Types of Varicose Veins

Clinical forms of varicose veins

Primary or essential varices:

Constitute the vast majority of this disease.

Can be classified geographically in:

# Internal saphenous varices and / or external.

They are practically the only form of varicose veins which may cause severe trophic disorders.

# Varices diffuse subcutaneous.

It occurs mainly in women. They usually do not cause ulcers.

# Varices saphenous not isolated.

The skin lesions are rare.

# Varices skin.

Are preferentially located on the edges of standing in the inferomedial part of the leg and thigh, and the outer thigh.

# Varices idiopathic deep.

Parietal hypotonia due to valvular insufficiency associated with deep vein tromboflebíticos unprecedented. Dan extensive subjective symptoms. Diagnostic venography. Very rare.

Varices secondary:

* Postphlebitic Varices

The aftermath left deep thrombosis, varicose dilation to remain superficial network and valvular insufficiency, even with the deep venous trunks and repermeabilizados.

The aftermath will be more severe and more frequent thrombosis was proximal. Are common.

More common in women and in middle age.

Morphologically, the clinical appearance of varicose veins postphlebitic can be summarized in three main types:

- The first type is very similar to that of saphenous varices.

- The second type presents as a diffuse venous insufficiency and anarchic.

- The third type is characterized by small or medium varices size, accompanying a escleroinflamatoria hypodermitisare.

* Varices congenital anatomical abnormalities:

# The Klippel-Trenaunay syndrome.

It manifests as a unilateral symptom triad, which appears in childhood or adolescence and is characterized by:

- Hypertrophy of a limb;

- Varicose veins, and

- Port-wine stain, which existed from birth.

# The absence of deep venous trunks.

The importance and topograiía of varicose veins vary depending on the location and deep vein agenesis extensiónde, the similarity with varicose veins can be absolute.

# Congenital arteriovenous fistula

Varicose veins sometimes develop in a relatively quick, a fact which should always attract attention. The lack of emptying of varicose veins when you raise the limb is the second sign of abnormality, and the pulsatile nature of the subcutaneous veins, the thrill or a continuous murmur with systolic reinforcement are diagnostic elements, but not always present.

# The absence or underdevelopment of ostial valves of the saphenous or other valves located above.

# The avalvulación femoral quite common, especially in man, which determinauna orthostatic hypotension and the initial expansion and secondarily venovenous anastomosis of superficial veins. The femoral avalvulación is incurable, leading to relapses in other dilated superficial veins other anastomosis.

# Cockett syndrome

The left common iliac vein is compressed by the artery of the same name that crosses it.

# Others:

- Anatomical abnormalities in the region of the popliteal fossa;

- Abnormal supramaleolares anastomosis;

- Lateral femoral veins;

- Previous saphenous patients without saphenous femoral, etc.

* Varicose veins of pregnancy:

Was generally between the second and the fifth month and make it more frequently in multiparas.

Can be seen in the lower limbs and also the height of the pelvis. In the vulva, are often unilateral and may be a source of complications during childbirth (bleeding and thrombosis).

In the lower extremities of varicose veins topography is quite peculiar: in fact, do not follow all the way from a saphenous vein, but plates are distributed in the leg or thigh, coating many times in these regions the appearance of subepidermal telangiectasias , blue, red or purple. Among the complications include phlebitis, subcutaneous network is relatively common.

The pathogenesis of these varices, it seems to say that is influenced by hormones.

* Varicose veins of stress or trauma.

During the practice of high-level sport, there are spikes of hydrostatic pressure, which end up impacting on the valves, which may force them, in addition to opening numerous side arterial anastomosis and muscle, and secondly, and above all, is a kind of effort that represents an obstacle to venous return, being sustained contractions, whereas the rhythmic contractions facilitate returns.

The main factor seems to be the trauma through direct injury to the vein wall, the massive opening of arteriovenous shunts or venous thrombosis with post-traumatic localized destruction of the valves. Minor trauma may be sufficient.

 
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