Immediately contact the vascular registrar to arrange an urgent vascular assessment for:
- Ascending thrombophlebitis within 7 cm of the saphenofemoral junction
- Significant haemorrhage from varicose vein.
Criteria for referral to public hospital specialist clinic services
- Symptomatic varicose vein with a CEAP* classification of C3, C4, C5 or C6. That is varicose veins with these clinical characteristics:
- pigmentation, eczema, lipodermatoscerleosis, atrophie blanche
- healed venous ulcer
- active venous ulcer.
Information to be included in the referral
Information that must be provided:
- Description of oedema.
Provide if available:
- Current and previous imaging results.
The Summary and referral information lists the information that should be included in a referral request.
* CEAP classification: clinical findings, etiological factors, anatomical cause, pathophysiological cause
Note the indications for varicose vein procedures in the Elective Surgery Access Policy 2015:
Venous conditions with the following symptoms:
- Chronic leg swelling/oedema
- Chronic dermatitis/eczema
- Leg ulcers or infections
- Superficial thrombophlebitis.
Venous disorders in patients less than 16 years old
Excluded as indications for surgery are:
- Venous conditions which are unlikely to lead to the conditions listed above
- Cosmetic veins in patients greater than 16 years old
- Spider veins in patients greater than 16 years old.
Where appropriate and available the referral may be directed to an alternative specialist clinic or service.
Referral to a public hospital is not appropriate for
- Spider veins
- Varicose veins without symptoms or complications
- CEAP classification of C0, C1 or C2. That is varicose veins with these clinical characteristics:
- no visible or palpable signs of venous disease
- telangiectasias or reticular veins
- varicose veins.