The Complications of the Varicose Veins  

We call Type 4 or CVD - Complicated Venous Disease all of the situations where complications have already happened. The most frequent complications are Trombophebitis, the Leg Ulcers, Hyper-pigmentations , the Venous Eczema, the Bleeding, Fibrosis, the Ocre Dermatitis, the Infections, the Pain, and  the  Clot of Lung. They are usually patients who have had this problem for a very  long time.   

All these types  follow an evolution, but it does not mean that one type  will necessarily evolute to the other. The varicose veins always get worse, but each patient will have a different history and it doesn't mean, although it is possible, that the type 1 will turn into type 4.  

Trombophlebitis  

The blood should flow inside of the vases, without interruptions. However, when  a bleeding happens as in an accident or caused by some disease, or even a controlled bleeding as the ones of any surgery, the body tries to protect itself and control this situation that causes a risk of death. The most important is the coagulation system. The coagulation then is a good thing, when it happens for protection. But in certain situations this coagulation system can malfunction and  cause serious problems.  

When a vein has sick walls, as in the varicose veins, or if the system that makes the blood flow, the venous  pump of the calf is working poorly, as in forced rests because of diseases or in long  trips, the Venous Thrombosis can happen.  

The Venous Thrombosis can be superficial or deep. The superficial happens in the vases of the surface of the member and the deep in the internal vases of the leg . 

Superficial Trombophlebitis   

The venous thrombosis can have several causes, and among them, the Varicose Veins. When the coagulation of the  blood inside the superficial veins happens, it is called Superficial Trombophlebitis.  

When the veins of the members are extensive, as in the varicose veins, the whole process of flow of the blood is in jeopardy. We can say, in a simple way, that when the blood doesn't have a good flow in  vein, it tends to coagulate, forming a clot (the thrombus) inside  the vein.  The superficial thrombophlebitis  is one of the complications of the varicose veins. A coagulation inside the vase happens, interrupting the circulation as if it was a cork.  

The patient complains about  pain, redness and swelling in the  varicose veins.  The Superficial Venous Thrombosis has an effective treatment, but the great problem is that,  although rarely, the clot can progress through the superficial veins to the deep veins. It can also, starting from the deep veins or through great superficial veins, release small pieces of coagulated blood, the embolus.  

The embolus  can, through the circulation, reach the lung. It stops there, impeding the circulation to happen and putting the life in risk. The progression of a Thrombus to the lung is called  the  Clot of Lung or Pulmonary Embolism.  

Deep Venous Thrombosis 

The Deep Venous Thrombosis, or DVT, is a fearsome occurrence, because it puts in risk the patient's life.  Several are its causes, and one of them is the presence of Varicose Veins of Lower Extremities. It is a serious disease that is characterized by the formation of clots inside the deep veins of the leg. One of its main consequences in a  short term is  the Clot of Lung which can lead to death,  prolong or   complicate  hospitalization after a surgery or even make the individual disabled for certain social activities and work, when it causes sequelae. 

The pos-phlebitic syndrome  can happen some years after DVT. It is characterized by swelling, dark coloration and hardening of the skin, eczema (chronic allergy of the skin) and ulcers (wounds)  due to the alterations and scars left by DVT  in the venous system. Certain people have  risk factors for this disease. There are certain situations that can cause the disease; they are the risk situations. The individual factors and risk situations can characterize the patient as being in the risk group for the development of the disease. This risk is called   Thromboembolic Risk . 

   We can mention as main individual risk factors for DVT, besides the varicose veins: people older than   40 years old, obesity, individuals who have  already had thrombosis, the use of contraceptives and therapy of hormonal replacement, neoplasy, pregnancy  and puerperal period, individuals with genetic abnormality of the coagulation system, traumatisms, surgeries, immobilization for long periods,  hospitalization, diseases of the  heart or lungs, and serious infections. 

Pulmonary Embolism

         The Lung Clots happens when a piece of the clot that was formed inside the deep veins of the leg is released and  reaches the blood vessels of the lungs. Depending on the size of the clot, the person cannot survive. In the case of varicose veins, although it can happen,  the Pulmonary Embolism  is a rare occurrence.   

Dermatitis Ocre 

The difficulty that the blood has to return to the heart in the cases of varicose veins, ends up in stasis and swelling . The  swelling and stasis  cause a series of alterations in the lower extremities, mainly in the more distal part. The  migration to the skin of elements of the blood happens, and they stay in places where they should not be. The presence of iron, derived of the hemoglobin of the blood,  gives the skin of the leg or the ankle  a dark and rusty aspect, called "Dermatitis  Ocre."  

Eczema 

Blood  stasis also causes  the inflammation of the skin, resulting in a venous eczema. The skin itches, peels and swells. It is an unpleasant and inconvenient problem caused by the varicose veins. 

Varicose Ulcer

It is a difficult to control complication of the varicose veins. Furthermore, it is an unpleasant condition.  The Venous Ulcer appears after a long evolution of the varicose veins. It is a wound, that  can have a great extension, reaching a great part of the individual's leg.  

Bleeding

The Bleeding is a serious complication that  happens when the varicose vein increases so much of size, that breaks  the skin that  recovers the vein and  perforates it, causing  a profuse bleeding.  

Swelling

It is a sign of venous stasis. The individual's lower extremities are swollen, mainly in the end of the day.  

Pain 

Usually the patients with varicose veins complain about pain in the lower extremities associated with the weight and fatigue sensation that gets worse with the heat. Other factors may cause pain, such as sitting or standing for very long periods of time during the day, being, therefore, more intense in the end  of the afternoon.  In the women those uncomfortable symptoms tend to get worse  in the premenstrual period and pregnancy. Associated with these symptoms, people usually complain about itching, tingling, heat, cramps, and the swelling of the ankles and lower extremities. These symptoms are proportional to the amount of varicose veins. 

The order in which the complications appear

In a large number of patients, the varicose veins can be present  for many years without complications, but the treatment should not be postponed, because the complications can take many years to appear, When they finally appear in a more advanced age, the effective treatment cannot be established anymore.  

In the beginning of the evolution of the Varicose Veins of lower extremities, it is observed the weight sensation or fatigue in the end of the day. The visible varicose veins of several sizes appear slowly. The edema begins to appear in the end of the day. After there is the pigmentation (dermatitis ocre) and  eczemas may  appear. In evolution of the disease, Trombophlebitis, ulcers and bleeding may occur .  

Click to enlarge - complications photos

Attention : Real photos , we do not recomend this part of the site for very sensitive persons

corona flebectática	hiperpigmentation and eczema	hiperpigmentation and dermatosclerosis	venous ulcer	venous ulcer and ankle anquilosis
telangiectasias bleeding	telangiectasias bleeding - microphoto	Trombophlebitis	Trombophlebitis close	Trombophlebitis microphoto
Venous ulcer with inflamation and infection	eczema and skin atrophy