Varicose vein

1. LIFE
STYLE
RELATED
HEALTH
HAZARDS

2. DIFFERENCE???

3. Varicose Veins

4.  Varicose Veins
 Are dilated, protruding,
tortuous saccular superficial
veins in the subcutaneous
tissues

5. ANATOMY
 The veins in the leg are
divided into two systems –
the deep veins and the
superficial veins. The two
systems are linked
periodically by
perforating veins.
A superficial vein can
become varicose because a
perforating vein is
allowing blood to flow the
wrong way (outwards).

7.  Normal Venous Pump Mechanism
The contraction of muscles compressing veins helps
push blood up through the leg veins back to the
heart. The valves allow the blood to flow towards
the heart only.

8.  Descending valvular incompetence
 If the valve at the top of a vein becomes
‘incompetent’ and stops working properly,
this allows a head of pressure to distend the
section of vein below it. This stretches the
vein’s wall, making it varicose, and this makes
the next valve down incompetent, and so on
down the leg.

9.  Descending valvular incompetence

10.  Descending valvular incompetence

11.  Occupation and posture (MAJOR)
 A number of studies have found that varicose
veins are more common in people who stand
up at work – particularly those who stand still
for long periods.

12.  Age
 More people develop varicose veins as they
get older – above 40

13.  Heredity
 It is not unusual for varicose veins to ‘run in
the family’ to some extent, but there is no
well-proven genetic basis for varicose veins

14.  Height and weight
 Although very obese people and very tall
people sometimes have particularly
troublesome varicose veins, no significant
correlation has ever been shown between
height and varicose veins, and the evidence
about obesity and varicose veins is
inconsistent.

15.  Pregnancy
 Varicose veins are more common in women
who have had children, and the more
pregnancies women have, the more likely
they are to develop varicose veins. Varicose
veins that develop in pregnancy are said to
result partly from the pressure of the womb
on the veins, but the evidence for this is poor,
and relaxation of the vein walls by hormones
may be more important.

16.  Diet and bowel habit
 It has been suggested that lack of fibre in the
diet and sitting straining on the lavatory
(rather than squatting briefly to pass a bulky
stool) might predispose to varicose veins. This
idea has given rise to a lot of debate, but there
is no real evidence to support it.

17.  Standing for long time
 Positive family history.
 Pregnancy.
 Abdominal tumors.
 Use of OCP(Oral Contraceptive Pills).
 Physical inactivity.
 Obesity.
 Increased age.

18. 
 Asymptomatic “early disease”
 Cosmetic
 Dull aching discomfort in lower extremities
 Exacerbated with standing and hot weather
 Itching and tingling
 Dry and hard skin
 Ulcers

19.  Dilation and tortuosity of superficial veins
 Pigmented skin at site of varicosity
 Ulceration
 Edema can be present

20.  Thrombophlebitis

21.  Ulcer
 Marjolin`s ulcer

22.  Talipes Equinovarus
 Hyperpigmentation &
Lipodermatosclerosis
 Bleeding

29.  Part One
 Get rid of the reflux
 Part Two
 Get rid of the varicose veins

30.  Compression stockings
 Surgical, vein stripping
 Endoluminal
 Laser
 Radiofrequency ablation
 Sclerotherapy
 Ultrasound guided
 Catheter delivered

31. Compression

32.  Typically requires general anesthesia
 Two incisions are need
 Can be painful post-operatively
 Requires 4-7 days off work

33.  Ankle-to-groin
 Segmental (groin to knee)

34.  Started in 1985
 For active or healed
ulcers.

37. Thank
You