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Varicose Veins (Pathophysiology (3 main sites where valve incompetence…

- - - - Small below knee varicosities not involving GSV or
        SSV
    - - Local or GA
      - Injection sclerotherapy: 1% Na tetradecyl sulphate
      - Endovenous laser or radiofrequency ablation
    - - Compression bandage for 24hrs
        
        Compression stockings for 1mo
  - - - SFJ incompetence
      - Major perforator incompetence
      - Symptomatic: ulceration, skin changes, pain
    - - Trendelenberg: saphenofemoral ligation
      - SSV ligation: in the popliteal fossa
      - LSV stripping: no longer performed due to potential
        for saphenous nerve damage. :red_cross:
      - Multiple Avulsions
      - Cockett’s Operation: perforator ligation
      - SEPS: Subfascial Endoscopic Perforator Surgery
    - - Bandage tightly and elevate for 24h
        
        D/C w/ compression stockings and told to walk daily.
    - - Early
        
        Haematoma: esp. groin
        
        Wound sepsis
        
        Nerve damage: e.g. long saphenous
      - Late
        
        Superficial thrombophlebitis
        
        DVT
        
        Recurrence: 10% @ 5yrs
- - - - Klippel-Trenaunay-Weber
        
        Abnormality of the deep venous system
        
        Varicose veins
        
        Port wine stain
        
        Bony and soft tissue hypertrophy of the limbs
      - Parkes-Weber Syndrome
        
        Multiple AVMs w/ limb hypertrophy
        
        AVMs can → high-output HF
- - - - Previous Hx of DVT
      - Signs of chronic venous insufficiency
        Suggests deep venous disease for which the
        varicosity may be the collateral.
      - Recurrent varicose veins
      - Difficulty in deciding whether GSV or SSV is incompetent