Varicose Veins

Question 1

define varicose veins

Answer 1

dilated, elongated and torturous veins due to increased intra-luminal pressure

Question 2

factors that help the legs get blood back to the heart

Answer 2

open veins
one-way valves
calf muscle pump

Question 3

2 systems of lower limb veins

Answer 3

1. superficial

2. deep

Question 4

superficial veins of the lower limb

Answer 4

long and short saphenous veins

Question 5

deep veins of the lower limb

Answer 5

tibial
popliteal
femoral
iliac

Question 6

classification of varicose veins

Answer 6

primary

secondary

Question 7

what are primary varicose veins due to?

Answer 7

incompetent valves in superficial veins

Question 8

what are secondary varicose veins due to?

Answer 8

occurred due to another issue e.g. DVT, pregnancy, pelvic neoplasms, AV fistulas, fractures, etc.

Question 9

diagnosis of varicose veins

Answer 9

clinical

duplex USS to show anatomy

Question 10

presentation of varicose veins

Answer 10

dull ache worse at the end of the day and prolonged standing
thrombophlebitis
bleeding
chronic venous insufficiency

Question 11

what is thrombophlebitis?

Answer 11

inflammation by local blood clots

Question 12

signs of chronic venous insufficiency

Answer 12

varicose eczema
haemosiderin deposits
lipodermatosclerosis
venous ulcer

Question 13

what is the idea of management of varicose veins?

Answer 13

disconnecting deep and superficial venous systems to disrupt the pressure impact

Question 14

non-interventional management of varicose veins

Answer 14

fitted support hosiery

graduated compression

Question 15

when is graduated compression contraindicated?

Answer 15

low ABPI/ arterial disease

Question 16

endovenous options for varicose veins

Answer 16

1. foam sclerotherapy
2. EVLT
3. radiofrequency ablation
4. clarivein

Question 17

what are the sclerosants used in foam sclerotherapy?

Answer 17

sodium tetradecyl sulphate (fibrovein)

liquid fibrovein

Question 18

what does foam sclerotherapy induce?

Answer 18

a chemical thrombophlebitis and subsequent closure of affected veins

Question 19

what is EVLT

Answer 19

this is laser therapy that induces a thermal thrombophlebitis

Question 20

what is radiofrequency ablation?

Answer 20

probe passed into the vein and is activated inducing a thermal thrombophlebitis

Question 21

what is clarivein?

Answer 21

probe rotates and injects sclerosant inducing a mechanical and chemical thrombophlebitis

Question 22

what does open surgery involve?

Answer 22

disconnection at LSV or SSV
stripping
multiple stab avulsions