The name of such a disease is based onvaricose veins of the lower extremities, stands for the Latin word "varicis". It is translated as "swelling", which fully reflects the main symptoms of this pathology, which is characterized by abnormal expansion of veins. It is accompanied by other, no less unpleasant manifestations in the form of impaired blood flow and valve dysfunction.
Medical statistics are unstoppable: the disease has affected the majority of the world's population! Thus, the clinical manifestations of varicose veins, expressed to varying degrees, are found in almost 90% of women and more than 65% of men. Unfortunately, the disease is getting younger - and today there are reports that it is even being detected in school-aged children!
If you have more than 80% of the symptoms listed, we strongly recommend that you consult a doctor for advice.
Varicose veinsis a disease of the veins, the clinical manifestations of which are the expansion and pathological tortuosity of the veins, with the formation of venous nodes and the subsequent progression of symptoms of chronic venous insufficiency of various degrees of severity (from the feeling of heaviness. , fatigue in the legs, various degrees of swelling, up to the development of subcutaneous and skin compressions, the appearance of dermatitis, eczema and the eventual formation of venous trophic ulcers).
Doctors classify this pathological condition as polyetiological, as it occurs due to the influence of various factors. The main ones include:
- Congenital predisposition;
- Pregnancy in women;
- Hormonal imbalance;
- Excess weight;
- Passive lifestyle.
A professional team of phlebologists from the "Doctor Nearby" network of family clinics is always ready to help those who want to be cured of this disease. The choice of a course of treatment is carried out on an individual basis, taking into account all factors. Together with the use of effective modern techniques, this allows you to achieve the desired results.
Causes and signs of developing varicose veins
The main pathogenetic mechanisms leading to varicose veins are:
- Increased intravenous pressure, which is mainly determined by the hydrostatic pressure in the vein, resulting from the action of gravity, measured by the height of the liquid column, i. e. the distance from the heart to the point of the foot where the measurement is made. And the pressure inside the body cavities - abdominal or pleural, when it increases (pregnancy, excess weight, lifting and carrying heavy objects, etc. ) venous blood return to the heart worsens.
- Relative weakness of the venous wall, which is determined genetically, but can sometimes change under the influence of inflammatory processes in the vein.
The interaction of these factors leads to progressive stretching of the vein, the development of insufficiency of the venous valves, the appearance of reverse blood flow and the appearance of stagnation in the venous bed.
With prolonged exposure to provocative factors, inflammatory processes develop, which with their development affect and weaken the strength of the venous wall of the venous valves.
As a result of all these processes, a pathological reverse flow of blood occurs in the vein, which is called reflux, and venous stagnation develops, which leads to the development of inflammation of the fat and subcutaneous skin, which, with further progress, leads toin the appearance of a trophic ulcer
Symptoms of varicose veins:
- Visually visible expansion and rotation of the saphenous veins, in advanced cases - the formation of venous nodes;
- Feeling of heaviness, fatigue, fullness in the calves in the lower extremities;
- Formation of telangiectasia ("vascular" stars, "networks");
- Calf muscle cramps at night;
- Swelling of the legs and feet;
- Itching, dryness, hyperpigmentation and bluish skin
- The appearance of trophic, weeping, poorly healing ulcers.
The danger of varicose veins
Varicose veins in the legs themselves are more of a cosmetic problem, but they can lead to unpleasant complications: chronic venous insufficiency and inflammation of the vein, which is 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 increase in blood clotting and its spread in the deep veins. Therefore, this condition requires mandatory medical supervision and treatment, and sometimes leads to emergency surgery. Modern medicine offers a number of effective techniques that can help eliminate the risk of developing such conditions, but treatment must be started at the right time.
Classification of varicose veins
There are different classifications of varicose veins, which are shown in the table below.
Varicose veins type/stage/class according to CEAP |
signs |
The form of the pathology, its degree and the complications it has led to |
|
C1 |
Damage to intradermal vessels: telangiectasia (colloquially - "spiders", "webs", "stars") and dilated reticular veins. |
C2 |
Enlargement, pathological tortuosity Damage to the saphenous veins. |
C3 |
Damage to the saphenous veins, accompanied by edema |
C4a С4b |
Appearance of hyperpigmentation (dark brown color) of the lower leg or eczema (inflammation of the skin, dermatitis) Development of lipodermatosclerosis (inflammation and thickening of the subcutaneous fatty tissue. |
C5 |
Healed trophic ulcer |
C6 |
"Open" trophic ulcer. |
Stages of development of the pathological condition according to Savelyev |
|
Compensation |
There are no symptoms or complaints, the examination reveals enlarged veins in one or both lower extremities. |
Undercompensation |
The patient experiences discomfort, which is expressed by swelling and "needles" of the legs, as well as cramps in the calf muscles at night. The condition is accompanied by swelling in the evening, which disappears in the morning. The examination reveals varicose veins of the lower extremities. |
Decompensation |
The discomfort listed above complements inflammatory skin lesions and eczema. The skin looks dry and shiny and hyperpigmentation appears. |
Dynamics of development of varicose veins
Clinical picture of the diseasedepend on the stage of development of the disease. At the same time, doctors identify the main clinical sign that determined the name of the disease - the expansion of the saphenous veins of the lower extremities.
