Dr. S.0 MIKAYE / LinkedIn
Jun 5, 2026, 16:59
Samwel Mikaye: A Practical Guide to Varicose Veins and Deep Vein Thrombosis
Samwel Mikaye, Medical Doctor at MSK, shared a post on LinkedIn:
”Varicose Veins
Varicose veins are enlarged, dilated, tortuous superficial veins caused by incompetent venous valves, usually affecting the legs.
Risk Factors
- Prolonged standing
- Pregnancy
- Obesity
- Increasing age
- Female sex
- Family history
- Lack of exercise
Pathophysiology
Valve incompetence – venous reflux – venous hypertension – vein dilation and tortuosity.
Clinical Features
- Visible twisted superficial veins
- Leg heaviness
- Aching pain
- Swelling
- Itching
- Night cramps
- Symptoms worsen after prolonged standing
Complications
- Venous ulcers
- Bleeding
- Thrombophlebitis
- Skin pigmentation
- Eczema
Investigations
- Mainly clinical diagnosis
- Duplex Doppler ultrasound Management Conservative
- Leg elevation
- Exercise
- Weight reduction
- Compression stockings Medical/Surgical
- Sclerotherapy
- Endovenous laser therapy
- Radiofrequency ablation
- Vein stripping surgery
Deep Vein Thrombosis (DVT)
Deep vein thrombosis (DVT) is formation of a blood clot in a deep vein, commonly in the legs.
Risk Factors (Virchow Triad)
Venous stasis
- Immobilization
- Long travel
- Bed rest Endothelial injury
- Surgery
- Trauma
Hypercoagulability
- Pregnancy
- Cancer
- Oral contraceptives
- Thrombophilia
Clinical Features
- Unilateral leg swelling
- Calf pain/tenderness
- Warmth
- Redness
- Dilated superficial veins
- Positive Homans sign (not reliable)
Complications
- Pulmonary embolism (major complication)
- Post-thrombotic syndrome
- Recurrent DVT
Investigations
- D-dimer
- Doppler ultrasound
- Venography (rare)
- Coagulation profile
Management Anticoagulation
- Heparin/LMWH
- Warfarin
- DOACs (e.g. rivaroxaban)
Other Measures
- Compression stockings
- Early mobilization
- Thrombolysis in severe cases
- IVC filter if anticoagulation contraindicated.”
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