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By far the majority of venous disease is secondary to venous insufficiency which is caused by reflux of the superficial leg veins.
What is superficial venous reflux?
Superficial veins are those veins located just beneath the skin. The longest of these superficial veins is the greater saphenous vein. It begins that the ankle and runs up the inside part of the leg and then at the groin connects to a the main deep vein of the lower extremity, the femoral vein.
When we stand, one way check valves present in our leg veins are supposed to prevent the backflow of blood down the leg. When these valves fail, blood will flow back down the leg causing the superficial veins to become distended. This distension causes pressure and aching symptoms, varicose veins, and eventually skin discoloration and ulceration.
In addition to the greater saphenous vein, there is a lesser saphenous vein that runs down the back of the leg, from behind the knee to the ankle. This can also reflux and cause symptoms.
A frequently overlooked source of venous insufficiency are the perforator veins. These are veins that run horizontally in the leg and connect the superficial venous system and deep venous system. These veins also have one way check valves that are supposed to prevent blood from refluxing from the deep system to the superficial system.
Thus, there are three sources of venous reflux, the greater saphenous vein, the lesser saphenous vein, and the perforator veins. Patients can develop venous symptoms for one, two, or all three of these sources. The Alaska Vein Clinic will assess for all three of these sources and prescribe a vein treatment program that is right for you.
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