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Venous insufficiency

Definition, risk factors, symptoms, evaluation, prevention and treatment

Circulatory system

To understand venous insufficiency, we must first understand the circulatory system.

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Oxygen-rich blood is pushed through arteries and capillaries to the body’s cells by the pumping action of the heart. Deoxygenated blood then travels back through veins to the lungs before returning to the heart. In the lower limbs, muscles act as pumps that send the blood upwards, fighting against gravity. Unidirectional valves also prevent blood from flowing back down.

Once a vein dilates, the valves no longer perform their function, causing blood flowing upwards to stagnate and sometimes even flow back down. Venous insufficiency is therefore caused by poor venous drainage. Over time, this issue affects venous branches too, creating varicose veins.

What are varicose veins?

Located underneath the skin, a varicose vein is a superficial vein that has become dilated, tortuous, and non-functional. Bluish and slightly raised, varicose veins are permanent and most often found on the lower limbs. Evolution of most varicose veins can be treated and controlled through a variety of methods. In addition, the symptoms associated with varicose veins can be relieved by preventing their formation.

Types of varicose veins

There are many different types of varicose veins, which are differentiated based on their size and location.

In most cases, varicose veins occur in superficial veins (accessory veins) along the legs, and often result from insufficiency in the internal or external (trunk) saphenous veins.

In a minority of cases, varicose veins can lead to superficial thrombosis caused by the inflammation of a vein.

If left untreated, venous insufficiency can lead to complications such as ulcers
or superficial thrombosis (thrombophlebitis). Around 80% of people aged 18 and 64 are
thought to have varicose veins or, at least, spider veins. It is estimated that around 1% of the population suffers or
has suffered from venous ulcers.

What are the risk factors?

Specific factors can increase the risk of developing varicose veins:

  • Heredity is one of the main causes.
  • Women are four times more susceptible to venous reflux than men, because hormones have a significant impact on vein walls. This is even more noticeable during pregnancy.
  • Loss of tissue elasticity due to aging weakens vein valves.

Other factors can also hasten the onset of varicose veins:

  • An increase in body weight, which increases blood pressure.
  • Standing or sitting for long periods of time, because blood pressure in the lower limbs is influenced by gravity.
  • Physical trauma to the legs can sometimes damage blood vessels.

What are the symptoms and complications of varicose veins
and how are they evaluated?


Symptoms of varicose veins manifest differently from one person to the next.

Therefore, any of the following symptoms may be observed:

  • Fatigue, heaviness and pain
  • Blue
    or violet subcutaneous discolouration and venous dilation
  • Edema
  • Cramps

Possible complications

  • Eczema
  • Pigmentation (stasis dermatitis)
  • Ulceration
  • Bleeding
  • Thrombophlebitis

Some individuals may exhibit few or no symptoms.


After filling out a questionnaire, the patient’s legs and feet are examined while in standing position.

Depending on the severity of the problem, a Doppler ultrasound (Duplex) may be performed to confirm diagnosis and establish proper treatment. This is a simple and painless exam that is conducted right at the clinic.

How can varicose veins be prevented and treated?



  • Healthy life habits
  • Compression stockings


  • Sclerotherapy
  • Endovenous
    radiofrequency ablation
  • Outpatient phlebectomy
  • Echosclerotherapy
  • Surgery