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Key Points Varicose veins are tortuous dilated segments of vein associated with valvular incompetence Risk factors include prolonged standing, obesity, pregnancy, and positive family history Most will simply be a cosmetic issue however can present with pain, aching, swelling, or itching Gold standard investigation is duplex ultrasound Management options in those that meet the criteria include vein ligation and stripping, foam sclerotherapy, and thermal ablation