What is chronic superficial venous insufficiency and why does it cause varicose veins?

Chronic superficial venous insufficiency is the disease process which causes varicose veins. Blood returning via the superficial veins have an uphill battle, literally. As they rely almost entirely on these one-way valves to help return blood to the heart against gravity, one could imagine what the consequences of valve failure might be.

When that blood refluxes down the superficial vein in the wrong direction, it pools in the lowest, most dependent veins and engorges and dilates them. For many people, these enlarged, swollen veins bulge out of the skin and are known as varicose veins and are a direct result of increased pressure from reflux. For others, the dilated veins are in the subcutaneous tissue (not visible on the skin surface) or manifest in other ways, like skin discoloration from poor skin circulation (stasis dermatitis) or purplish discoloration of the ankle with numerous tiny veins (corona phlebectatica).

Regardless of whether or not there is an outward manifestation of these dilated, engorged veins in the leg, symptoms nearly always accompany these incompetent veins. The symptoms are generally the body’s reaction to blood stasis in these veins, and includes classic dull/aching pain, tired and heavy legs at the end of the day, restlessness and cramping/charley horses at night, and ankle swelling.

Normal vs Incompetent Vein Valves with RefluxNormal vein valves on the left versus incompetent valves with reflux on the right.

Normal vs Malfunctioning Valves

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