The phenomenon called leakage is the failure of the valves in the vein system that will prevent the blood from going down. In other words, even if it is not closed completely, or even if it is completely closed, it escapes into the blood from the space between, and the expansion in the already expanded vein accelerates and as a result, varicose disease occurs. or arises from reasons that develop outside of it (secondary). · This issue was first described by W.Harwey, the Father of Circulation. The basic information simply given above has remained valid until today.
· It is very rare that congenital valves do not develop in the vein system. It's very rare. There are 14 patients in the literature. Having a similar situation in the relatives of two people brings to mind genetic transmission. Venous insufficiency develops very early in these patients.
· Venous Insufficiency is a general pathology that occurs with varicose veins. In patients with congenital valve deficiency, scar formation on the inner surface of the ankle is common. Foot swelling (edema) accompanies the picture. The blood pooling at the bottom when standing up, the blood flowing to the legs, the decrease in the amount of blood returning to the heart and the resultant decrease in the blood pumped by the heart Low blood pressure: Orthostatic (positional) Hypotension. When you stand up suddenly, you may experience fainting due to a drop in blood pressure. There is no rule that it will be seen in every patient with varicose veins.
· One of the interesting findings is that there are fewer valves in the left intra-abdominal fen (iliac vein) in autopsy studies. It has been claimed that this is the reason why more varicose veins are seen on the left leg.
" In a similar study, it was observed that these valves were absent in healthy volunteers without varicose veins and those with a familial history of varicose veins. This indicates the importance of genetic factors in the development of varicose veins.
· Another study showed interesting findings in adults and children with varicose veins (yes, varicose veins also occur in children) 16% of adults and 32% of children were found to have no valves. Whites were more likely to have lack of caps than Africans
· Dystrophic changes have been made in the microscopic studies of the valves in varicose veins. Defects in collagen fibers, elastic fibers and muscle cells have been observed.
· Inflammatory reaction (phlebitis, not only clot but also inflammation in the vessel wall) in patients who have had thrombosis (clot) in the deep veins. As a result, varicose veins develop at a rate of 25%. This is among the long-term problems of DVTs, i.e. Deep vein Thrombosis. Microscopic studies have shown that enlargement (dilation) in a normal vein and fibrosis (a kind of wound healing) in these valves over time. This enlargement may be a circular enlargement in the entire diameter of the vein, or the enlargement in only one region also causes insufficiency in the valves. In both cases, the insufficiency of the valves, the escaping of the blood and the turbulence that occurs increase the damage to the valves.
· This is how Secondary Failure happens due to a cause like DVT. Especially in DVT that occurs in the region below the knee, the clot goes down to the veins that go down to the ankle, so the pathology progresses further. As a result, the first changes are seen in the ankle.
· We have roughly taken a simple glance at the meaning of the word reflux, that is, insufficiency or leakage, that varicose patients see in their ultrasound reports.
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