What Causes Varicose Veins?
Doctor Answers 3
The cause of varicose veins
Varicose veins could occur in isolation or can result from associated venous reflux disease. Venous reflux disease occurs in 10% of patients with varicose veins. However, it is important when treating varicose veins to determine if the patient has venous reflux disease.
If venous reflux disease is found, it is treated now with VNUS Closure or EVLT (endovenous laser therapy). Once VNUS Closure is performed, the varicose veins that are still there are treated with microphlebectomy, and rarely with treaditional sclerotherapy.
Other factors that contribute to the formation of varicose veins include obesity, hormonal changes (women), family history of varicose veins and venous stasis ulcers and male parent with varicose veins and venous reflux disease, among others.
Malfunctioning venous valves.
Varicose veins ARE a result of venous reflux disease. Think of your veins like a tree with the trunk containing the valves. If the valves malfunction then the venous pressure backs up and this leads to the blood being directed into the branches rather than up the trunk resulting in varicose veins. This process is called venous insufficiency with reflux. There are many potential factors that can lead to venous insufficiency including genetics, pregnancy, standing or sitting for long periods of time and even trauma. A full venous evaluation by a vein specialist would help to make the diagnosis and formulate a treatment plan.
Multifactorial Causes of Varicose Veins, genetic and lifestyle related
Varicose veins are almost never formed in isolation; there is most often, a deeper, larger, vein that is "incompetent" that connects to the superficial, visible varicose vein. This is the "Venous Reflux" disease that you have heard of.
This refluxing vein is usually the greater or lesser saphenous vein with valves that are not functioning normally. These root cause veins typically give rise to the varicose veins seen on the surface, and thus, to treat the varicose most effectively, the incompetent saphenous vein needs to be diagnosed first with a duplex ultrasound. Once identified, the vein can be treated with laser or radiofrequency (EVLT or VNUS), and the microphlebectomies performed at the same time to remove the varicose veins. This can most often be performed under local anesthesia under 1 hr. To simply treat the varicose veins with sclero/laser without treating the root cause will lead to multiple recurrences and failed treatments.
The most common causes of varicose veins is largely genetic with a higher female prevalance. Lifestyle issues with pregnancy, obesity, and work (people who stand on their feet all day), can tip the balance to forming varicose veins.
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