Varicose veins are prominent veins that have lost their valve effectiveness and, as a result of dilation under pressure, become bulging, elongated and thickened. The most common underlying cause of varicose veins is reflux within the great saphenous vein in the thigh. This can lead to pooling in its branches. In turn, the pooling become visible varicose veins just under the skin surface.

Varicose veins are related to venous insufficiency, an abnormal circulatory condition with decreased return of blood from the leg veins up to the heart and pooling of blood in the veins. Normally, one-way valves in the vein close to keep blood from flowing downward with gravity. When the valves in the vein become weak and don’t close properly, they allow blood to flow backward, or "reflux."

Inova's vascular and interventional radiology experts successfully treat many patients in Northern Virginia and the Washington, DC, area at several convenient locations for varicose veins using the latest traditional and minimally invasive methods.

Statistics and risk factors

Chronic venous disease of the legs is very common. Approximately half of the U.S. population has venous disease – 50 to 55 percent of women and 40 to 45 percent of men. Of these, 20 to 25 percent of the women and 10 to 15 percent of men will have visible varicose veins.

Varicose veins affect 1 out of 2 people age 50 and older, and 15 to 25 percent of all adults. Risk factors include age, family history, obesity, jobs that require long periods of sitting or standing, gender (more common among females) and pregnancy. Pregnancy, especially multiple pregnancies, is one of the most common factors accelerating the appearance of varicose veins.


Symptoms caused by venous insufficiency and varicose veins include:

  • Aching legs
  • Leg fatigue
  • Throbbing
  • Swelling
  • Leg heaviness
  • Symptoms that worsen as the day progresses

Many people find they need to sit down in the afternoon and elevate their legs to relieve these symptoms. In more severe cases, venous insufficiency can cause skin discoloration and ulceration which may be very difficult to treat. One percent of adults over age 60 have chronic ulceration.

People without visible varicose veins can still have symptoms. The symptoms can arise from spider veins as well as from varicose veins because, in both cases, the symptoms are caused by pressure on nerves by dilated veins.


A physician specially trained in performing minimally invasive, image-guided treatments, will use duplex ultrasound of the leg veins to diagnose venous insufficiency. The doctor will map the veins and examine the deep and superficial venous systems to determine whether the veins are open and to pinpoint where there is reflux. This will help determine the appropriate treatment necessary for each patient.