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WHY DOES VEIN DISEASE OCCUR?

The underlying cause of most vein problems is a phenomenon known as "venous reflux." Venous reflux refers to the condition in which blood in a vein or a group of veins flows backwards (away from the heart), causing blood to accumulate in the veins. Reflux can lead to a variety of symptoms that medical professionals will often refer to as "chronic venous insufficiency" (CVI) or "chronic venous disease" (CVD) to describe the medically significant problems that result from long-term insufficient flow of blood through the veins. It is important to understand that vein problems are progressive, meaning that symptoms can worsen if reflux is not properly treated.

Vein problems are very common. Population studies estimate that more than 70% of adults in the United States have visual vein problems, the majority of which have either spider veinsvaricose veins, or both.¹⁻³

Continue reading below to learn more about vein problems and treatment options. At Dallas Vein Institute, it is important to us that you are empowered with the knowledge you need to make the treatment decisions that are right for you.

How does vein disease develop?

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The human circulatory system consists of arteries, which carry blood away from the heart, and veins, which carry blood back to the heart. Arterial circulation is a high pressure system, meaning that the movement of blood is dependent on high pressures that push blood through arteries. On the other hand, the venous circulation is a low pressure system, meaning that the movement of blood has to rely on the contraction of surrounding muscles to squeeze the vein (like a tube of toothpaste) and propel blood through the vessels.

Healthy veins have one-way valves that open to allow blood to flow towards the heart, and close to prevent flow in the opposite direction. When standing, blood in the veins of the legs must flow upwards against the downward pull of gravity. For some individuals, this downward gravitational pull causes the walls of the leg veins to stretch apart over time, which tends to also pull apart the vein valves and damage them. In other individuals, an obstruction in the veins, such as a blood clot, can damage vein valves. Damaged valves allow blood to leak backwards (a phenomenon known as "venous reflux") and accumulate in the veins, leading to more valves stretching out and failing. While blood continues to accumulate in the veins, the veins become bulgy and twisted. Very small vessels may be affected, causing visible spider veins, as well as major vessels, causing visible varicose veins.⁵ In many instances, the exact cause of vein problems is not known and may be attributed to your genetics.

 

If left untreated, varicose veins may worsen and cause the formation of alternative vessels (called "collateral veins"), which allow blood to detour around the varicose veins through veins that are deeper in the leg. Over time, the deep veins may also be affected by vein problems, causing blood to accumulate throughout the veins of the leg.

Stagnant blood in the leg begins to cause an inflammatory reaction, causing fibrosis (thickening and scarring of tissue), and potentially ulcers (open wounds on the skin). This condition is commonly referred to as Chronic Venous Insufficiency (CVI). Other symptoms of CVI include darkening of the skin, itchiness, pain, and swelling throughout the leg.

Healthy Veins

Diseased Veins

Are some individuals at higher risk of vein disease?

The following factors may make you more susceptible to vein problems.

  • Gender  |  more women are diagnosed with vein problems than men​

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  • Family History  |  vein problems may run in your family

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  • Age  |  risk of vein problems increases with age

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  • Lifestyle or Occupation  |  prolonged standing or sitting may increase your risk of vein problems

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  • Smoking  |  prolonged smoking leads to harmful changes in blood vessels and blood composition

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  • Obesity  |  added pressure to your leg veins from your abdomen may increase your risk of vein problems

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  • Pregnancy  |  vein problems developed during pregnancy typically resolve within 3-12 months after giving birth, but not always

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References

[1] Michael H. Criqui, Maritess Jamosmos, Arnost Fronek, Julie O. Denenberg, R., & D. Langer, John Bergan, and B. A. G. (2003). Chronic Venous Disease in an Ethnically Diverse Population The San Diego Population Study. American Journal of Epidemiology, 158(5), 448-456. PMC 2015 Jan 6.

[2] Chiesa, R., Marone, E. M., Limoni, C., Volonté, M., Schaefer, E., & Petrini, O. (2005). Chronic venous insufficiency in Italy: The 24-cities Cohort study. European Journal of Vascular and Endovascular Surgery, 30(4), 422–429.

[3] Wrona, M., Jöckel, K. H., Pannier, F., Bock, E., Hoffmann, B., & Rabe, E. (2015). Association of Venous Disorders with Leg Symptoms: Results from the Bonn Vein Study 1. European Journal of Vascular and Endovascular Surgery, 50(3), 360–367.

[4] Jacobs, B. N., Andraska, E. A., Obi, A. T., & Wakefield, T. W. (2017). Pathophysiology of varicose veins. Journal of Vascular Surgery: Venous and Lymphatic Disorders, 5(3), 460–467.

[5] Goldman, M. P., Fronek, A. (1989). Anatomy and Pathophysiology of Varicose Veins. J Dermatol Surg Oncol, 15, 138–145.

[6] Eberhardt and Raffetto (2014). Contemporary Views in Cardiovascular Medicine: Chronic Venous Insufficiency. Circulation. 2014;130:333-346.

[7] Cesarone MR et al. (2002). ‘Real’ epidemiology of varicose veins and chronic venous diseases: the San Valentino Vascular Screening Project. Angiology 2002; 53: 119–130.

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