Etiology

Definition    Varicose veins are defined as a permanent deformation of the superficial venous system. The veins become enlarged and tortuous

Synonym : Chronic Venous Insufficiency (CVI) (of the legs)

Physiopathology  

Varicose veins are a disease that affects the superficial venous system (internal or external saphenous veins). The veins become :

-Dilated (distended, widened)

- Incontinent at the leak points : arches of the saphenous veins, perforating veins…

- Incontinent (blood flowing the wrong way – up to down -) past the anti-reflux valves.

The consequence of this blood stasis is a chronic edema. 

Cost 

Chronic Venous Insufficiency of the legs an important issue economically and a major health

Epidemiology 

varicose veins affect 1 out of 10 adult.

Age: rare before adolescence. It is a disease of young people around 30.

Gender: It affects women 80% of the time.

Varicose veins’ major complication is phlebitis (approx. 250 000 a year) and lethal pulmonary embolism in 25 000 of these patients.

To prevent this, the treatment is a surgical one.

Etiology of the Primary varicose veins  :   the more frequent ones

Their exact cause is unknown, but it seems to come from a hereditary pathology of the vein walls.

-Familial disposition: family antecedents in 80% of cases. Relative Risk = 2 if 1 parent with a varicose veins history and = 3.1 if 2 parents with a varicose veins history.

-Prolonged standing

-Obese or overweight

-Hormonal treatment

-Occident: The incidence rate is higher than Africa, Asia or Oceania. Moreover, migrants are very quickly as much at risk as the country in which they move to, which eliminates the race factor.

-Sedentary life style.

-Tight clothes.

-Chair-sitting.

-Pregnancies > 3.

-Chronic constipation.

-Anomaly of the arch of the foot (flat foot or hollow foot).

The secondary varicose veins are most often post-phlebitis.