Recently I had a question from a patient who had had a duplex ultrasound scan elsewhere and she had been told that she had reflux and floppy valves and she wanted to know whether this was really the cause of her varicose veins and thread veins.
The function of veins is to carry blood upwards from the legs back to the heart and gravity is always trying to pull the blood downwards in the wrong direction. Now whenever anything travels in the wrong direction in the body we call it reflux. Some of you might be familiar with acid reflux indigestion. That is a condition in which acid comes up in the wrong direction instead of going downwards to digest your food. Well similarly if blood is coming downwards in the wrong direction under the pull of gravity towards the legs we call it vein reflux or to give it its full title superficial vein reflux.
Now inside the lining of the vein there are delicate folds that come together and shut tight preventing blood from coming down in the wrong direction. If these valves do not meet properly if they are floppy or if the vein is very large and the valves cannot meet then gravity can indeed pull the blood down in the wrong direction and that can cause distension and the appearance of varicose veins or even thread veins. In the video below, we can see a duplex ultrasound scan. At the top is skin and lower down is the muscle layer. The veins appear as circles because they are in cross-section as if we are going into a tunnel towards feet. In the video I demonstrate a fold in the lining – a valve – which is meeting correctly. When I squeeze the patient’s leg forcing blood upwards we can see the valve opening. And when I let go and when gravity tries to pull the blood back down in the wrong direction the valve shuts tight. Here is an example of a valve which is not working properly. It is indeed floppy. It is not meeting properly and it is not doing its job of resisting the flow of blood downwards. And in this situation there is indeed superficial vein reflux. Now on a duplex ultrasound scan a blue signal indicates blood going upwards from the leg to the heart in the right direction. And when I squeeze the leg we see a blue signal. When I let go of the leg the valves should meet properly and there shouldn’t be any colour at all – or only just a very brief flash of red. However if the valves are floppy and if there is superficial vein reflux the valves do not meet and when I let go we see a red signal as in this situation.
So in answer to the question posed – “yes floppy valves cause superficial vein reflux and superficial vein reflux causes varicose veins and thread veins”.
Contact me today for a confidential chat
If you’re worried about your veins and would like a confidential chat please do get in touch. I am happy to offer simple advice by telephone or email for free and without obligation.
The VeinCare Centre also offers a screening assessment with our vascular technologist. For £25 you can have a scan with Wendy Parsons. She is not a doctor and so she could not give you medical advice but she can check your deep veins and your varicose veins and give you an idea of how bad they are and what treatment options might be available. If you would like to have an appointment with Wendy please call 0800 698 3467.