Clinical presentation includes lower extremity pain, fatigue, itching and/or heaviness, which often worsen with prolonged standing, associated with dilated tortuous veins.
Underlying venous insufficiency can be documented by duplex ultrasound.
Symptomatic treatment involves compression stockings.
Open surgical or endovenous therapy are treatment options.
Venous ulceration and bleeding are recognised complications.
Varicose veins are subcutaneous, permanently dilated veins 3 mm or more in diameter when measured in a standing position. 
Associate Professor of Surgery
University of Arizona Health Science Center
Vascular and Endovascular Surgery Section Staff
Tucson Medical Center
LRL declares that he has no competing interests.
Dr Luis R. Leon Jr would like to gratefully acknowledge Dr Maureen K. Sheehan and Dr Boulos Toursarkissian, previous contributors to this topic. MKS and BT declare that they have no competing interests.
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