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Samwel Mikaye: A Practical Guide to Varicose Veins and Deep Vein Thrombosis
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.”

Samwel Mikaye: A Practical Guide to Varicose Veins and Deep Vein Thrombosis

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