Venous disease (varicose veins, chronic venous insufficiency) is a common problem affecting the general population throughout the world. In India, it is estimated that around 15-20% of population is suffering from vein disease. As a clinician, I have come across few consistent and practical hurdles in the management of these patients:
Ulcerations or chronic non-healing sores of the lower leg, ankle or foot are most commonly caused by chronic venous insufficiency. These ulcers are frequently found to be associated with varicose veins or patients who have had deep venous thrombosis in the past.
Spider veins are well-defined small veins measuring from 0.1mm to 1mm in diameter and appear on the surface layer of the skin. They may appear as scattered irregular veins but commonly occur in clusters of varying density. They are commonly seen in females (especially post pregnancy) and in elderly people.
Approximately 30% of patients with varicose veins will experience an episode of clotting of a varicosity, which is called acute thrombophlebitis. This is usually limited to the superficial venous system and therefore superficial to the muscle layer. In some situations there is the potential for the clot to extend to the deep veins of the leg, a more serious situation.
Women who have the genetic predisposition to develop varicose veins, in other words, a family history of varicose veins, often develop them and suffer from them during their first pregnancy. A common story is that the woman developed mild and perhaps few varicose veins with her first pregnancy only to have the varicosities become much worse and more difficult to tolerate during her second pregnancy.