Varicositas, commonly called “varicose veins“

Varicositas (lat. varus, node) is a disease most common in western society. According to studies, approximately 40% of the population are more or less affected by, and suffering from, dilated leg veins.

Varicose veins: An aesthetic problem only?

By no means: Varicose veins are not only an aesthetic problem. Rather, they also may cause various discomforts such as leg pain, itching, creeping sensation and, in the course, inflammation of veins or thrombophlebitis, ulcer of the lower leg and even deep venous thrombosis, which could in turn increase the risk of pulmonary infarction.

An illness of the veins

Varicosity is an illness of the veins, i.e. of the vessels transporting our blood back to the heart. As opposed to arteries, veins constitute very delicate or even extremely thin vessels.

Anatomy

Veins of the leg are classified into a profound system (dark blue) and a superficial system (light blue). The systems are connected to each other by venous valves. Approximately 130 such venous valves are found per leg, whereby the largest valves are in the inguinal region and in the hollow of the knee (popliteal region).

How do varicose veins come about? Due to our upright walking posture, high pressures are exerted on the veins. That causes dilation, and in the course more venous valves cannot close anymore. The blood remains down in the legs, which often are felt heavy. Further aggravation to the veins comes from peculiarities of modern living such as activities in the sitting, too little movement, overweight, malnutrition, nicotine.   Classification: Varicose veins (varices) may appear in different forms, ranging from light bluish reticulose veinlets in the skin (spider-burst) to thick “cord-like” varicose veins (trunk varices), partly above the surface of the skin – indication of an advanced state of illness, in which most of the venous valves are destroyed. Spider Veins Tenuous veinlets unpleasing to look at, bluish or reddish, to be found single or all over the leg combined with cutaneous lesions. Reticular varices Light form of varicosity. Dilated bluish veins directly under the surface of the skin, not to be mistaken for normal venous markings. Varicosity of lateral saphenous branches   Light to severe forms of varicosity, yet limited to lateral branches.   Trunk varicosity Light to severe forms of varicosity affecting also the large venous valves in the inguinal region or in the knee bend. In most cases, lateral branches are also.abnormally dilated. In the case of isolated trunk varicosity, blood flows back from the venous valves though the lateral branches are not dilated.   Late start of treatment After years of neglected varicosity this patient sought the advice of an hospital outpatient department. His advanced state of varicosity had by then caused severe pathological changes in the skin (dermatoliposclerosis) together with an ulcer in the right lower leg (ulcus cruris) and overstrain of the deep crural vein (chronic venous insufficiency). Delayed treatment of varicosity: Buildup of severe changes in the skin in combine with dilation of the deep crural veins (chronic venous insufficiency). Timely start of treatment Thogh case of extended varicosity, patient could still be treated minisurgically under local anaesthesia (tumescence anaesthesia). Well-timed treatment of varicosity: Prevents the buildup of severe changes in the skin and dilation of the deep crural veins (chronic venous insufficiency).