Evaluation and Management of Primary Varicose Veins of Lower Limb in A Tertiary Care Centre

Abstract

Introduction: Incompetent valves of deep, superficial or perforating veins lead to varicose veins. Dilated, elongated or tortuous subcutaneous veins of lower legs are a manifestation of increase in venous pressure. This increase in venous pressure results from the reflux of blood due to incompetence. The diseased Great Saphenous Vein (GSV) is removed by High Saphenous Ligation and Stripping (HLS) surgery. Aims and Objectives: To study the clinical and socio-demographic profile, precipitating factors/ risk factors, complications and clinical outcomes of management of varicose veins. Material and Methods: Data collected from 150 patients with varicose veins by appropriate history taking and clinical examination, relevant radiological and laboratory investigations and follow-up of cases to study the clinical outcome. Results: Study was conducted with 150 patients. Most common age group affected with primary varicose veins was between 41-60 yrs of age with male predominance (64.7%). Most of the cases in present study were engaged in work involving long standing hours i.e. farming (34%) and housewives (28%). Most common presenting complaints were oedema (88%), dilated veins (74%) and pain (71.3%). Conservative management was tried in all cases while Trendelenburg operation and SPJ ligation was done in 26.7% and 9.3% cases. Stripping and PERF ligation was done in 28.7% and 25.3% cases respectively. A total of 24.7% were lost to follow up. By the end of 6 month, quality of life improved in 70% cases. By the end of 6 month, symptoms improved in 72.5% cases while it disappeared in 26.5% cases. Conclusion: Males have been found to have larger incidence than females. They are mostly affected in their fourth and fifth decade of life. Ulceration and pain are the frequent findings in this condition. Compression stocking has beneficial effects if prolonged standing cannot be avoided during work hours. Trendelenburg operation with flush ligation with subfascial or extra fascial stripping is the definitive management and shows significant clinical improvement.