Venous Diseases
Venous Insufficiency
Written byTriantafyllos Giannakopoulos MD, PhD, FEBVS, FACSMedically reviewed: 27 July 2026
Understanding vein function and venous insufficiency
Normal Function
Understanding Vein Function
Veins carry oxygen-poor blood — after the organs have consumed it — from the body back to the heart. This pathway between the heart and body is also known as systemic circulation.
Systemic Circulation
Transport of blood from the body to the heart
Pulmonary Circulation
Transport of blood from the heart to the lungs
Veins have valves that prevent reverse flow.
Venous Valves — Normal Function
Pathological Function
Venous Insufficiency: When Veins Do Not Function Adequately
Venous Insufficiency is the condition where venous drainage is reduced and veins do not function adequately (they thrombose or become insufficient). Venous blood from a body region (oxygen-poor, rich in metabolic toxins) drains (is removed) through the veins.
This condition causes pooling/stasis of venous blood in the affected area and symptoms include heaviness, edema (swelling), warmth, redness and pain. Additionally, redness and pain occur in the case of a clot, corresponding to the vein location where the clot is found, which may be palpable as a cord, firm and painful.
Early diagnosis and treatment are important for preventing complications such as skin changes, ulcers and thrombosis.
Importance of Early Diagnosis
Venous Insufficiency — Valvular Dysfunction
What are Varicose Veins?
Varicose veins are dilated veins that appear near the skin surface, often on the legs and ankles. They affect millions of people worldwide.
Understanding Varicose Veins and Venous Insufficiency
The veins of the lower limbs bear the task of returning blood from the legs to the heart against gravity, and the energy needed for this is provided by the calf muscles (gastrocnemius) when we walk.
Blood Return
To the heart against gravity
Venous Valves
Prevent reverse blood flow
Although very durable, damage and degeneration of the valves that allow upward flow, and modern lifestyles (inactivity) make their function difficult.
Illustration of varicose veins on the lower limb
Modern Lifestyle and Vein Health
Heredity, unhealthy diet, increased body weight, lack of walking and prolonged standing lead to permanent damage and dysfunction of the valves (chronic venous insufficiency) and venous stasis where blood pools in the lower limbs.
The consequence is the formation of venous varicosities causing fatigue, edema (swelling) and cramps in the leg.
In neglected cases, the skin of the shins hardens and darkens while ulcers that heal with difficulty eventually appear. Simultaneously, the likelihood of superficial venous thrombosis increases.
Heredity
Genetic predisposition for venous insufficiency.
Body Weight
Increased weight burdens the veins.
Lack of Walking
Inactivity affects venous circulation.
Standing
Prolonged standing worsens symptoms.
Modern lifestyle affects venous circulation
Varicose Vein Symptoms
Feeling of fatigue
Edema (swelling)
Cramps
Personalized Therapeutic Solutions
Minimally invasive vascular surgery methods
The treatment of the disease is individualized based on the patient's body type and detailed color ultrasound study — mapping of the type, degree and source of insufficiency by the treating Vascular Surgeon.
Minimally Invasive Methods
- Endovenous Laser Ablation (EVLT)
- Ultrasound guided Foam Sclerotherapy
- MechanoChemical Ablation (MOCA)
- RadioFrequency Ablation (RF)
- Steam Ablation
- Cyano-acrylate Closure
Surgical Methods
Great Saphenous Vein Stripping
Classic surgical method of Great Saphenous Vein stripping
Classic stripping method
Thermal ablation of great saphenous vein with laser
Laser treatment of varicose veins - vascular surgery
Thermal ablation with laser
Important Treatment Information
It is noted that in most cases of minimally invasive ablation methods of the great saphenous vein (Laser, RF etc.), this concerns the portion of the vein from the thigh to just below the knee.
In the same procedures, any coexisting varicose veins with specific course must be removed with small incisions, depending on their location.
High Success Rates
Success rates are very high.
Short Hospitalization
The duration of hospitalization is only a few hours.
References
- De Maeseneer MG, et al. ESVS 2022 Clinical Practice Guidelines on the Management of Chronic Venous Disease of the Lower Limbs. Eur J Vasc Endovasc Surg 63(2):184–267 (2022) — doi.org/10.1016/j.ejvs.2021.12.024
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