In terms of general incidence, it may be said that 10 to 20% of the population is affected by varicose veins of the lower limbs. Varicose veins are dilations of superficial veins on the lower limbs which alter the flow direction of blood, leading to the formation of fibrosis of the subcutaneous cellular tissue, ulcers (lesions) and predisposition to thrombosis. The treatment of varicose veins has various objectives: the prevention of complications (phlebitis, ulcers, changes in the skin); the relieve pain, weight and oedema (swelling); improvement in the appearance of the limb (aesthetic). There are different methods of treating varicose veins on lower limbs, all of which seek to eliminate deficient veins. These include surgical removal, thermal ablation (coagulation) or chemical ablation (sclerosis). When choosing between the different types of treatment, it is important to consider the type and distribution of the varicose veins, factors inherent to the patient ranging from age to existence of associated diseases, and the surgeon’s experience and preferences. Although the standard treatment is currently traditional surgical removal of varicose veins, new, less aggressive techniques in which only the affected veins are treated, preserving the healthy veins, are becoming ever more valid and successful alternatives.
Deep vein thrombosis is a potentially serious disease caused by the formation of clots (thrombus) in the interior of deep veins. These clots are most commonly formed in the veins of the leg (calf), but they may also appear in the thigh and occasionally in the upper limbs. The importance of venous thrombosis results from two types of complications. Firstly, in the early stages the clot may move up to the lung and block an artery. This condition is called pulmonary embolism and may be fatal depending on the size of the clot and size of the affected area. Secondly, chronic venous insufficiency or post-thrombotic syndrome may occur at late stages due to the destruction of the vein valves. Various therapeutic options are available for vascular surgery including anticoagulation and fibrinolysis, or depending on the circumstances even endovascular stenting or surgical venous bypass treatment.
Chronic venous insufficiency is defined as an anomaly in the functioning of the venous system which is caused by a problem with vein valves, and may or may not be associated with the obstruction of venous flow. It may affect the superficial venous system, the deep venous system or both. In addition, venous dysfunction may result from a congenital disorder or may be acquired. It is an extremely significant disease affecting people from different age groups and one which may cause serious socioeconomic problems. It has high rates of incidence and prevalence, and is associated with varicose veins, ulcers and trophic lesions on the lower limbs. Diagnosis is clinical and, when necessary, additional diagnostic tests are performed, such as venous ultrasound scans. Treatment uses conservative methods such as elastic socks or bands, specific local care and minimal invasive surgical procedures.