Varicose veins are enlarged, tortuous veins seen in the legs and feet. They may occur as small spider veins or may become extremely enlarged. Varicose veins progress over a period of time, later giving rise to symptoms and may be responsible for multiple complications in some patients.

Symptoms of Venous Veins insufficiency:

Leg pain, aching or cramping
Burning or itching of the skin
Leg or ankle swelling
Heaviness of legs
Swelling in the ankles
Open wounds or sores
Skin pigmentation around the ankles
Skin discoloration or texture changes
Venous ulcers (non-healing wounds) around the ankles
Rupture of veins and bleeding
Development of clot formation (thrombosis)

Risk Factor of Venous Veins insufficiency:

Gender
Age
Heredity
Pregnancy
Standing occupation
Obesity
Prior injury or surgery
Sedentary lifestyle

The Spectrum of Varicose Veins

% of Population with Venous Insufficiency

ALL ABOUT VARICOSE VEINS

Compression stockings for Varcose Veins

Why Do Varicose Veins Develop?

Leg veins carry blood from the legs to the heart against gravity. These veins have many one-way valves, so that the blood goes up towards the heart only, and not downwards. If these valves are damaged, on standing up or sitting, the blood in the veins will now flow down into the legs due to the effect of gravity, leading to gradual dilatation and enlargement of the veins, leading to Varicose Veins.

Veins carry blood up to the heart

Blood going up Cannot come down

Leaking valves lead to vein enlargement

Normal & Varicose Veins

Incompetent vein valve

Common sites of vein valve leakage leading to Varicose Veins

Sapheno Femoral Valve Leakage

At the groin. Leads to enlargement of great saphenous vein from the groin to ankle

Sapheno Popliteal Valve Leakage

Behind the knee joint. The short saphenous vein gets dilated from the knee to the ankle

Perforator Vein Valves Leakage

Valves in the communicating veins between the superficial and deep veins leak giving rise to dark skin around the ankles

Indicates advanced Venous Insufficiency

Anterior Circumflex Vein Reflux

Doctors will gauge the severity of Varicose veins by the CEAP Method

“C” = Clinical Condition

C0 - no visible venous disease
C1 - telangiectasias or reticular veins
C2 - varicose veins
C3 - edema
C4 - skin changes without ulceration
- C4a – pigmentation or eczem
- C4b – LDS or “atrophie blanche”
C5 - skin changes with healed ulceration
C6 - skin changes with active ulceration

“E” = Etiology(Cause) (primary vs. secondary)

“A” = Anatomy (defines the location of the disease within superficial, deep and perforating venous systems)

“P” = Pathophysiology (reflux, obstruction, or both)

About Varicose Veins

Varicose Veins are Large Dilated, tortuous veins seen in the legs. They may be present Silently for many years, but in some people, they may be the cause of much agony. It is estimated that 41% of all women will suffer from abnormal leg veins by the time they are in the 50s.

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