Ectatic or varicose and reticular veins near the ankle indicate that there may be truncal or axial venous insufficiency or both. Truncal venous insufficiency can originate at the saphenofemoral junction at the saphenopopliteal junction and involve the short saphenous vein, or segmental reflux (at least 6 types) of the great saphenous vein. Axial reflux occurs from perforator veins of the Cockett's type (old terminology) within 18 cm of the ankle bone and can cause this type of problem as you show in the picture - causing reticular and varicose veins and corona phlebectasia. A venous Duplex scan needs to be done along with vein mapping (Vein Lite examination) to make a treatment plan for you. Seek a board certified vein specialist - that does not mean a urologist who is board certified, but rather, a physician who has added board certification from the American Board of Venous and Lymphatic Medicine.