DefinitionThis section has been translated automatically.
Abnormal, congenital or acquired, short or long, spindle-, cylinder- or sack-shaped dilated epifascial vein sections with a tendency to tortuosity, whereby several turns can form regular varicose clusters and convolutes. S.a. Varicosis.
ClassificationThis section has been translated automatically.
- Depending on the location, level and calibre of the affected veins, a distinction is made:
- Trunk varices: vena saphena magna and parva (complete and incomplete)
- Side branch varices (e.g. arcade and arch veins)
- Perforating varices
- Pudendal Varices
- Reticular varices: Intracutaneous reticular veins
- Spider veins varices
- Staging of the truncal varicosis of the saphenous vein (according to Hach):
- Stage I: Insufficiency of the crusts in the groin.
- Stage II: Insufficiency starting from the crust to a hand's breadth above the knee joint.
- Stage III: Insufficiency starting from the crust to below the knee.
- Stage IV: Insufficiency from the crust to the medial ankle.
- The staging of saphenous varicosis of the saphenous vein trunk is also classified according to Hach:
- Stage I: Insufficiency of the krosse in the hollow of the knee.
- Stage II: Insufficiency starting from the crusty leg to a hand's breadth above the knee joint.
- Stage III: Insufficiency from the crust to the middle of the lower leg.
- Stage IV: Insufficiency from the crutch to the lateral ankle.
|Venous classification according to Weiss|
|Type Ia||Matting||< 0,2||light red, two-dimensional|
|type II||Veneto Asia||1-2||purple|
|type III||Reticular Varices||2-4||blue|
|type IV||Site branch varices||3-8||blue-green||subcutaneous|
|Type V||Regular charities||> 8||blue-green|
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Occurrence/EpidemiologyThis section has been translated automatically.
Varicose veins are one of the most common clinical pictures in the Central European population. About 70% of the German population show pathological changes of the peripheral venous system, with women being affected significantly more often than men. A total of approx. 12 million patients are affected by varicosis, with approx. 20% suffering from trunk varicosis, 50% from branch varicosis, two thirds from reticular and one third from spider veins. In total, 5% of the cases are in need of treatment.
EtiopathogenesisThis section has been translated automatically.
Not clarified in all details. In most cases there are congenital, degenerative changes in the vein wall, especially in the tunica media and the collagenous fibrous skeleton. Predisposing factors include age, standing activity, overweight, chronic constipation, regular alcohol consumption, pregnancy and multiple births, lack of exercise.
LocalizationThis section has been translated automatically.
Located mainly in the area of the legs, in the course of the vena saphena magna and parva.
Clinical featuresThis section has been translated automatically.
Feeling of heaviness in the leg (improvement through walking or running), tired legs, pain in the area of the varicose veins (especially when standing), premenstrual pain in the area of the varicose veins (also over reticular varicose veins and spider veins), ankle swelling and evening ankle edema, increase in symptoms when warm, improvement through elevated leg positioning, nightly foot and calf cramps.
DiagnosisThis section has been translated automatically.
Apparative diagnostics with ultrasound Doppler/colour duplex sonography devices and CW Doppler duplex sonography devices. Phlebography only in problem cases. Photoplethysmography is suitable for assessing the course of the disease.
Differential diagnosisThis section has been translated automatically.
Generally typical and therefore unmistakable clinical picture.
- Fatty tissue hernias (hernias of the fascia of the foot lifts in the lateral area of the lower legs)
- Pieced nodules (heel edges and lateral foot edges)
- Hemangioma, cavernous
Complication(s)This section has been translated automatically.
Chronic venous insufficiency; rupture of varices; thrombophlebitis. Isomorphic stimulus for e.g. psoriasis vulgaris, lichen planus, eczema, nummular, dermatoliposclerosis, hyperpigmentation, ulcus cruris.
TherapyThis section has been translated automatically.
Depending on vein involvement and severity (truncal veins, lateral branches), compression therapy, sclerotherapy, foam sclerotherapy or surgery ( crossectomy, Babcock stripping of the saphenous vein, cryostripping), endoluminal laser therapy or radio wave therapy (VNUS closure) are indicated.
General therapyThis section has been translated automatically.
As general measures, weight normalisation and regular physical activity are recommended. Furthermore, if the activity is predominantly sitting or standing, a sufficiently frequent interruption of this posture should be ensured. Hydrotherapeutic measures often lead to an improvement of the symptoms. In many cases a medical compression stocking is indispensable. Diuretics can be used to start treatment of pronounced oedema.
External therapyThis section has been translated automatically.
S.u. Compression therapy and compression bandage, phlebological. Consistent compression therapy is used as an alternative or supplement to sclerotherapy and surgery, as an accompanying measure immediately after sclerotherapy and surgery, and as an auxiliary therapy for varicosis such as phlebitis and varicose vein rupture. Short-stretch bandages, permanent compression bandages or the medical compression stocking are used. The legs can be elevated and, if necessary, lymph drainage and intermittent compression therapy (see AIK below) can be performed.
Operative therapieThis section has been translated automatically.
The procedures consist of miscectomy (removal of the truncal veins at the junction with the deep vein system), truncal vein resection, exhairesis of lateral branches and perforator dissection. Contraindications are acute deep leg and pelvic vein thromboses, hemodynamically relevant collateral functions of veins, sufficient venous segments for bypass material, severe general diseases, bed-riddenness, disorders of hemostasis and lymphedema. Recurrence rates after venous surgery are up to 40%.
Progression/forecastThis section has been translated automatically.
Primary varicosis and secondary varicosis and development of chronic venous insufficiency may occur.
LiteratureThis section has been translated automatically.
- Bradbury A et al (1999) What are the symptoms of varicose veins? Edinburgh vein study cross sectional population survey. BMJ 318: 353-356
- Breuninger H et al (2001) Cryostripping of the long saphenous vein with a percutaneously guided probe. Dermatol Surgery 27: 545-548
- de Araujo T (2003) Managing the patient with venous ulcers. Ann Intern Med 138: 326-834
- London NJ et al (2000) ABC of arterial and venous disease. Varicosis veins. BMJ 320: 1391-1394
- Margolis DJ et al (2002) Hormones replacement therapy and prevention of pressure ulcers and venous leg ulcers. Lancet 359: 675-677
- Schöpf E, Friedel S (1985) Newer aspects of diagnosis and therapy of primary varicosis. Dermatologist 36: 379-380
- Stansby G (2000) Women, pregnancy, and varicose veins. Lancet 355: 1117-1118
- Weiss RA, Weiss MA (1993) Painful teleangiectasis: diagnosis and treatment. in: Bergan JJ, Goldman MP (eds) Varicose veins and teleangiectasias: diagnosis and treatment. Quality Medical (St. Louis), pp 389-406
Incoming links (19)Butcher's broom root; Congestive heart failure pelvines; Klippel-trénaunay syndrome; Laser therapy endovenous; Phlebalgia; Phlebectasia; Polidocanol; Postthrombotic syndrome; Stewart's bluefarb syndrome; Varice reticular; ... Show all
Outgoing links (23)Angiokeratomas (overview); Chronic venous insufficiency (overview); Compression bandage phlebological; Compression, pneumatic intermittent; Compression stocking medical; Compression therapy; Crossectomy; Cryostripping; Dermatoliposclerosis; Hemangioma, cavernous; ... Show all
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