WHAT ARE VARICOSE VEINS?

 

Varicose veins are the pathological enlargement of the veins in our body. This enlargement can occur in every part of our body (eg liver, bowel, testicle, abdomen), but most commonly occurs in the legs. For the formation of varicose veins, the venous blood pressure must be increased. This may in some cases be due to obstruction of the main vein or abnormal connections between the artery and vein, such as arteriovenous fistula, malformation (AVM, AVF). However, the most important cause of varicose veins in the leg is venous insufficiency, which is the failure of the one way walves in the veins.

Not all the enlarged vessels are varicose veins

Varicose veins are most commonly seen in our legs because of the effect of gravity. They can be of various types and sizes. In general, varices begin to develop years after venous insufficiency.  Over time, both the severity of venous insufficiency and the size of varicose veins increase.

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Varicose veins in our legs are most commonly caused by venous insufficiency in the superficial vessels, and in this case, both superficial venous insufficiency and varicose veins can be treated easily. However, the veins that appear to be varicose veins in the leg can sometimes be the "bypass" vessels that our body produces to overcome an obstruction or incompetence in deep veins.  If these "useful" veins are mistaken for ordinary varicose veins and removed surgically or closed with sclerotherapy, the circulation will be further impaired and the leg will be worse then before. These bypass veins can be differentiated from classic varicose vein with a careful color Doppler ultrasound examination. Similarly, if the veins that look like varicose veins result from abnormal connections between the leg artery and vein (such as fistula, malformation) they should be treated with a completely different method such as by occluding these abnormal connections angiographically (embolization). This condition also can be differentiated with a good color Doppler examination.

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In conclusion, varicose veins in our legs are swollen vessels formed as a result of increased pressure of the venous blood. However, not every swollen vein is classic varicose vein of the type we understand. In some cases, they may occur due to other reasons that may need to be handled and treated differently. Therefore, each varicose vein patient should be evaluated in detail by experienced physicians, especially with a meticulous color Doppler ultrasound examination, to identify the underlying causes correctly.

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 Video: Why is Doppler ultrasound so important in varicose veins?