Physiology

Veins are blood vessels which return blood from various parts of the body to the heart after the blood has circulated through the tissues and organs. To overcome the force of gravity, leg vein blood must be pumped upward through one-way valves that open toward the heart allowing venous blood flow back to the pelvis. The valves normally close between each muscle contraction to prevent reflux of blood back down through the veins below the level of the groin.

When valves fail to function properly, they open in the opposite direction beyond the normal checkpoint (reflux) allowing downward pressure in the veins to increase. This condition is known as venous insufficiency, venous reflux disease or chronic venous insufficiency. As pressure increases in the veins over long periods of time this results in the development of bulging varicose veins, oozing of serum (water and protein) through the vein walls into the surrounding tissues resulting in edema (swelling) and other complications.

The more advanced complications of skin discoloration and eventual scarring of the skin and fat to the underlying muscle (stasis dermatitis or lipodermatosclerosis) may lead to the development of recurrent skin infections and venous ulcerations. The longer this condition is present the more damage from the leaking serum (red and white blood cells) will occur. With modern and accurate diagnostic testing, and effective minimally invasive treatments such as endovenous closure, a more proactive and preventative approach to venous insufficiency is clearly warranted to reduce the long term complications of this disease.

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