[Diagnosis and treatment of acute ascending lower limb varicophlebitis in geriatric population]

Acute lower limb varicophlebitis is generally considered as a nonhazardous condition. In spite of that notion, acute ascending varicophlebitis (AAVP) involving proximal part of saphenous trunks with propagation of thrombus into deep veins may cause life-threatening complications--deep vein thrombosis and pulmonary embolism. Difficulties in AAVP diagnosis in elderly individuals account for untypical insidious clinical presentation and inadequate interpretation of symptoms by patient. Duplex scanning of lower limb veins is one of the most valuable diagnostic tools that influence the management of patients with AAVP. Elderly age is not a contraindication for surgery in patients with AAVP. Ligation of SFJ (SPJ) constitutes the main operative step, preventing progression of thrombosis and PE. In the absence of marked local inflammation at the site of thrombosed veins, varicosities may be removed simultaneously using minimally invasive techniques--perforating inversion saphenous stripping and hook phlebectomy. Further management of elderly patients with thrombosed vein recanalization is specified according to clinical findings and duplex scanning of the veins.