WHAT ARE THE TYPES OF VENOUS INSUFFICIENCY (INCOMPETENCE)​

 

Venous insufficiency is the accumulation of venous blood in the leg. This occurs mainly deterioration of the function of the one-way valves located in the leg veins which normally help the blood to flow to the lungs. The accumulated blood may cause complaints, such as swelling, pain, burning, cramping and itching. Besides, due to increased blood pressure on the vein wall, the normal leg veins start to enlarge and protrude from the skin over time, forming what we call varicose veins. In other words, varicose vein is not a disease alone, it is one of the symptoms of venous insufficiency.

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Superficial vein insufficiency

Venous insufficiency is mostly seen in veins near the surface (superficial vein insufficiency). This occurs most common in the main superficial vessels called "Saphenous Vein". Approximately half of the varicose veins have venous insufficiency in the "Great Saphenous Vein" and roughly 20% in the "Small Saphenous Vein". Superficial vein insufficiency is also common in connecting vessels called "perforating veins" and "pelvic" veins in the lower abdomen.

 

 

 

 

 

 

 

 

 

 

 

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Deep vein insufficiency

Approximately 95% of the patients with varicose veins have superficial vein insufficiency and can be treated with non-surgical methods if the incompetent veins are correctly identified. In less than 5% of the patients with varicose veins, the disease is due to the insufficiency or obstruction of the deep veins. In these patients, the deep veins, which are the main veins of the leg, are problematic, so our body uses superficial vessels to send deoxygenated blood to the lung. As time goes by, these vessels, which become enlarged and curved, appear to be varicose veins from the outside, but are actually the "bypass" vessels produced by the body to overcome the problem in deep veins. Therefore, it would be a big mistake to take these vessels as ordinary varicose veins and ablate them or remove surgically. Because, in this case, the venous circulation will deteriorate and the leg will become even worse than before. I must emphasize that ordinary varicose veins and varicose-like bypass veins can be easily differentiated with a venous color Doppler examination, as long as the operator has enough knowledge on varicose veins and experience on color Doppler ultrasound.

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 Video: Why is Doppler ultrasound so important in varicose veins?