The varicose veins of the lower limbs affect nearly a third of the population

and involve the great or small saphenous vein in 30 to 50% of cases. Although the risk of developing varicose veins increases with age, 15% of the population is affected by this pathology before age 40.

Evans, C.J.; Fowkes, F.G.; Ruckley, C.V.; Lee, A.J. Prevalence of varicose veins and chronic venous Insufficiency in men and women in the general population : Edinburgh Vein Study. J. Epidemiol. Community Health 1999, 53, 149–153.

The varicose veins of the lower limbs affect nearly a third of the population

and involve the great or small saphenous vein in 30 to 50% of cases. Although the risk of developing varicose veins increases with age, 15% of the population is affected by this pathology before age 40.

Evans, C.J.; Fowkes, F.G.; Ruckley, C.V.; Lee, A.J. Prevalence of varicose veins and chronic venous Insufficiency in men and women in the general population : Edinburgh Vein Study. J. Epidemiol. Community Health 1999, 53, 149–153.

Schéma réseau veineux de la jambe

The venous network of the lower limbs

Schéma réseau veineux de la jambe

The main function of the venous network is to drain the non-oxygenated blood to the heart. To prevent the blood from falling downwards in the upright position, the veins are equipped with stepped valves, with valves functioning like flaps that open to allow the blood to flow upward and close to prevent it from going downword.

The venous network of the lower limbs consists of:

composed of veins located in the middle of the muscles (in particular the femoral veins). This is the most important network, since it carries 90% of the venous blood

composed of veins located in the subcutaneous tissues (especially the great and small saphenous veins, but also the tributary veins, which are the peripheral vessels to the saphenous veins). This secondary network carries  only 10% of the venous blood and allows the drainage of the blood of the skin and the subcutaneous tissues

which connect the superficial network to the deep network

It is on the superficial network that varicose veins are formed.

Varicose veins

Schéma du fonctionnement des valvules veineuses

Varicose veins are enlarged, swollen and twisting veins. Because of the dilation of the wall, the valves no longer play their role and the blood flows backward instead of returning back to the heart. The blood stagnates and causes a hyperpressure that damages the surrounding tissues. Symptoms such as heaviness, pain, night cramps and itching are frequently associated. In the absence of treatment, and depending on the course of the disease, complications are possible such as pigmentation, weakening of the skin that can go as far as the ulcer, and more rarely, variceal hemorrhage and phlebitis (venous thrombosis).

which can be of very different sizes, more or less close to the skin and therefore, more or less visible to the naked eye

which are small, unsightly, very fine, red, purplish or blue vessels visible under the skin. They are not classified as varicose veins; the medical term is “telangiectasia”

Schéma du fonctionnement des valvules veineuses

Treatment of varicose veins

Conservative treatments for varicose veins are based on:

whose principle is to exert a compressive force adapted to the importance of the varicose vein (in the form of tapes, socks, stockings or tights)

which increase the tonus of the venous walls and thus stimulate the circulation of the blood (but their action remains essentially symptomatic)

that relieves pain in case of complications like leg ulcers

Varicose vein removal treatments are :

which consist either to ligate the varicose vein or to remove it partially or totally, as it is the case for great saphenous veins

used to treat varicose veins of small and medium size, and which aims to destroy the venous endothelium by injecting an irritating solution

which consist of transmitting a large amount of heat inside the varicose vein to destroy it

Hybrid VBOX

VBOX® hybrid is intended for permanent venous obliteration of saphenous veins and tributary veins in patients with superficial venous reflux.

VBOX hybrid et pièce à main

it combines the advantages of radiofrequency and steam methods

approach is performed by 20G catheters or 6F introducers

admission in the morning and exit in the afternoon

injection of an anesthetic solution around the varicose vein

depending on the number and size of varicose veins to be treated

such as pain, bruises or pigmentation

causes little trauma

3 days after endovenous thermal ablation versus more than 3 weeks after stripping

Learned societies

Introduction
venous network
Varicose veins
Treatment
Hybrid VBOX
Learned societies