Complications of superficial vein incompetence and varicose veins

Abstract

This chapter discusses the complications of superficial vein incompetence and varicose veins. One in five patients presenting with varicosities, and hence superficial incompetence, will show at least some evidence of venotensive tissue change, such as an area of slight subcutaneous thickening and brown discoloration of the overlying skin. In all new patients presenting with active liposclerosis from any cause, often with ulceration, one-half are due to superficial incompetence with or without varicosities. This is a common, potentially disabling complication of superficial incompetence and the underlying cause is venous hypertension due to heavy downflow in superficial veins overwhelming a comparatively weak pumping mechanism. The mechanism by which venous hypertension causes tissue damage is still not completely understood. The probable sequence of events is that venous hypertension stimulates the proliferation of capillaries, raises capillary pressure, and increases the permeability of the capillary wall through which an excess of exudate passes. This contains electrolytes and the smaller protein molecules, including fibrinogen.