Veins of the Leg

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About Leg Veins

Generally the veins in your leg serve as a pathway for blood to return to your heart after it has passed through the active tissue, such as skin or muscle.

The venous system in the leg consists of three main groups of veins:

The deep veins

These veins are the main veins in your leg and they carry the majority of blood flow. Blood flow is generally directed into these deep veins from the rest of the leg and whenever your leg muscles are working they act to pump blood along the deep veins and back up towards your heart.

The superficial veins

These veins lie below the skin and fat of your leg and assist the return of blood into the deep veins via junctions and perforating veins. They are usually deep enough that even if swollen they are difficult to see or feel. Problems in these veins and its junctions are the most common cause of varicose veins.

The reticular and cutaneous (or surface) veins

These veins lie just below the skin and drain into the superficial veins. They are often visible as blue lines in patients with thin or pale skin, and this is quite normal. When swollen, these become varicose veins. They are also connected to very small subcutaneous veins which can become visible. These are known as telangiectasia, commonly referred to as spider veins.

Veins and Valves

When standing or straining, blood is pushed out of your chest and abdomen, and it is pulled down by gravity into the legs. It is normal for a small amount of reverse flow (reflux) to occur when first standing or straining. Within a second, a series of valves normally close over in the deep and superficial veins which prevent too much blood from entering backwards into the veins.

Sometimes the valves may be damaged, or they may fail. These are veins which are referred to as “incompetent”. The increased pressure may cause the veins to dilate or swell, becoming varicose, and can cause damage to the skin leading to irritation and itching (“venous eczema”) and over a very long period of time, ulcers.

Treatment options to prevent complications of venous hypertension (including varicose veins) involve limiting the unwanted pressure effect on the skin with external compression such as bandages or stockings, removing or blocking the offending varicosities or varicose veins via phlebectomy or injection sclerotherapy, and eliminating the source of the reflux via saphenous vein stripping, ultrasound-guided sclerotherapy, or endovenous laser ablation.