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Review
. 2000 May 20;320(7246):1391-4.
doi: 10.1136/bmj.320.7246.1391.

ABC of arterial and venous disease. Varicose veins

N J London  1 , R Nash
Affiliations
Review

ABC of arterial and venous disease. Varicose veins

N J London et al. BMJ. .
No abstract available

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Figures

Figure
Figure
Trunk varices are varicosities in the line of the long (top, left) or short (top, right) saphenous vein or their major branches. Reticular veins (arrow, bottom) are dilated tortuous subcutaneous veins not belonging to the main branches of the long or short saphenous vein, and telangiectasia (bottom) are intradermal venules <1 mm
Figure
Figure
Trunk varices are varicosities in the line of the long (top, left) or short (top, right) saphenous vein or their major branches. Reticular veins (arrow, bottom) are dilated tortuous subcutaneous veins not belonging to the main branches of the long or short saphenous vein, and telangiectasia (bottom) are intradermal venules <1 mm
Figure
Figure
Trunk varices are varicosities in the line of the long (top, left) or short (top, right) saphenous vein or their major branches. Reticular veins (arrow, bottom) are dilated tortuous subcutaneous veins not belonging to the main branches of the long or short saphenous vein, and telangiectasia (bottom) are intradermal venules <1 mm
Figure
Figure
Mechanisms of failure of calf muscle pump and venous hypertenion. Superficial veins do not normally allow reflux of blood (left). However, if superficial veins are incompetent (right), some of the blood ejected by the calf muscle pump during systole refluxes back down the superficial veins into the calf muscle pump during diastole. This retrograde circuit can overload the calf muscle pump, leading to dilatation and failure. The subsequent rise in end diastolic volume leads to venous hypertension. Adapted from Browse et al
Figure
Figure
Thrombophlebitis presents as severe pain, erythema, pigmentation over, and hardening of the vein. Thrombophlebitis in varicose veins results from stasis, whereas thrombophlebitis occurring in normal veins should alert clinicians to the possibility of an underlying malignancy or thrombophilia. Recurrent thrombophlebitis in varicose veins raises the possibility of underlying thrombophilia
Figure
Figure
One of the complications of injection sclerotherapy is brown skin pigmentation (arrows)
Figure
Figure
Skin pigmentation is due to haemosiderin deposition. This patient also has thrombophlebitis of the long saphenous vein with overlying pigmentation (arrow)
Figure
Figure
Varicose eczema occurs over prominent varicose veins and in the lower third of the leg. It may be dry, scaly, and vesicular or weeping and ulcerated
Figure
Figure
Demand management. High priority cases should be refered for vascular assessment. Many regions are not offering NHS treatment for medium and low priority cases on the basis that resources are needed more for other conditions
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