Varicose veins
Varicose veins are abnormally large, tortuous veins seen in the lower limbs. Varicose veins result from increased venous pressure secondary to reflux through leaking valves. Some cases may results from old clots in the deep venous system or rarely from a congenital condition called May Thurner syndrome. It is a progressive condition that worsens over time, which may end up with severe skin changes and chronic venous ulcers
Symptoms of Venous Veins insufficiency:
• Leg or ankle swelling and heaviness of legs
• Leg pain, aching or cramping
• Burning or itching of the skin
• Skin discoloration or texture changes
• Venous ulcers (non-healing wounds) around the ankles
• Rupture of veins and bleeding
• Development of clot formation (thrombosis)
Risk Factor of Venous Veins insufficiency:
• More common in females
• Increased with age
• Familial
• Pregnancy
• Standing occupation
• Obesity
• Prior injury or surgery
• Sedentary lifestyle
Normal Varicose Veins
Incompetent vein valve
Leaking valves lead to vein enlargement
Blood going up cannot come down (Intact valves)
Common Sites Of Vein Valve Leakage Leading To Varicose Veins
Valves in the communicating veins between the superficial and deep veins leak giving rise to dark skin around the ankles
The corona phlebectatica (CP) is classically described as the presence of abnormally visible cutaneous blood vessels at the ankle with four components: “venous cups,” blue and red telangiectases, and capillary “stasis spots.” Previous studies showed that the presence of CP is strongly related to the clinical severity of chronic venous disorders (CVD) and the presence of incompetent leg perforators
We use The CEAP classification to gauge the severity of the disease
CEAP Classificatin
Date Name Age M/F
Clinical
C0 No visible or palpable signs C1 Telangectasias or Reticular veins
C2 Varicose veins, C2r Recurrent varicose veins C3 Oedema
C4a Pigmentation or Eczema C5 Healed ulcer
C4b Lipodermatosclerosis C6 Active ulcer
C4c Corona Phlebectactica C6r Recurrent active ulcer
S Symptomatic Ache, Pain, Tightness, Skin irritation, Heaviness, Cramps A Asymptomatic
Etiologic Classification
Ec Congental Ep Primary Es (Esi 2ndary Intravenous, Ese 2ndary Extravenous)
Anatomic Classification
As Superficial veins
GSVa Above knee, GSVb Below knee, SSV small saphenous vein, AASV Anterior accessory saphenous
Ap Perforator veins, Ad Deep veins, An No venous location identified
Phathophysiology
Pr Reflux Po Obstruction, Pr, o Reflux and Obstruction, Pn No venous pathology found
Right C S/A E A P Left C S/A E A P
Sonar Right
Sonar Left
Opinion
Dr E O