The pathogenesis of the development of varicose veins remains obscure, and there have been many theories suggesting the primary cause. Recognized predisposing factors include age, sex, race, weight, height, pregnancy, diet, erect stance, clothes, alcohol, heredity, bowel habit and occupation. However the primary causative factors have centred around vein wall weaknesses, valvular deficiencies, and haemodynamic effects. This review looks at the evidence for and against arteriovenous anastomoses being the initiating factor in the development of varicose veins.
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