What is the pathophysiology of varicose veins? What causes varicose veins?
A new study published in th Journal of Vascular Surgery Venous and Lymphatic Disorderse 2017 May;5(3):460-467 looked into this topic by doing an exhaustive literature review. The study was conducted by the Section of General Surgery, Department of Surgery, University of Michigan, Ann Arbor.
The researchers were looking to see if the preponderance of evidence suggested whether "venous hypertension and valvular incompetence precede and influence the development of vein wall changes or whether the reverse is correct".
The results of the study were inconclusive:
1. It is clear that valvular incompetence and hemodynamic factors play a significant role.
2. Numerous factors influence the development of varices on the cellular level, including hypoxia, dysregulated apoptosis, and alterations in the extracellular matrix.
The authors concluded that "based on currently available evidence, varicose veins are a complex disease with multifactorial pathogenesis; it is as yet not possible to state conclusively what inciting factor is responsible for the development of varicose veins".
Dr. karamanoukian's comment: This is like the "which came first argument, the chicken or the egg?" The question will eventually be answered.