Venous pathophysiology.

Chronic venous insufficiency and varicose veins are among the most prevalent medical problems in the adult population. Historically, our understanding of venous reflux disease focused upon the anatomical mechanisms of valvular incompetence. More recent investigations into the cellular and molecular aspects of venous insufficiency have shown that the disease is a complex multifactorial process reflecting both systemic abnormalities of connective tissue synthesis and cellular inflammatory reaction. New minimally invasive endovenous treatments for primary lower extremity venous insufficiency have spurred growing clinical interest in this disease. The intent of this review article is to discuss the prevalence, epidemiological risk factors, and current theories of the pathophysiology of primary venous insufficiency.