Varicose Veins: A Short Review

Introduction to varicose veins:

Varicose veins are usually seen in lower limbs of the individuals who use to stand for longer hours. Varicose veins can be defined as “Dilated, tortuous and elongated veins caused by reversal of blood flow through faulty valves.”

Types of varicose veins:

These include long sephenous vein varicosity, short sephenous vein varicosity, varicose veins due to perorator incompetence, thread veins, reticular varices and the combination of these types.

Sites varicose veins:

Varicosities can occur in lower limbs, pampiniform pexus of veins, vulva and at the sites of portosystemic anastomosis such as esophagus and around the umbilicus.

Clinical features of varicose veins:

Clinical features include swelling of leg, dragging pain, heaviness in the legs, night time cramps, oedema feet, discoloration, ulceration in the feet and painful walk.

Tests for varicose veins:

Brodie-Trendelenburg test, Perthe’s test, three tourniquet test, Schwartz test, Pratt’s test, Morrissey’s cough impulse test, Fegan’s test, Ian Airid test are used to diagnose varicose veins. Abdominal examination is necessary to rule out the cause of varicose veins such as pelvic tumors, lymph nodes which may compress the veins.

Investigations:

Venous Doppler, Duplex scan, venography, plethysmographyAVP (Ambulatory Venous Pressure, Ultrasound abdomen, plain x-ray and varicography can be advised in order to know the condition of varicose veins.

Differential Diagnosis of varicose veins:

Differential Diagnoses of varicose veins include lymphoedema, arteriovenous malformation, orthostatic oedema, renal or cardiac disease, hepatic disorders.

Treatment of varicose veins:

Elastic crepe bandage application, Diosmin therapy, elevation of limb and Unna boots are the practical conservative treatment of varicose veins. Among drugs, calcium dobesilate (500mg BD), Diosmin (450 mg BD), toxerutin (500mg BD) can improve the capillary dynamics.

Moreover, injection sclerotherapy and surgery are the other treatments of varicose veins. Stripping of veins is the common surgical procedure being done for varicose veins.

Complications of Varicose veins:

Varicose veins may bleed, can cause eczema and dermatitis, and may produce venous ulcers. Periostitis, Marjolin’s ulcer, lipodermatosclerosis, DVT, calcification and thrombophlebitis are the other complications of long standing varicose veins.