The 2 major veins of the superficial system namely the Great Saphenous and Short Saphenous (GSV and SSV).
Primary venous disease occurs as a result of focal or diffuse structural weakening of the vein wall. The exact nature and cause are not completely understood. Valvular incompetence in the superficial veins can occur due to disruption by thrombotic events, be congenitally absent, atretic or dysfunctional over time.
Symptoms and complications from CVI may include:
Varicose veins are defined as “subcutaneous” veins in the lower extremities dilated to >3mm in diameter in the upright position. More often their appearance may be alarming but they are benign and treatment is sometimes done for aesthetic reasons.
Venous Duplex ultrasound of standard study for evaluation. They map the superficial veins and identify the location and degrees of reflux.
Treatment depends on patient choice, severity and fitness. Options include:
In patients who are considering or unsure about surgery, a trial of compression treatment can be employed. Recommendations include:
Most chronic discomfort and skin changes can be ameliorated by judicious use of compression garments, skin care, lifestyle changes and topical dressings.
Surgery may be:
When considering surgery, anatomy and general medical status are key. Endo-venous therapies are standard of care today. The obvious advantages include no incisions, no need for general anaesthesia, earlier return to work and higher likelihood of being performed as a day procedure. Nevertheless, there are instances where open surgery still proves advantageous. These include:
Speak with your friendly vascular surgeon today to discuss treatment options.
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