Varicose Vein

Overview
  • Varicose Veins are tortuous, dilated veins which develop due to long-term increases in venous intraluminal pressure. Although varicosities are frequently associated with luminal thrombosis they only rarely generate thromboemboli.
Pathophysiology
  • Overview
    • Varicosities are thought to be caused by chronic increases in venous intraluminal pressure leading to loss of vascular wall support and thus dilation.
  • Primary Disease
    • Varicosities in the absence of other disease processes are considered "primary" varicosities. These are usually observed in the superficial veins of the dependent areas of the body, such as the legs, which can encounter large intraluminal pressures during extended periods of standing or sitting, especially during pregnancy.
  • Secondary Disease
    • Secondary disease is usually associated with a different disease process which causes venous stasis and thus increased venous pressure. Esophageal varices are essentially varicosities present in the esophagus associated with portal hypertension usually as a result of cirrhosis. Hemorrhoids are essentially varicosities present in the anus associated with increased venous intraluminal pressure due to a number of possible pathogenic mechanisms.
Clinical Consequences
  • The clinical consequences of esophageal varices and hemorrhoids are covered on their own pages. Primary varices are usually only of cosmetic concern. However, poor venous return from involved tissues, especially in the legs, can lead to localized peripheral edema, skin changes, and poor wound healing.