🔵 Varicose veins #shortnote
●Definition and anatomy:-
Tortuous, dilated superficial veins, usually in the legs.
Usually due to valve incompetence. Common sites:
-The sapheno-femoral junction of the long saphenous vein, which runs along the medial leg.
-Sapheno-popliteal junction of the short saphenous vein, which runs along the lateral calf.
-Perforator veins (from deep to superficial), which are on the medial calf.
●Signs and symptoms:-
-Often asymptomatic, but can cause an aching pain, worse on standing. Check this is not due to other disease – e.g. PVD, arthritis – being wrongly attributed to the more visible veins.
-Saphena varix: venous dilation at the sapheno-femoral junction.
*Signs of venous disease:-
-Haemosiderin deposition in legs.
-These changes are commoner with perforator vein incompetence.
-Abdominal or pelvic masses compressing IVC or iliac veins e.g. pregnancy, obesity.
-Compression therapy: stockings or graded compression bandaging.
-Avoid prolonged standing.
-Indications: pain, ulceration, cosmesis (usually not on NHS).
-Options: SFJ ligation and vein stripping, stab avulsions, radiofrequency or laser ablation, injection of sclerosing foam.
-Stop oral contraceptive pill 4-6 weeks pre-op due to DVT risk.