Superficial venous insufficiency and varicose veins

The role of your leg veins is to carry blood up from your feet to a large vein in the abdomen called the inferior vena cava, which then brings the blood to the heart.

Veins have valves that prevent the blood from flowing backwards toward your feet when you are standing.

There are two sets of veins in the legs:

• Deep veins, which perform most of the work of moving blood back to your heart
• Superficial veins: the two main superficial veins are the great saphenous vein, which begins at the foot and travels up the inside of the leg, ending at the groin; and the small saphenous vein, which also begins at the foot and travels up the back of the calf, ending at the popliteal fossa (at the back of the knee). 

Venous insufficiency is a very common disorder that affects 20 to 30 percent of the population, predominantly women. Other risk factors include family history, being overweight, age, multiple pregnancies and having a job that requires standing for long periods.

Venous insufficiency may be caused by:

• Deep veins malfunction: this is usually a sequela of thrombosis (or phlebitis) which damages the valves of the deep veins.
• More frequently, by valve malfunction in the superficial veins: this is called superficial venous insufficiency, and may cause a saphenous vein or one of its branches to become a varicose vein.

Many medical solutions are currently available to relieve the symptoms of venous insufficiency.

Various treatments also exist to remove unattractive superficial veins, depending on their size:

• For spider veins and smaller varicose veins: foam or liquid sclerotherapy, as long as there are abnormalities affecting the major veins
• For saphenous vein insufficiency:
  • Destruction via endovenous thermal ablation
  • Removal through surgical vein stripping and/or phlebectomy
  • Preservation by restructuring the venous pathways: strategic points, identified prior to the procedure via Doppler ultrasound, are tied off (CHIVA technique). 

At the American Hospital of Paris, we practice the full range of modern-day techniques to explore and treat spider and varicose veins. All methods are minimally invasive and performed on an outpatient basis.

Whether you are seeking relief for your legs or wish to discuss your options for the removal of varicose veins, you will need to see a doctor specialized in vascular medicine or surgery. After this initial visit, you will undergo a venous Doppler ultrasound to obtain a precise “map” of your legs veins. This will be used to identify the mechanism causing your venous insufficiency and determine the most appropriate treatment method.