Varicose veins overview

Jump to navigation Jump to search

Varicose veins Microchapters


Patient Information


Historical Perspective




Differentiating Varicose veins from other Diseases

Epidemiology and Demographics

Risk Factors


Natural History, Complications and Prognosis


History and Symptoms

Physical Examination

Laboratory Findings




Other Imaging Findings

Other Diagnostic Studies


Medical Therapy


Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Varicose veins overview On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides


American Roentgen Ray Society Images of Varicose veins overview

All Images
Echo & Ultrasound
CT Images

Ongoing Trials at Clinical

US National Guidelines Clearinghouse


FDA on Varicose veins overview

on Varicose veins overview

Varicose veins overview in the news

Blogs on Varicose veins overview

Directions to Hospitals Treating Varicose veins

Risk calculators and risk factors for Varicose veins overview

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [3]


Varicose veins are veins that have become enlarged and twisted. The term commonly refers to the veins on the leg, although varicose veins occur elsewhere. Veins have leaflet valves to prevent blood from flowing backwards (retrograde). Leg muscles pump the blood in veins to return it to the heart. When veins become enlarged, the leaflets of the valves no longer meet properly, and the valves don't work. A common cause of valve failure is Deep Vein Thrombosis (DVT), which can cause permanent damage to the valves. The blood collects in the veins and they enlarge even more. Varicose veins are common in the superficial veins of the legs, which are subject to high pressure when standing.


Varicose veins are more common in women than in men, and are linked with heredity.[1] Other related factors are pregnancy, obesity, menopause, aging, prolonged standing, leg injury and abdominal straining. Varicose veins are bulging veins that are larger than spider veins, typically 3 mm or more in diameter.[2] Varicose veins are distinguished from reticular veins (blue veins) and telangiectasias (spider veins) which also involve valvular insufficiency,[3] by the size and location of the veins.

Natural History, Complications and Prognosis

These often occur in people who are involved in work requiring prolonged periods of standing. The high pressure that builds up during those periods cause the veins to become tortuous and their valves to fail. With time, these varicosities can enlarge and cause swelling as well as pain of legs at the end of the day. Eventually, these can become associated with superficial ulcers which can bleed and/or get infected. Stagnation of the venous blood in these veins can also lead to formation of blood clots.

Serious complications are rare but severe varicosities can lead to major complications such as thrombophlebitis, venous ulcers & clotting of blood[4], due to the poor circulation through the affected limb.



Besides cosmetic problems, varicose veins are often tortuous and painful, especially when standing or walking. They often itch, and scratching them can cause ulcers.


Medical Therapy

Non-surgical treatments include sclerotherapy, elastic stockings, elevating the legs, and exercise. The traditional surgical treatment has been vein stripping to remove the affected veins. Newer surgical treatments are less invasive (see radiofrequency ablation) and are slowly replacing traditional surgical treatments. Since most of the blood in the legs is returned by the deep veins, and the superficial veins only return about 10%, they can be removed or ablated without serious harm.[5]


Several techniques have been performed for over a century, from the more invasive named "saphenous stripping" up to mini invasives like superficial phlectomies and CHIVA cure.


  1. Ng M, Andrew T, Spector T, Jeffery S (2005). "Linkage to the FOXC2 region of chromosome 16 for varicose veins in otherwise healthy, unselected sibling pairs". J Med Genet. 42 (3): 235–9. PMID 15744037.
  2. NHS Direct[1]
  3. Weiss R A, Weiss M A, Doppler Ultrasound Findings in Reticular Veins of the Thigh Subdermic Lateral Venous System and Implications for Sclerotherapy, Journal of Derm Surg Onc, Vol 19 No 10 (Oct 1993) p947-951.
  4. "Complications of Varicose veins". NHS.
  5. Merck Manual Home Edition, 2nd ed.[2]

Template:WH Template:WS