Varicose Veins

Varicose veins are tortuous, elongated, dilated, thickened, superficial veins with non-functional, incompetent valves. Incompetent valves allows blood to flow backwards, causing pooling and high pressures within the superficial veins.

It's causes include:

• Previous DVT – Leaves deep valves incompetent

• Increased pelvic pressure e.g. pregnancy, pelvic tumour

• IVC Obstruction

• Severe tricuspid (Right AV valve) valvular incompetence

• Congenital venous malformation e.g. Klippel-Trenunay Syndrome

• AV malformation – Congenital, Acquired (Trauma)

• Pregnancy-related

Most are asymptomatic, but patients may also present with symptoms of venous insufficiency, which includes itch, heaviness, swelling, pain, discolouration, ulceration, and venous eczema.

Treatment is usually only required if there's bleeding, pain, ulceration, thrombophlebitis or significant psychological morbidity. The options here include:

• Radiofrequency ablation - Destruction of endothelium of the vein via high temperature catheter

• Endovascular laser ablation - Destruction of vein using laser

• Injection Sclerotherapy – Injection of sclerosant substance at several points of the vein, leading to occlusion