Varicose veins--which afflict 10% to 20% of all adults --are swollen, twisted, blue veins that are close to the surface of the skin.  Because valves in them are damaged, they hold more blood at higher pressure than normal.  That forces fluid into the surrounding tissue, making the affected leg swell and feel heavy.

Unsightly and uncomfortable, varicose leg veins can promote swelling in the ankles and feet and itching of the skin.  They may occur in almost any part of the leg but are most often seen in the back of the calf or on the inside of the leg between the groin and the ankle.  Left untreated, patient symptoms are likely to worsen with some possibly leading to venous ulceration.

The normal function of leg veins - both the deep veins in the leg and the superficial veins - is to carry blood back to the heart. During walking, for instance, the calf muscle acts as a pump, contracting veins and forcing blood back to the heart.

To prevent blood from flowing in the wrong direction, veins have numerous valves.  If the valves fail (a cause of venous reflux), blood flows back into superficial veins and back down the leg. This results in veins enlarging and becoming varicose.  The process is like blowing air into a balloon without letting the airflow out again--the balloon swells.  

To succeed, treatment must stop this reverse flow at the highest site or sites of valve failure.  In the legs, veins close to the surface of the skin drain into larger veins, such as the saphenous vein, which run up to the groin.  Damaged valves in the saphenous vein are often the cause of reversed blood flow back down into the surface veins.

Gravity is the culprit.  The distance from the feet to the heart is the furthest blood has to travel in the body.  Consequently, those vessels experience a great deal of pressure. If vein valves can't handle it, the backflow of blood can cause the surface veins to become swollen and distorted.

Conditions contributing to varicose veins include genetics, obesity, pregnancy, hormonal changes at menopause, work or hobbies requiring extended standing, and past vein diseases such as thrombophlebitis (i.e. inflammation of a vein as a blood clot forms.)  Women suffer from varicose veins more than men, and the incidence increases to 50% of people over age 50.

Varicose veins may ache, and feet and ankles may swell towards day's end, especially in hot weather.  Varicose veins can get sore and inflamed, causing redness of the skin around them.  In some cases, patients may develop venous ulcerations.

If the source of the reverse blood flow is due to damaged valves in the saphenous vein, the vein may be removed by a surgical procedure known as vein stripping.  Under general anesthesia, all or part of the vein is tied off and pulled out.  The legs are bandaged after the surgery but swelling and bruising may last for weeks.

Closure is used, like vein stripping, to eliminate reverse blood flow in the saphenous vein, but without physically removing the vein, and can be performed without general anesthesia.   Like other venous procedures, the Closure procedure involves risks and potential complications. Each patient should consult their doctor to determine whether or not they are a candidate for this procedure, and if their condition presents any special risks.  Complications reported in medical literature include numbness or tingling (paresthesia) skin burns, blood clots, temporary tenderness in the treated limb.