Venous disease - presentation, investigation and therapy Flashcards
What are the main components of the venous system in the lower limbs?
Superficial veins → Great & small saphenous veins
Deep veins → Femoral, popliteal, tibial veins
Perforator veins → Connect superficial & deep veins
Valves → Prevent backflow of blood
What is the normal function of the venous system in the lower limbs?
✅ Returns deoxygenated blood to the heart
✅ One-way valves prevent reflux
✅ Muscle pump (calf muscles) assists venous return
What are the common symptoms of deep vein thrombosis (DVT)?
Unilateral leg swelling
Pain or tenderness in the calf
Redness & warmth over the affected area
Positive Homan’s sign (pain on dorsiflexion of the foot)
How is DVT diagnosed?
🔍 Wells Score – Risk stratification
🩺 D-Dimer – Elevated in clot formation
🖥 Doppler Ultrasound – First-line imaging
📉 Venography – Rarely used but gold standard
What are the main treatment options for DVT?
✅ Anticoagulation (Heparin → Warfarin / DOACs)
✅ Compression stockings (prevent post-thrombotic syndrome)
✅ Thrombolysis (for massive DVT or phlegmasia)
✅ IVC filter (if anticoagulation is contraindicated)
What are the clinical signs & symptoms of chronic venous insufficiency (CVI)?
Venous eczema (itchy, scaly skin)
Hemosiderin staining (brown pigmentation)
Varicose veins
Venous ulcers (medial malleolus)
Leg swelling & aching (worsens with prolonged standing)
What are the risk factors for chronic venous insufficiency?
🚨 Venous hypertension (from previous DVT)
🚨 Obesity
🚨 Pregnancy
🚨 Prolonged standing (occupational)
🚨 Varicose veins
What are the main treatment options for symptomatic varicose veins?
Conservative 🏃♂️
✅ Compression stockings
✅ Leg elevation
✅ Weight loss & exercise
Endovenous treatment 💉
✅ Endovenous laser ablation (EVLA)
✅ Radiofrequency ablation (RFA)
✅ Foam sclerotherapy
Surgical treatment 🏥
✅ Vein ligation & stripping (less common)
