Varicose Vein Patterns

Different patterns of vein problems exist. Each pattern tells the doctor where the most likely site of venous reflux exists. Treating varicose vein problems early prevents worsening of the patterns of venous disease.

Venous Reflux

The most common cause of varicose veins is reflux in the Greater and Lesser Saphenous Veins. Valves that have failed transmit pressure down the vein causing enlargement of the vein branches along the course of the GSV. The typical location of vein clusters in GSV reflux are shown below.

The photograph shows the pathway of the GSV as marked on the skin. Varicose veins are branches of the main vein.

Reflux occurs when vein valves are broken and allow blood to move down the vein towards the foot under the force of gravity. Usually it is the vein valve at the top of the leg which becomes incompetent first. Blood moves down the vein under pressure to the next valve which eventually fails. Each subsequent valve fails as more pressure is forced upon it from above. This causes veins to dilate and become varicose veins.

Normal Valve Function

An example of normal veins and vein valves is presented above left. All the valves are closed and will only allow blood to flow up towards the heart. When valve failure occurs so that pressure is allowed to enter the superficial veins, other vein segments and vein valves will become dilated and permit vein blood flow to move away from the heart and down towards the feet as illustrated below.

Veins that become dilated can be seen in many sizes, shapes and colors. Large caliber varicose veins, small veins or venules as well as spider veins or telangiectasia can occur as a result of pressure buildup in the venous system. Examples of large veins and spider veins are seen below.

Large Varicose Veins (Reflux)

Spider Veins