#Vein of stars band skin#

Table 1 - The CEAP classification for the clinical manifestations of varicose veins

#Vein of stars band skin#

* I n the UK, cosmetic issues alone does not qualify for treatment of varicose veinsĬ0 -No visible or palpable signs of venous disease C1 - Telangiectasias or reticular veins C2 - Varicose veins (C2r - Recurrent varicose veins) C3 - Edema C4 - Changes in skin and subcutaneous tissue secondary to CVD (C4a - Pigmentation or eczema, C4b - Lipodermatosclerosis or atrophie blanche, C4c - Corona phlebectatica) C5 - Healed C6 - Active venous ulcer (C6r Recurrent active venous ulcer)Įp - Primary Es - Secondary (Esi - Secondary intravenous, Ese - Secondary extravenous) Ec - Congenital En - No cause identified They can also present with clinical features of venous insufficiency, such as ulceration, varicose eczema, or haemosiderin deposition. On examination, varicosities will be present in the course of the great and / or short saphenous veins (Fig. Subsequent complications if left untreated can include skin changes, ulceration, thrombophlebitis, or bleeding (often presenting post-trauma). Worsening varicose veins may then cause aching or itching.

Patients will typically present initially with cosmetic issues*, presenting with unsightly visible veins or discolouration of the skin There are four major risk factors for the development of varicose veins: Figure 1 - Varicose veins develop from valvular incompetence, resulting in dilation of the superficial venous system. This is done under ultrasound guidance and also may be performed under local (or general) anaesthetic.

Thermal ablation – which involves heating the vein from inside (via radiofrequency or laser catheters), causing irreversible damage to the vein which closes it off.

This is done under ultrasound guidance to ensure the foam does not enter the deep venous system, however this method only requires a local anaesthetic.

Foam sclerotherapy – injecting a sclerosing (irritating) agent directly into the varicosed veins, causing an inflammatory response that closes off the vein (Fig.

The surgeon must be aware of surrounding arterial and nervous structures, such as the saphenous and sural nerves.

Vein ligation, stripping, and avulsion – making an incision in the groin (or popliteal fossa) and identifying the responsible, refluxing vein, before tying it off and stripping it away.

The treatment options that are available include:

A venous leg ulcer (a break in the skin below the knee that has not healed within 2 weeks).

Superficial vein thrombosis (characterised by the appearance of hard, painful veins) with suspected venous incompetence.

Lower‑limb skin changes, such as pigmentation or eczema, thought to be caused by chronic venous insufficiency.

Symptomatic primary or recurrent varicose veins.

Table 1 – The CEAP classification for the clinical manifestations of varicose veins Pr: Reflux, Po: Obstruction, Pr,o: Reflux and Obstruction, Pn: no venous pathophysiology identifiable ClassificationĪ standardised reporting method for the clinical manifestations of varicose veins has been described by the CEAP ClassificationĬ0 -No visible or palpable signs of venous disease C1 – Telangiectasias or reticular veins C2 – Varicose veins (C2r – Recurrent varicose veins) C3 – Edema C4 – Changes in skin and subcutaneous tissue secondary to CVD (C4a – Pigmentation or eczema, C4b – Lipodermatosclerosis or atrophie blanche, C4c – Corona phlebectatica) C5 – Healed C6 – Active venous ulcer (C6r Recurrent active venous ulcer)Įp – Primary Es – Secondary (Esi – Secondary intravenous, Ese – Secondary extravenous) Ec – Congenital En – No cause identifiedĪs: Superficial veins, Ap: Perforating veins, Ad: Deep veins, An: no venous location identified As it displays a cough impulse, it is commonly mistaken for a femoral hernia suspicion should be raised in any suspected femoral hernia if the patient has concurrent varicosities present in the rest of the limb. These can be best identified via duplex ultrasound and management is via high saphenous ligation. A saphena varix is a dilatation of the saphenous vein at the saphenofemoral junction in the groin.