Blood pumps out through the heart to the body through the arteries, then returns back to the heart from the body through the veins.

Veins contain one-way valves that direct blood flow back to our chest.

In our legs, blood flows from superficial veins under our skin to deep veins in our muscles,

and then from distal to proximal, that is, from our feet towards our center.

When our calves contract, blood is squeezed up past the knee,

then when our thigh muscles contract, blood is pushed up into our

torso, and the valves prevent back flow.

However, if the valves in our leg veins fail, blood flows down and out, and veins

under our skin can become enlarged and tortuous.

These so-called varicose veins affect as many as 15% of men and 29% of women.

Veracose veins are not just a cosmetic issue. They can be associated with feelings of pain,

heaviness, and itchiness. Compression stockings were traditionally the standard therapy

for management of symptoms, but of the last

decade, the lack of evidence for compression efficacy, combined with the development of

minimally invasive endovenus ablation techniques, has shifted treatment recommendations.

Under local anesthesia, a vascular surgeon or interventional radiologist makes a small incision,

and under ultrasound guidance threads a catheter into the varicose vein,

and then uses laser or high-intensity radio waves to cauterize, burn the vein from the inside

out, closing it off. The body then reroutes blood through other veins.

There is a risk of damaging the surrounding nerves, which happens in about 7% of cases,

but most nerve damage is temporary. Full surgical removal of varicose veins has fallen into

disfavor, but based on a five-year follow-up of a randomized

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