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Varicose veins are veins that have become enlarged and twisted. The term commonly refers to the veins on the leg,〔(【引用サイトリンク】date=2010-07-06 ) Mount Sinai Hospital, New York〕 although varicose veins can occur elsewhere. Veins have pairs of leaflet valves to prevent blood from flowing backwards (retrograde flow or venous reflux).〔(【引用サイトリンク】title=Understanding Venous Reflux - the cause of varicose veins and venous leg ulcers )〕 Leg muscles pump the veins to return blood to the heart (the skeletal-muscle pump), against the effects of gravity. When veins become varicose, the leaflets of the valves no longer meet properly, and the valves do not work (valvular incompetence). This allows blood to flow backwards and they enlarge even more. Varicose veins are most common in the superficial veins of the legs, which are subject to high pressure when standing. Besides being a cosmetic problem, varicose veins can be painful, especially when standing. Severe long-standing varicose veins can lead to leg swelling, venous eczema, skin thickening (lipodermatosclerosis) and ulceration. Life-threatening complications are uncommon, but varicose veins may be confused with deep vein thrombosis, which may be life-threatening.〔(Żylaki – Przewlekła niewydolność żylna: Zakrzepica – Medycyna Praktyczna: Lekarze pacjentom ). Zakrzepica. Retrieved on 2013-09-02.〕 Non-surgical treatments include sclerotherapy, elastic stockings, leg elevation and exercise. The traditional surgical treatment has been vein stripping to remove the affected veins. Newer, less invasive treatments which seal the main leaking vein are available. Alternative techniques, such as ultrasound-guided foam sclerotherapy, radiofrequency ablation and endovenous laser treatment, are available as well. Because most of the blood in the legs is returned by the deep veins, the superficial veins, which return only about 10% of the total blood of the legs, can usually be removed or ablated without serious harm.〔(Merck Manual Home Edition, 2nd ed ). Merck.com. Retrieved on 2013-09-02.〕〔("Varicose veins" ). in ''Health Encyclopaedia''. nhsdirect.nhs.uk〕 Secondary varicose veins are those developing as collateral pathways, typically after stenosis or occlusion of the deep veins, a common sequel of extensive deep venous thrombosis (DVT). Treatment options are usually support stockings, occasionally sclerotherapy and rarely, limited surgery. Varicose veins are distinguished from reticular veins (blue veins) and telangiectasias (spider veins), which also involve valvular insufficiency, by the size and location of the veins. Many patients who suffer with varicose veins seek out the assistance of physicians who specialize in vein care or peripheral vascular disease. These physicians include vascular surgeons, phlebologists or interventional radiologists. ==Signs and symptoms== * Aching, heavy legs (often worse at night and after exercise). * Appearance of spider veins (telangiectasia) in the affected leg. * Ankle swelling, especially in evening. * A brownish-yellow shiny skin discoloration near the affected veins. * Redness, dryness, and itchiness of areas of skin, termed stasis dermatitis or venous eczema, because of waste products building up in the leg. * Cramps may develop especially when making a sudden move as standing up. * Minor injuries to the area may bleed more than normal or take a long time to heal. * In some people the skin above the ankle may shrink (lipodermatosclerosis) because the fat underneath the skin becomes hard. * Restless legs syndrome appears to be a common overlapping clinical syndrome in patients with varicose veins and other chronic venous insufficiency. * Whitened, irregular scar-like patches can appear at the ankles. This is known as atrophie blanche. 抄文引用元・出典: フリー百科事典『 ウィキペディア(Wikipedia)』 ■ウィキペディアで「varicose veins」の詳細全文を読む スポンサード リンク
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