Venous and lymphatic disease Flashcards
Name 3 venous and lymphatic diseases.
Varicose veins, chronic venous insufficiency and lymphoedema.
What causes varicose veins?
Leaky valves and so there is a backflow of blood. Mostly in long saphenous vein. More common in females.
What are the signs and symptoms of varicose veins?
Cosmesis (cosmetic surgery), discomfort in legs, swelling, acute haemorrhage, itching and skin changes.
When would intervention be done on varicose veins?
Superficial thrombophlebitis, signs of chronic venous insufficiency, bleeding, cosmetic and anxiety that disease may progress.
Name some treatments of varicose veins.
Surgery, injection and compression. Conntraindications if previous DVT surgery, obese etc.
What is the surgery for varicose veins?
PIN - perforate invaginate stripping. Complications include: minor haemorrhage, pain, thrombophlebitis and haematoma.
Name some minimally invasive treatments of varicose veins.
Foam scleropathy, endovenous laser ablation and radiofrequency ablation, compression hosiery.
What are the advantages of these minimally invasive treatments?
Less pain, less time off work, reduce surgical trauma, do not require an operating theatre. Just as effective as surgery in the short term. Long term results not known.
What is chronic venous insufficiency?
When venous walls or valves are not working properly, making it difficult for blood to return to heart from legs.
What are the symptoms of chronic venous insufficiency?
Ankle oedema, telangectasia (dilation of capillaries, can see them on surface with spidery appearance), hypopigmentation.
What causes CVI?
Venous hypertension, venous engorgement and stasis and imbalance of Starling forces/fluid exudate. High ambulatory venous pressure. Calf muscle pump fails due to: superficial/deep venous reflux, obesity or inactivity.
What is a leg ulcer?
Breach in the skin between the knee and the ankle present for over 4 weeks. Mostly venous in origin.
How are leg ulcers treated?
Exclude arterial disease. Compression therapy, dressings, exercise.
What are the causes of lymphoedema?
Primary: congenital, praecox, tarda. Secondary: malignancy, surgery, RT or infection (filariasis). Can use elevation or manual drainage to treat.
