A Brief Review of Varicose Veins in the Upper Limb from an Ayurvedic Perspective

Abstract

Varicose veins typically occur in the lower limbs, caused by valvular insufficiency leading to the swelling and tortuosity of subcutaneous veins. Although rare in the upper limbs, they can be successfully diagnosed and treated. Rare causes include congenital vascular anomalies like Klippel-Trenaunay syndrome and Parkes Weber syndrome, characterised by Arteriovenous (AV) fistulae. Subclavian vein thrombosis-induced venous outflow obstruction is another uncommon cause. Diagnosis involves a thorough history taking with clinical examination, often supplemented by investigations. Invasive procedures are rarely necessary but may be used in unique cases to define the pathology further. Treatment for upper limb varicose veins closely mirrors lower limb approaches. The stab-avulsion technique combined with stripping of lengthier sections yields outstanding cosmetic and functional results. Surgical ligation with stripping effectively eliminates varicosities with a low risk of recurrence. Sclerosing agents like Sodium Tetradecyl Sulphate and Polidocanol are substitutes for surgery. In cases of varicosities resulting from upper limb arteriovenous fistulae, surgical intervention involving ligation of the distal venous limb or division of the fistula is the standard approach. In summary, while upper limb varicose veins are exceptionally rare, they can be accurately diagnosed and effectively treated with surgical interventions similar to lower limb varicose veins.