Varicose veins affect 1 out of 2 people age 50 and older, and 15-25% of all adults. It is estimated that 10-15% of men and 20-25% of women have or will have varicose veins in their lifetime. They are the most common form of chronic venous disease encountered in medical practice.

The cause of varicose veins can ultimately be traced back to increased pressure, most commonly due to a combination of gravity and incompetent valves. Veins close to the surface of the skin often dilate under this pressure. This causes them to become elongated, rope-like, bulged and thickened, giving them their classic appearance. In many cases, the source of backflow of blood across the non-working valves, or reflux, is found higher up the leg than the actual site of the bulging veins. The endovenous laser seals off this reflux at the source, effectively closing off the rest of the pathway of refluxing blood.

The risk factors for varicose veins include increased age, heredity/family history, female gender, previous pregnancy and occupation that involves prolonged standing. The symptoms of varicose veins and venous insufficiency often do not correlate well with the presence, size or extent of the varicosity. They include leg pain, aching, itching, throbbing, cramping, fatigue, heaviness or restlessness, all of which worsen as the day progresses or as the person is on their feet. Some signs of advanced disease include skin discoloration, swelling and skin breakdown. Often elevating the legs or using support stockings provides some relief.

Diagnosis of varicose veins is straightforward by clinical appearance, but it is important to assess venous insufficiency and reflux with duplex ultrasound. This allows the provider to accurately map the venous anatomy, as well as search for the source of reflux causing the varicose veins. Duplex ultrasound is necessary to determine if the individual is a candidate for endovenous laser, or requires a different treatment modality.