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Varicose Veins Types Vary And Influence Best Management

Varicose veins types vary significantly.  Location and connections hugely influence untreated outcomes.  That and targeting best treatments.

As I mentioned earlier a varicose vein shows reverse blood flow as your muscles relax.  Short-lasting back flow should cause the internal one-way valves to snap shut.  

varicose veins types include the lateral vein system frequently with spider veinsTypical lateral leg veins with associated spider veins

Failure to do so means the vessel will not clear the draining blood.  This delay will cause further local deterioration producing larger and more extensive varicose veins.

Being able to sequentially follow people using ultrasound we can now see how your varicose veins develop over time.

Local Veins

The most basic of the varicose veins types is a local varicose vein.  Just a section. 

If we watch this over months and years the small area will spread further towards your head, feet and internally deeper to the skin.  The greater the extent the worse your veins become. 

You will probably have noticed this yourself.  Initially you may well have seen one local vein.  Then more appeared.

As I mentioned pregnancy can have a huge effect on sudden worsening and extension of varicose veins.

Beyond these local occurrences there are some definite patterns.

Lateral Vein System

The major split in varicose veins types is the lateral vein system, compared to others we call truncal veins.

As you would expect from their name lateral leg veins occur most commonly on the outside of your legs.

Varicose veins types with lateral veins appearing on the inside of the lower thighProgression of lateral veins

Usually they show first in your outer thigh.  Then your outer lower leg. 

From there they tend to involve the inner far thigh to knee area followed by below your inner knee.

They are most commonly associated with spider veins, otherwise known as telangiectasiae. 

These are the finer vessels in the network and are located in your skin, making them more visible. 

Often the first problem you will notice.

Developmental Origin

Lateral leg veins are a developmental stage.  Before you were born these were the first skin draining vessels to appear. 

As you matured, still before you were born, the other systems were made.  These latter ones took over. 

In quite a few people the lateral leg veins involute and disappear once the others are established. 

But in many they don’t. 

Some will never give any problems.  But others will, giving rise to extensive networks creating spider veins.

Varied Presentation

Frequently lateral leg veins do not seem to get raised and twisted like people expect of traditional varicose veins. 

But left long enough, and deteriorating more rapidly, they can eventually look exactly the same.


Usually they have their own connections to drain blood to deeper vessels. 

Often this is through a perforator at the edge of the muscle fascia to the deeper veins below right about your mid knee area. 

Like all veins there are many interconnections.  At times lateral veins will develop compromised connections to more traditionally recognised varicose veins types.


Frequently in the past lateral leg veins have been ignored. 

But they can by themselves cause aching and pain and all the other problems associated with more obvious varicose veins.

Long Saphenous Varicose Veins Types

The next most common in presentation is those veins in the long saphenous vein distribution.  I explain about this system elsewhere.  

Varicose veins types demonstrating veins associated with the long saphenous veinVaricose veins in long saphenous vein drainage area

Extending from your ankle to the top of your thigh it drains skin blood from the front and inside of your lower leg and often practically all the thigh area.

Because of the huge area of skin veins it drains the saphenous vein was most commonly the one cut and tied or stripped. 

Starting with an incision in your groin.

Also due to the vast extent of this system it tends to be the one most strongly associated with pain and skin problems. 

The vast height of back flow creates a huge column of water pressure from groin to ankle. 

Interestingly if you have this problem you often see spider veins showing about your inside foot just below your ankle.

Anterolateral Vein

A major branch of your long saphenous vein is the anterolateral vein, often called the anterior accessory vein of the thigh. 

It is not present in everybody.  And its length can vary. 

But it drains the skin on the front and outside of your thigh.  This can also extend to the outside of your lower leg. 

At times varicose veins associated with it may also connect with ones on the back and front of your lower leg.

It commonly produces huge knotty veins in the front of your thigh. 

Right in your face…

Causing most people to want to do something about them!

Short Saphenous Vein

Another of the varicose veins types is the related short saphenous vein.  This passes on the surface of your calf muscle from your heel to back of your knee. 

It drains blood from the skin of the back and outside of your lower leg. Again it can produce large knotty varicose veins in these areas. 

Often ones you tend not to see so much yourself.  But others walking behind you can.

Giacomini Vein

Sometimes connecting these two veins is a very variable one. Some people can have it on one leg and not the other. 

It is known by the name of the person first describing - the Giacomini vein.

Traditionally it runs from the crease of your knee to near the top of your inner thigh.

Its drainage area is generally the back of your thigh.

Perforator Veins

As your veins are an interconnected network with multiple channels there are also vessels known as perforator veins. 

The name arises from their connecting of veins from the surface to the deep veins in the muscle requiring them to perforate or track through the fascia of firm binding tissue over the outside of the muscle.  I will discuss a lot on these elsewhere.

Many perforators connect the saphenous, lateral and other veins along their length to the deep veins below. 

They can become damaged or malfunctioning in themselves accounting for why sometimes these veins have significant problems that do not extend along to their highest deep connection.

Besides these there are quite a number of other perforators that connect directly from your skin vessels to the deep veins in the muscles below.  They tend to drain a localised area of your skin.

Although they are short in length due to the high pressures that develop in your leg muscles they can become hugely significant.

They can cause the full range of complications just from their own limited collections.

Other Vein Systems

Within the varicose veins types there are other veins. 

Usually these are short branches or tributaries of the veins I have already mentioned.  They tend to be quite variable in existence and presentation.

Of course there are mixes of varicose veins types in any situation. 

The longer you delay treatment to more likely it will be that a greater number of the different types can become involved.


But whatever the underlying problem to be managed effectively I need to understand which types are causing your problems.

Then I can directly target your treatment according what your body is doing. 

I can assess this best with ultrasound imaging.

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