Valve malfunction
Superficial veins have multiple valves along their course. The most important are located just before their connections with the deep veins at the groin and behind the knee.

Valves can become damaged and go floppy. Normal flow ceases and reversed flow occurs back along the vein. Then blood will pool under pressure lower down. This causes the superficial vein to enlarge and become twisted ( varicose ).

This causes a state of venous insufficiency and the veins are said to be incompetent.

Causes of venous insufficiency :

• Valve failure : this is often hereditary
• Muscle pump failure : e.g in immobile people, but is commonly associated with prolonged standing
• Deep vein thrombosis can cause deep vein blockage , but may also cause permanent damage to vein valves
• Multiple pregnancies, obesity and older age are all contributing factors

How things can be helped:

Compression stockings will help the muscle pump but will not make the veins go away

Sclerotherapy injections will treat the effects of vein pressure on the smaller superficial veins. This will not fix valve reflux.

Foam sclerotherapy is a newer injection method that will shrink larger localized superficial varicose veins. This requires accurate control of the injection by using ultrasound.

Surgical stripping is an established and effective way to remove a segment of incompetent superficial vein. It is performed under general anaesthetic and requires a considerable recovery period.

Radiofrequency ( RF ) ablation [ VNUS Closure ]
This is a recent alternative to stripping the superficial vein in the thigh, but will also require general anaesthetic, and has had some unwanted side-effects.

Endovenous laser therapy
This is the main treatment offered at SVC. It closes off (ablates) the main vein that has damaged valves. There is less local tissue damage than with surgery.