THE ANATOMY OF THE VEINS
There are two kinds of veins in the legs:
- The superficial veins: starting in the subcutaneous fat, these are the ones that may develop varicose veins. There are two important superficial veins in the lower limbs:
the internal saphenous vein: from the inside of the ankle to the groin
the external saphenous vein: from the outside of the ankle to the knee bend
- The deep veins running in between muscles, close to the bone. While deep veins are not affected by varicose disease, they, however, may be the site of thrombosis (blood clot in a deep vein).
Veins are used to bring the blood from muscles and tissues back to the heart, contrary to arteries that transport blood from the heart to the organs.
Therefore, at the level of the legs, in a standing or a sitting position, veins must carry the blood up to the heart, facing against gravity.
To enable the blood going up, the veins are equipped with anti-backward flow valves, which permit blood
flowing upwards and which prevent it from falling down towards the feet.
At any movements of the legs and especially during the walk, veins get crushed by muscular contractions and by movements of the joints, that pushes the blood upwards, thanks to the valves.
This disease is related to a weakness of the venous wall, probably with hereditary origins. This weaknesswill worsen gradually, and it is favored by various risk factors such as trades with extended standing position, trampling, putting on weight, pregnancy, heat, risk sports, etc…
The venous wall will end up dilating, and the valvules will diverge, letting blood flee to the bottom (backward flow). This backward flow will involve an increase in pressure in the vein (hyperpression). Dilation becomes permanent: it is a varicose vein.
A vicious circle will be created:
The backward flow causes a hyperpression, the hyperpression worsens the dilation of the vein, and the more the vein dilates, the more the backward flow worsens.
This phenomenon will extend gradually to the nearer veins and will contaminate an increasingly wide surface venous network.
The varicose veins represent a real handicap:
For aesthetic reasons:
The varicosities or telangiectasis are skin venules, as thin as hair, in the shape of stars or legs of spider of blue, violet or red color, generally very apparent. They precede the varicose veins which are larger and very unaesthetic dilated veins.
For the comfort of life:
The varicose veins can be responsible for pains, heavness, unpleasant swelling, tingling sensations, itching or restless legs. These signs prevail especially in the evening, after one day of trampling, when the weather is hot, before periods or during a pregnancy.
Night cramps are sometimes due to the varicose veins.
More or less quickly will appear the oedemas, then gradually cutaneous disorders: brown spots appear, the skin becomes hard and fragile, with a risk of varicose ulcer.
Acute complications can appear, even when the varicose veins represent only an aesthetic discomfort: the paraphlebitis, or haemorrhagic rupture