The name of such a disease is basedvaricose veins of the lower extremities, from the Latin word "varicis". It is translated as "swelling", which fully reflects the main symptom of this pathology, which is characterized by abnormal expansion of blood vessels. It is accompanied by other, less unpleasant manifestations in the form of impaired blood flow and impaired valve function.
Medical statistics are merciless: the disease has affected the majority of the world's population! Thus, the clinical manifestations of varicose veins expressed in different degrees are detected in almost 90% of women and more than 65% of men. Unfortunately, the disease occurs at a young age - and today there are reports that it is even found in school-aged children!
If you have more than 80% of the symptoms listed, we strongly recommend that you see a doctor for advice.
Varicose veinsIt is a disease of the veins, the clinical manifestations of which are the formation of venous nodes and the subsequent progression of various degrees of chronic venous insufficiency symptoms (from the feeling of heaviness). , fatigue in the legs, various degrees of swelling, the development of subcutaneous compressions, the appearance of fatty tissue and skin, dermatitis, eczema and, as a result, the formation of venous trophic ulcers).
Doctors classify this pathological condition as polyetiological, because it occurs as a result of the influence of various factors. The main ones include:
- congenital tendency;
- Pregnancy in women;
- Hormonal imbalance;
- Excessive weight;
- Passive lifestyle.
The team of professional phlebologists of the "Doctor Nearby" family polyclinic network is always ready to help those who want to recover from this disease. The selection of the treatment course is carried out individually, taking into account all factors. Along with the use of modern effective techniques, it allows you to get the desired result.
Causes and symptoms of the development of varicose veins
The main pathogenetic mechanisms that cause varicose veins are:
- Increased intravenous pressure, is mainly determined by the hydrostatic pressure in the vessel, caused by gravity, measured by the height of the fluid column, that is, the distance from the heart to the point on the leg where the measurement is taken. When the internal pressure of the body cavities - abdominal or pleural, increases (pregnancy, excess weight, lifting and carrying heavy objects, etc. ), venous blood return to the heart deteriorates.
- Relative weakness of the venous wall, is determined genetically, but sometimes it can change under the influence of inflammatory processes in the vessel.
The interaction of these factors leads to the progressive stretching of the vein, the development of insufficiency of venous valves, the appearance of reverse blood flow and the formation of stagnation in the venous bed.
With long-term exposure to provoking factors, inflammatory processes develop, which, as they develop, affect and weaken the strength of the venous wall of the venous valves.
As a result of all these processes, pathological reverse blood flow from the vein occurs, which is called reflux, and venous stasis develops, which leads to the development of subcutaneous fat and inflammation of the skin, which results in further progression. the appearance of a trophic ulcer
Symptoms of varicose veins:
- Visually noticeable expansion and curvature of the saphenous veins, in advanced cases - the formation of venous nodes;
- Heaviness, fatigue, feeling of fullness in lower limbs;
- Formation of telangiectasia (vein "stars", "nets");
- Cramps of calf muscles at night;
- Swelling of the legs and feet;
- Itching, dryness, hyperpigmentation and blueness of the skin
- The appearance of trophic, weeping, poorly treated ulcers.
Risk of varicose veins
Varicose veins on the legs themselves are more of a cosmetic problem, but can cause unpleasant complications: chronic venous insufficiency and inflammation of the vein called acute varicothrombophlebitis. Acute varicothrombophlebitis is a pathological condition that occurs as a result of inflammation of the venous wall and the appearance of a blood clot in the lumen. A dangerous complication of varicothrombophlebitis is the continuous growth of a blood clot and its spread to deep veins. Therefore, this condition requires mandatory medical supervision and treatment, and sometimes leads to emergency surgery. Modern medicine offers a number of effective methods that help eliminate the risk of developing such conditions, but treatment must be started on time.
Classification of varicose veins
There are different classifications of varicose veins, which are presented in the table below.
Varicose vein type/stage/class according to CEAP |
Symbols |
The form, degree and complications of the pathology |
|
C1 |
Damage to intradermal vessels: telangiectasia (so-called "spiders", "webs", "stars") and dilated reticular vessels. |
C2 |
Expansion, pathological curvature, damage to the saphenous veins. |
C3 |
Damage to the saphenous veins accompanied by edema |
C4a C4b |
The appearance of hyperpigmentation (dark brown color) of the lower leg or eczema (skin inflammation, dermatitis) Development of lipodermatosclerosis (inflammation and thickening of subcutaneous fatty tissue). |
C5 |
Healed trophic ulcer |
C6 |
"Open" trophic ulcer |
Stages of development of the pathological condition according to Saveliev |
|
Compensation |
No symptoms or complaints; |
Subcompensation |
The patient experiences discomfort expressed by swelling of the legs and "pins and needles", as well as cramps in the calf muscles at night. The condition is accompanied by swelling in the evening and disappears in the morning. Varicose veins of the lower extremities are revealed during the examination. |
Decompensation |
The concern listed above complements inflammatory skin lesions and eczema. The skin looks dry and shiny, hyperpigmentation appears. |
Development dynamics of varicose veins
Clinical picture of the diseasedepends on the stage of disease development. At the same time, doctors identify the main clinical symptom that determines the name of the disease - the expansion of the saphenous veins of the lower extremities.
