MEDICO LEGAL M A G A Z I N E
VASCULAR SURGERY – A MEDICO-LEGAL OVERVIEW PART II By Mr Michael Gaunt MA, MD, FRCS. Consultant Vascular Surgeon, Cambridge
As discussed in the last issue, focussing on arterial conditions, vascular surgery is a high risk speciality for medicolegal claims, primarily because when problems occur within the vascular system they can do so quickly and with severe limb and lifethreatening complications. This article will concentrate on conditions of the venous and lymphatic systems.
Ve n o u s C o n d i t i o n s The veins are the low pressure vascular structures that return blood to the heart. One of the commonest venous conditions is varicose veins which can affect up to 1 in 4 of the adult population and their treatment is one of the commonest procedures performed in UK hospitals and clinics. Varicose veins occur when the one way valves inside the veins become incompetent resulting in abnormal blood flow which produces
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Sp o n s o re d by:
a spectrum of symptoms from mild cosmetic issues to non-healing venous ulcers. Treatment ranges from injection sclerotherapy to surgical ‘stripping’ of the veins. Traditional surgery can be associated with significant complications such as damage to nerves, major arteries and veins and deep vein thrombosis. Newer techniques include the less invasive endothermal ablation techniques such as the endovenous laser (EVLA) or VNUS Closure methods which appear to be associated with a lower incidence of such problems, however complications and poor outcomes still occur. Thrombosis can occur in arteries or veins. Thrombus forms in flowing blood whereas clot forms in blood that has ceased to flow. Thrombosis can occur to block or partially block an artery or vein in one part of the body and then a piece of thrombus can break off and be carried in the blood stream to lodge
