The Theoretical Basis of Varicose Vein Formation

The three major theories of varicose vein formation are tested against the known facts. No evidence is found to implicate the valve cusps. Very little evidence is found to support the theory of primary valve incompetence, and much of the evidence found is inconsistent with it. All the known facts in both valved and unvalved varices are consistent with the theory of primary vein dilatation, but not with the hypothesis that this is due to congenital weakness of the wail. It is concluded that varicosis is an acquired condition, due to some unidentified factor in western life, which either raises wall stress or prevents development of a vein of normal strength. The need for stress-measuring techniques is noted.