Venous Disease - Presentation, Investigation and Treatment

Question 1

What is the anatomy and function of the DEEP venous system in the lower limbs

Answer 1

= main route for blood to return from the legs to the heart via the IVC
- mirror major arteries

Question 2

Describe common symptoms and management of deep venous thrombosis

Answer 2

MEDICAL MANAGEMENT
Anticoagulation
Compression stockings

SURGICAL MANAGEMENT
Thrombectomy
Thrombolysis

Question 3

Describe clinical signs and symptoms of chronic venous insufficiency

Answer 3

• Achy or tired legs
• Burning tingling or “pins and needles” in legs
• Cramping in your legs at night
• Discoloured skin that looks reddish-brown
• Oedema (swelling) in lower legs and ankles
• Flaking or itching skin on your legs or feet
• Full or heavy feeling in your legs
• Leathery-looking skin on your legs
• Ulcers (open sores) usually near ankles
• Varicose veins

Question 4

List common risk factors for development of chronic venous insufficiency

Answer 4

• Genetics
• Increased age
• Female, especially multiparous
• High BMI
• Sedentary lifestyle – especially prolonged standing
• Previous damage to veins – DVT, trauma

Question 5

Outline the main treatment options for symptomatic varicose veins (conservative, endovenous)

Answer 5

Encourage exercise
Compression
Endovenous ablation
Open surgery – less common

Question 6

What is the anatomy and function of the SUPERFICIAL venous system in the lower limbs

Answer 6

= collateral route for venous return via GSV and SSV
- can be harvested for use as conduit

Question 7

Where do the superficial and deep venous system connect?

Answer 7

• Saphenofemoral junction (groin)
• Popliteal vein (knee)
• Perforators (various levels)