Varicose Veins

“Dilated superficial veins, usually in the lower limbs”

Risk Factors

• Increasing age
• Multi parity
• Pregnancy
• Obesity
• Sex (female)
• Previous DVT

Aetiology

• Increased pressure in small superficial veins

Pathophysiology

• Vein wall dilatation and secondary valvular incompetence

Clinical Presentation

• The cosmetic appearance of dilated superficial veins
• Pain/tenderness
• Cramps
• Bleeding
• Restless legs
• Venous eczema
• Ulcers

Investigations

• Duplex Ultrasound

Management

• Conservative:
  • Weight loss
  • Avoid exacerbating factors (prolonged standing/sitting)
  • Compression stockings
• Medical:
  • Sclerotherapy
• Surgical:
  • Endothermal ablation
  • Phlebectomy
  • High ligation and vein stripping of the long saphenous vein

Complications

• Venous ulcers
• Thrombophlebitis
• Deep vein thrombosis
• Chronic venous insufficiency
• Varicose eczema