The beginning of the development of the disease
At first, patients feel heaviness in the legs, fatigue and pain in the legs. Visual signs of pathology are not visible during this period. There are often cases where the above symptoms are absent, so patients do not seek professional medical help. During the examination by a phlebologist, he identifies dilated soft veins, the skin on which has not undergone pathological changes.
Subcompensation phase
As the disease progresses, patients note pain, swelling appears when standing or sitting for a long time, disappears after night. During the examination, the phlebologist notes slight swelling in the ankle area.
Decompensation stage
The development of the pathology is expressed by a constant feeling of heaviness in the lower extremities, rapid fatigue and cramps of the calf muscles at night. In addition, severe itching occurs in the evenings.
When examined by a doctor, obvious expansion of the vessels of the lower extremities and disruption of blood flow are revealed. Tension of blood vessels, adhesion of their walls to the skin, hyperpigmentation, cyanosis, roughness and dryness of the skin are noted.
Skin changes appear in the lower third of the leg. First, they represent the appearance of the brown color of the skin, the development of inflammation - dermatitis or eczema, the appearance of the density of subcutaneous fatty tissue, against the background of which trophic ulcers later begin to form and progress.
Diagnosis of varicose veins
Treatment of varicose veinsThe patient is appointed after undergoing a comprehensive diagnostic study, which allows to accurately determine the stage of development of the disease and the pathological changes it leads to. Depending on the situation, it may include the following studies of the lower veins:
- Examination;
- Duplex/triplex scanning.
- Study of some coagulation indicators, markers of thrombophilia
The main methoddiagnosis of varicose veinsis an ultrasound examination, in addition, they also perform full-spectrum tests and perform functional tests.
Treatment of varicose veins
Modern phlebology offers a number of effectivemethods of treatment of varicose veins. Their choice is made individually based on the clinical situation and the patient's instructions.
Conservative methods should not contradict surgical methods, as they are used in combination. Sometimes conservative treatment can be carried out independently, but it should be understood that it cannot lead to a cure, even if it slows down the development of the pathology and has a positive effect on the patient's condition.
Conservative therapy |
|
When should you use it yourself? |
|
Solvable problems |
|
Techniques used |
Compression therapy, which reduces the diameter of the vessels and eliminates reflux, as well as stimulates the return of venous blood to the heart and lymphatic drainage. The process uses elastic bandages and therapeutic compression stockings, which the patient wears every day for the rest of his life or until the end of surgical correction. The use of therapeutic compression stockings adequately and quickly corrects hemodynamic disturbances in the legs.treatmentvaricose veinsin advanced stages. |
Drug therapy includes prescribing pharmacological drugs aimed at relieving discomfort in the legs or improving blood microcirculation and lymphatic drainage. The most commonly used drugs are:
|
|
Surgical methods |
|
Phlebectomy |
|
What is this? |
Surgery to remove varicose veins. |
What problems does it solve? |
Normalization of blood flow through saphenous veins |
Indications |
|
Features |
The procedure involves removing the affected veins located under the skin. |
Duration |
From 60 minutes to 120 minutes. |
Traumaticity |
Small scars of 5-10 cm in the groin area and 0. 5-4 cm on the legs. The patient stays in the hospital for 1-7 days. Sick leave up to 24 days |
Endovenous laser coagulation/obliteration of varicose veins (EVLK/EVLO) |
|
What is this? |
A technique aimed at eliminating the vein using a medical laser beam. |
Indications |
|
Traumaticity |
Minimally, the operation is performed with a vein puncture. It is performed on an outpatient basis. |
Features of the recovery period |
Immediately after the operation, the patient should walk for 30-40 minutes. Compression stockings should be worn for at least 2 weeks. Pain is often absent or minimal |
Sclerotherapy |
|
What is this? |
A procedure involving the introduction of a special substance - a sclerosant - into the lumen of the vessel, leads to the formation of a protein-erythrocyte plug with the subsequent disappearance of the vessel. |
Indications |
Phlebeurism. |
Features |
The technique is effective for the treatment of intradermal veins, in other cases - in addition to the removal of small residual branches of the main trunks. |
Complications |
Complications are relatively rare. |
Prevention of varicose veins
Prevention includes:
- wear compression stockings;
- Maintaining body weight within normal limits;
- Maintaining an active lifestyle;
- avoid standing for a long time;
- A timely visit to a phlebologist in case of family history or the appearance of symptoms of the disease.
If you still feel the first signs of varicose veins, hurry to seek professional medical help!