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Pathophysiology of varicose veins
Benjamin N Jacobs1, Elizabeth A Andraska2, Andrea T Obi2
1Section of General Surgery, Department of Surgery, University of Michigan, Ann Arbor, Mich.
Journal of Vascular Surgery. Venous and Lymphatic Disorders
|April 17, 2017
Summary
Varicose veins are a complex condition with an incompletely understood cause. Current evidence suggests a multifactorial pathogenesis involving hemodynamic and cellular factors, rather than a single inciting event.
Area of Science:
- Vascular Biology
- Medical Pathophysiology
Background:
- Varicose veins are a prevalent condition impacting quality of life and healthcare costs.
- The exact pathophysiologic mechanism underlying varicose vein development remains unclear.
- A key debate centers on whether venous hypertension and valvular incompetence precede or result from vein wall changes.
Purpose of the Study:
- To synthesize current knowledge on the hemodynamic, cellular, and molecular processes involved in varicose vein development.
- To provide an updated understanding of the multifactorial pathogenesis of varicose veins.
Main Methods:
- Comprehensive review of the English-language literature.
- Analysis of hemodynamic factors contributing to varicose veins.
- Examination of cellular and molecular mechanisms in varicose vein formation.
Main Results:
- Evidence suggests valvular incompetence and hemodynamic factors play a significant role.
- Cellular-level factors such as hypoxia, apoptosis, and extracellular matrix alterations are implicated.
- Data remain inconclusive regarding a single initiating factor, with arguments supporting multiple contributing causes.
Conclusions:
- Varicose veins are a complex disease with a multifactorial pathogenesis.
- The precise inciting factor for varicose vein development is not yet definitively established.
- Imbalance in several factors likely contributes to the development of varicose veins.