers

Post thrombotic syndrome = heaviness, cramps, pain, pruritic, and paraesthesia, pretibial oedema, skin induration, hyperpigmentation, venous ectasia, redness, and ulceration

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5
Q

What investigations should be performed when deep venous insufficiency is suspected?

A

Doppler US = asses extent of venous reflux, stenosis, DVT, varicose veins

Bloods = FBC, U+Es, LFTs

ECHO

Foot pulses

ABPI

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6
Q

How is deep venous insufficiency managed?

A

Analgesics

Compression stockings

Elevate the feet above the level of the heart

Severe = deep venous stenting

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7
Q

What complications can occur as a result of deep venous insufficiency?

A

Swelling

Recurrent cellulitis

Chronic pain

Ulceration

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