Veins are ordinarily designed to move blood in an upward direction, from the foot back towards the trunk, using an elaborate mechanism of valves. In some people, that mechanism can be disrupted such that when they stand up, blood reverses direction and goes down the leg. This is called venous reflux.
The blood has nowhere to go except down and out, which causes the little veins underneath the skin to go from being invisible and painless to engorged, swollen, visible and painful. This is how varicose veins form.
It is best to think of the problem anatomically like an upside-down tree, where the vein with the reflux is the trunk and the leaves represent the varicose veins.
There are several veins which can develop reflux, the most common being the greater saphenous vein and the small saphenous vein. These are the most common ‘trunks’ which can lead to varicose veins further down the leg (‘leaves’).
The treatment of varicose veins involves dealing with both the trunk of the tree as well as the leaves. If you pull the leaves off of a tree without dealing with the trunk, they grow right back! Vein ablation shuts down the vein with reflux. Don’t worry though, you don’t need these veins for anything and you won’t miss them when they are shut down.
Unlike a stripping procedure (which is an old-fashioned procedure that we do not do anymore), an ablation shuts the vein down and leaves it in place. There are two types of vein ablation: laser ablation and radio-frequency ablation. Both accomplish the same goal: they very safely and effectively shut down the vein in the leg with reflux without any incisions.
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