The beginning of the development of the disease
Initially, patients feel heaviness in the legs, fatigue and pain in the legs. During this period, visual signs of pathology are not visible. There are often cases when the above symptoms are also absent, so patients do not seek professional medical help. During an examination by a phlebologist, he identifies dilated soft veins, the skin of which has not undergone pathological changes.
Undercompensation stage
As the disease develops, patients notice pain, swelling appears when standing or sitting for long periods of time, which goes away after night. During the examination, the phlebologist notices slight swelling in the ankle area.
Decompensation phase
The course of the pathology is expressed in a constant feeling of heaviness in the lower extremities, rapid fatigue and calf muscle cramps at night. In addition, severe itching appears in the evening.
When examined by a doctor, a pronounced expansion of the veins of the lower extremities and impaired blood flow are revealed. The tension of the veins, adhesion of their walls to the skin, hyperpigmentation, cyanosis, roughness and dryness of the skin are noted.
Skin changes appear on the lower third of the leg. First, they represent the appearance of a brown color of the skin, the development of inflammation - dermatitis or eczema, the appearance of compression of the subcutaneous fatty tissue, against the background of which trophic ulcers then begin to form and progress.
Diagnosis of varicose veins
Treatment of varicose veinsdescribed after the patient has undergone a comprehensive diagnostic study, which makes it possible to accurately determine the stage of the development of the disease and the pathological changes to which it has led. Depending on the situation, it may include the following studies of the lower veins:
- Inspection;
- Duplex/triplex scanning.
- Studies of some coagulation indicators, markers of thrombophilia
The main methoddiagnosis of varicose veinsit is an ultrasound examination, in addition to which they also perform a full range of tests and do functional tests.
Treatment of varicose veins
Modern phlebology offers a number of effectiveVaricose veins treatment methods. Their selection is carried out on an individual basis, based on the clinical case and the patient's indications.
Conservative techniques should not be opposed to surgical ones, as they are used in combination. Sometimes conservative treatment can be carried out independently, but it is important to understand that it cannot lead to a cure, although it slows down the development of the pathology and also has a positive effect on the patient's condition.
Conservative therapy |
|
When to use it yourself? |
|
Problems that can be solved |
|
Techniques used |
Compression therapy, which reduces the diameter of veins and eliminates reflux, as well as stimulates venous blood return to the heart and lymphatic drainage. In this process, elastic bandages and therapeutic compression stockings are used, which the patient wears every day for the rest of his life or until the end of the surgical correction. The use of therapeutic compression stockings adequately and quickly corrects hemodynamic disorders in the legs even withtreatmentvaricose veinsin advanced stages. |
Drug therapy includes the prescription of pharmacological drugs aimed at eliminating discomfort in the legs or improving blood microcirculation and lymphatic drainage. The most commonly used drugs are:
|
|
Surgical techniques |
|
Phlebectomy |
|
What is this? |
Surgery to remove varicose veins. |
What problems does it solve? |
Normalization of blood circulation through saphenous veins |
Indications |
|
Features |
The procedure involves removing the affected veins located under the skin. |
Duration |
From 60 to 120 minutes. |
traumatisation |
Small wounds 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/disappearance of varicose veins (EVLK/EVLO) |
|
What is this? |
A technique that aims to eliminate a vein using a medical laser beam. |
Indications |
|
traumatisation |
Minimally, the operation is performed through a vein puncture. It is performed on an outpatient basis. |
Characteristics of the recovery period |
Immediately after the operation, the patient should walk for 30-40 minutes. It is necessary to wear compression stockings for at least 2 weeks. Pain is often absent or minimal |
Sclerotherapy |
|
What is this? |
A procedure that involves the introduction of a special substance into the lumen of the vessel - sclerosant, which causes the formation of a protein-erythrocyte plug with the subsequent disappearance of the vein. |
Indications |
Phlebeurism. |
Features |
The technique is effective for the treatment of intradermal veins, in other cases - as an addition to the removal of the remaining small branches of the main trunk. |
Complications |
Complications are relatively rare. |
Prevention of varicose veins
Prevention includes:
- Wearing compression stockings;
- Maintaining body weight within normal limits;
- Maintaining an active lifestyle;
- avoid standing for long periods of time;
- A timely visit to a phlebologist in case of family history or the appearance of symptoms of the disease.
If you still notice the first signs of varicose veins, hurry to seek professional medical help!