Venous disease is chronic and evolutive. The absence of treatment will therefore lead to a more or less rapid and significant aggravation of the venous condition and its symptoms. In some cases, more serious complications may occur, such as skin disorders leading to ulcers, phlebitis (vein thrombosis) and haemorrhages.
Correct
Correct
phlebological
treatment and an annual Duplex scan
and clinical examination may prevent many complications, which may be irreversible.Learn more
Modern phlebology is a discipline which allows highly effective prevention of the three sorts of complications related to the presence of varicose veins:
Skin disorders are almost inevitable in the absence of treatment of varicose veins of a large diameter and with significant reflux. Several stages follow on from one another and once attained, all of them are irreversible, even though properly carried out treatment can stop their development:- First stage: ochre dermatitis, which is characterized by brownish stains then blotches starting at the level of the foot and ankle, then spreading up around the leg to the knee.
- Second stage: inflammatory hypodermatitis, when the skin becomes red and often painful during outbursts.
- Third stage: sclerotic hypodermatitis, when the skin becomes permanently very hard, retracts, and prevents visibility of any type of oedemas.
- Fourth stage: varicose ulcer, when the skin breaks down either spontaneously or after a trauma at a previous stage, sometimes with "pseudo healing" in the form of livedoid vasculopathy (when the ulcer hole heals with a whitish fibrin deposit, and could reopen spontaneously at any time if the varicose veins are not treated)
- Fifth stage: varicose eczema, which begins with mild itchiness of the skin and develops into real eczema blotches. It can occur at any stage but mainly in the most advanced stages of the disease.
These final stages, sclerotic and inflammatory hypodermatitis and ulceration, often lead to very painful end of life.
Varicose phlebitis (vein thrombosis) are much rarer than skin disorders. However, they can be more serious and lead to spreading of the thrombusinto the deep vein possibly causing apulmonary embolism.
Varicose phlebitis can occur at any time in the evolution of varicose disease but the risk increases with age and therefore the time the chronic disease has had to progress: their severity depends both on the diameter of the clogged vein and the proximity of the deep vein.
The occurrence of varicose phlebitis is increased by the same factors as deep phlebitis: smoking, oral contraception alone and in association with smoking, prolonged sitting (plane or coach trips for example), prolonged standing, local inflammations (inflammatory attacks in arthrosis of the knee for example) or a predisposed genetic disease (thrombophilia, chronic inflammatory disease).
If the percentage of the occurrence of varicose phlebitis is small in a first-line treatment among the population suffering from varicose disease, the percentage of its recurrence is much higher.
- The appearance of a varicose haemorrhage is even rarer, whether on very large varicose veins or on very dilated small spider veinson the feet and ankles, occurring almost always when they have reached the stage of hypodermatitis.
As for varicose phlebitis, the percentage of its recurrence is much higher.
It is therefore very important to consult a specialist after a varicose phlebitis or haemorrhage.
- The appearance of deep phlebitis (deep vein thrombosis, DVT) is increased among patients with varicose veins.
Causes of deep phlebitis are:- bed confinement, prolonged sitting (plane or car trips), plaster cast;
- hormonal factors (pregnancy), oral contraception alone and in association with smoking;
- inflammatory diseases and cancers;
- thrombophilia, which might spontaneously lead to phlebitis;
- congestive heart failure;
- traumas especially when they are very serious (car crashes, burns).
A Duplex scan is indispensable in order to make a proper diagnosis and to determine the appropriate therapeutic indication.
An annual Duplex scan and clinical examination is essential whatever the initial technique chosen.
Proper treatment and follow-up of varicose veins may prevent many complications, which may be irreversible.