Varicose Veins

  • Rishi Mandavia
  • Muzaffar A. Anwar
  • Alun H. DaviesEmail author


Varicose veins are characterized by tortuous and dilated veins that are incompetent in terms of their ability to pump venous blood in sufficient amounts back to the heart. The disease mainly affects the lower limbs [1]. Varicose veins can cause significant morbidity and negatively impact quality of life [2]. Symptoms include pain, heaviness, aching, swelling, restless legs, cramps, and itching. Complications of varicose veins include bleeding and skin changes including lipodermatosclerosis (an inflammation of the fat layer below the epidermis) and ulceration [1]. The etiology of varicose veins is unclear. Our current understanding is that varicose veins are a manifestation of chronic venous insufficiency (CVI), whereby return of venous blood is impaired owing to calf muscle pump failure (i.e., the ability to press venous blood toward the heart via calf muscle contractions), venous obstruction, or reflux. This causes an increase in venous blood pressure resulting in swelling of the leg and the cutaneous manifestations characteristic of this condition [3]. Risk factors for varicose veins include female sex, obesity, pregnancy, positive family history, prolonged standing, and a past history of deep vein thrombosis. The reported incidence of varicose veins is variable, ranging from 2 to 56 % in men and 1 to 73 % in women [4]. Diagnosis is clinical, reliant on clinical history and examination. The gold standard imaging technique is color duplex ultrasound enabling assessment of the deep and superficial venous systems.


Varicose Vein Vein Wall Chronic Venous Insufficiency Chronic Venous Insufficiency Calcium Dobesilate 
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Copyright information

© Springer-Verlag Wien 2014

Authors and Affiliations

  • Rishi Mandavia
    • 1
  • Muzaffar A. Anwar
    • 1
  • Alun H. Davies
    • 1
    Email author
  1. 1.Academic Section of Vascular SurgeryImperial College London, Charing Cross HospitalLondonUK

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