Varicose veins natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Complications

Most varicose veins are relatively benign, but severe varicosities can lead to major complications, due to the poor circulation through the affected limb.

• Pain, heaviness, inability to walk or stand for long hours thus hindering work
• Skin conditions / Dermatitis which could predispose skin loss
• Bleeding : life threatening bleed from injury to the varicose vein
• Ulcer : non healing varicose ulcer could threaten limb amputation.
• Development of carcinoma or sarcoma in longstanding venous ulcers. There have been over 100 reported cases of malignant transformation and the rate is reported as 0.4% to 1%.
• Coagulation of blood in varicose veins cause superficial thrombosis, deep vein thrombosis (DVT), Pulmonary Embolism (PE) & could precipitate stroke in the rare case of predisposed individuals (that is, patients with patent foramen ovale).