Venous and Lymphatic Disease Flashcards
Are deep varicose veins more serious than superficial varicose veins?
yes
Can varicose veins be familiar ?
yes
where are the two main sites where varicose veins form?
saphenofemoral junction
saphenopopliteal junction
is the short or long saphenous vein more commonly affected? (and give percentages)
= long (80-87%)
short (21-30%)
Are varicose veins more prevalence in women or males?
females
What percentage of patients have combined varicose veins affecting the two junctions?
21%
What occupations are more likely to have varicose veins?
people who stand up for long periods of time
- hair dressers
- teachers
whats the reason thought to cause varicose veins on pregnant women?
- hormonal changes
- as well as weight changes
state 7 symptoms of varicose veins
localised/ generalised discomfort nocturnal cramps swelling acute haemorrhage superficial thrombophlebitis pruritus skin changes (dry, red, ulcerated)
state the one investigation done for varicose veins
duplex scan
what are the chances varicose veins will occur again after being treated?
100%
what are the two methods of superficial venous surgery
ligation of the sapheno-femoral or sapheno-popliteal junctions
vein stripping
state some indications for intervention
patient has bad symptoms
superficial thrombophlebitis
signs of chronic venous insufficiency
bleeding
State four contraindications for venous intervention
- arterial insufficiency
- previous DVT
- morbid obesity
- co-morbitity
state 4 complications of venous intervention
- minor haemorrhage
- thrombophlebitis
- wound pain/infection
- damage to deep veins or nerves
state three minimal invasive procedures done to treat varicose veins
Foam sclerotherapy
Endovenous laser ablation (EVLA)
Radio frequency ablation (VNUS)
state 4 advantages of minimal invasive procedures compared to surgery
- less side effects
- reduced time off work
- doesn’t require an operating room
- local anaesthetic so reduces surgical trauma
As well as surgery and minimal invasive procedures, what else can be done to treat varicose veins?
compression hosiery
What is the definition of a leg ulcer ?
• breach in the skin between knee and ankle joint, present for over 4 weeks
State two investigations done for chronic venous insufficiency ?
Duplex
ABPI
state the pathophysiology of chronic venous insufficiency
- Venous hypertension
- High AVP -failure of muscle pump, valves, or outflow obstruction
- Venous engorgement and stasis
- Imbalance of Starling forces and fluid exudate
- Standing motionless - pressure at foot ~90mmHg
- Active movements: pressure falls to 30mmHg – pressure falls due to the muscle pump pushing the blood back up to the heart
- Known as ambulatory venous pressure (AVP)
State 6 ways that chronic venous insufficiency can occur?
Ð Superficial venous reflux Ð Deep venous reflux Ð Venous obstruction Ð Neuromuscular Ð Obesity Ð Inactivity
What four ways can chronic venous insufficiency be treated?
compression hosiery (for oedema)
dressings (for ulcers)
systematic and topical steroids
exercise (calf muscle pump to increase venous return)
what is Klippel-Trenaunay Syndrome
when the leg and foot is swollen due to lymphatic system
