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Leg Vein
Problems THE VEINS IN YOUR LEGS
An understanding of varicose veins and venous
insufficiency begins with understanding the unusual
arrangement of the veins in your legs. You really have two
venous systems. You can see the superficial veins under your
skin. When these become dilated and tortuous, they are
called varicose veins. The word "varicose" comes from the
Latin for dilated. The longest and largest of these veins is
connected to the femoral vein and courses down the inner
aspect of your thigh and leg. It is called THE GREATER
(longer) SAPHENOUS VEIN. Another large superficial vein
begins behind the knee and runs down the back of the calf of
your leg. It is THE LESSER (shorter) SAPHENOUS VEIN. Both
have branches that extend under the skin.
The second venous system in your legs, comprising the deep
veins, begins with the femoral vein and runs deep inside the
leg muscles. The deep veins carry the greatest portion of
blood from your legs to be returned to your heart. That is
no small amount, as the leg veins may hold as much as 70
percent of your total blood volume, depending on your
posture.
The superficial veins are connected to the deep veins by
short veins called PERFORATING VEINS. It is important to
realize that the superficial veins drain through these
perforating veins directly into the deep veins. As blood
flows faster and faster through the deep veins to return to
your heart, the flow literally sucks blood out of the
superficial veins and empties them. If the deep veins are
obstructed, that will affect the superficial veins as well.
But you can have abnormalities of the superficial veins and
have normal deep veins. This is often the case when one has
uncomplicated varicose veins, without symptoms.
Another unique feature of the veins in your legs is that
they have valves. These are just two flaps that open and
allow the blood to flow toward your heart. They float open
with the blood flow. They flap together to prevent the blood
from flowing backward toward your toes. There are two
distinct features of varicose veins. First, they are swollen
and dilated, and second, the valves inside them do not work.
The veins are thin-walled, but they do contain a muscular
layer and elastic fibers.
When the elastic and muscular layer are overstretched,
the vein is a lot like a balloon that has been blown up too
often - a dilated sac. Because of the vein's dilation, the
flap-like valves do not quite meet. They cannot prevent
blood from flowing backward toward your toes. As a result,
when you are standing, the blood tends to run downhill and
accumulates in the vessels in your lower legs, causing
discoloration and swelling.
There are also valves in the perforating veins to prevent
blood from flowing backward out of the deep veins into the
superficial veins. When a perforating vein is dilated, its
valves are incompetent, too. The point where it connects to
the superficial veins may be especially large and rounded
under the skin. These points are sometimes called
"blow-outs."
Varicose veins are abnormally stretched or swollen veins
that protrude from the surface of the skin in a rope-like
manner. Generally found on the legs, varicose veins are the
result of faulty vein valves or weak vein walls.
Spider veins, or broken capillaries, are medically referred
to as telangiectasias. They are dilated capillary veins less
than 2mm in diameter that exist just below the surface of
the skin on the legs or face. Spider veins are blue, red, or
purplish in color with a web-like or linear appearance.
What Happens
Leg vein problems begin when the vein valves that prevent
blood from flowing in the wrong direction (reflux) become
weak or malfunction. This causes blood to pool in the veins,
forcing them to protrude from the skin becoming tortuous or
rope-like and varicose. This increased venous pressure can
lead to further failure of other vein valves and to the
development of varicose veins.
In addition to being unsightly and even embarrassing,
varicose veins and spider veins can cause varying degrees of
discomfort, including:
- swelling
- throbbing
- heaviness
- aching
- leg cramps
Varicose veins are a progressive disease that can
eventually lead to ankle swelling, pigmentation, ulceration,
bleeding, and advanced Chronic Venous Insufficiency (CVI).
It is important to seek medical treatment early in order to
stop the natural progression of this disease, and reduce
symptoms to achieve the best possible cosmetic results.
Spider veins often occur in conjunction with varicose veins
due to increased venous pressure. They also develop on their
own due to an increased number of shunts, or microscopic
short-cuts, connecting the venous and arterial systems.
In women, varicose veins can manifest itself in the genital
area – pelvic congestion syndrome. Pelvic congestion
syndrome is caused by poorly functioning veins in the
ovaries and pelvic region, which can result in varicosities
in the abdomen, buttocks, vulva, and legs. Women that suffer
from a generalized aching in their pelvic area, especially
when standing, lifting, or after sexual intercourse, may
suffer from this condition. With today’s advanced diagnostic
tools, doctors can now easily identify pelvic congestion
syndrome in women.
Causes
While no one knows what causes varicose and spider veins,
we do know that a number of factors can increase the
likelihood of developing leg vein problems. We also know
that the primary factor contributing to the development of
varicose and spider veins is heredity, or the genetic
predisposition to weak vein walls and vein valves resulting
in leg vein problems.
There are also a number of lifestyle variables known to
accelerate and aggravate the development of varicose or
spider veins:
- pregnancy
- birth control pills
- hormone replacement therapies
- lack of exercise
- prolonged sitting or standing
- obesity
- constipation
- aging
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