The name of such disease is based onvaricose veins of the lower extremities, the Latin word "varicis" is found. It translates as "swelling", which fully reflects the main symptom of this pathology, which is characterized by abnormal expansion of the veins. It is accompanied by other no less unpleasant manifestations in the form of impaired blood flow and valve dysfunction.
The medical statistics are inexorable: the disease has affected most 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 becoming younger and today there are reports that it is detected even in school-aged children.
If you have more than 80% of the symptoms listed, we strongly recommend that you consult a doctor.
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 varying degrees of severity (from a feeling of heaviness, fatigue in the legs, varying degrees of swelling, up to the development of compaction of the subcutaneous adipose tissue and skin, the appearance of dermatitis, eczema and eventual formation of venous trophic ulcers).
Doctors classify this pathological condition as polyetiological, since it arises due to the influence of various factors. The main ones include:
- Congenital predisposition;
- Pregnancy in women;
- Hormonal imbalances;
- Overweight;
- Passive lifestyle.
A professional team of phlebologists from the "Doctor Near" network of family clinics is always ready to help those who want to be cured of this disease. The selection of the course of treatment is carried out individually, taking into account all factors. Together with the use of modern and effective techniques, this allows you to achieve the desired results.
Causes and signs of the development of varicose veins.
The main pathogenic mechanisms that lead to varicose veins are:
- Increased intravenous pressure, which is determined mainly by the hydrostatic pressure in the vein, resulting from the action of gravity, measured by the height of the liquid column, that is, the distance from the heart to the point on the leg 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. ), worsens the return of venous blood to the heart.
- Relative weakness of the venous wall., which is genetically determined, 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 venous valves, the appearance of reverse blood flow and the appearance of stagnation in the venous bed.
With prolonged 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, a pathological reverse flow of blood occurs along the vein, which is called reflux, and venous stagnation develops, which leads to the development of inflammation of the subcutaneous fat and skin, which , with further progression, leads to the appearance of a trophic ulcer
Symptoms of varicose veins:
- Visually noticeable expansion and tortuosity of the saphenous veins, in advanced cases - formation of venous nodes;
- Feeling of heaviness, fatigue, fullness in the calves of the lower extremities;
- Formation of telangiectasias ("stars", vascular "networks");
- Cramps in the calf muscles at night;
- Swelling of feet and legs;
- Itching, dryness, hyperpigmentation and bluish discoloration of the skin.
- The appearance of trophic, suppurating and poorly healing ulcers.
Risks of varicose veins
Varicose veins in the legs 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 varicombophlebitis is the continued growth of the blood clot and its spread to 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 in a timely manner.
Classification of varicose veins.
There are different classifications of varicose veins, which are presented in the following table.
Type/stage/class of varicose veins according to CEAP |
Signs |
The form of the pathology, its degree and the complications to which it led. |
|
C1 |
Damage to intradermal vessels: telangiectasia (colloquially - "spiders", "webs", "asterisks") and dilated reticular veins. |
C2 |
Dilation, pathological tortuosity Damage to the saphenous veins. |
C3 |
Damage to the saphenous veins, accompanied by edema. |
C4a С4b |
The appearance of hyperpigmentation (dark brown color) of the lower leg or eczema (skin inflammation, dermatitis). The development of lipodermatosclerosis (inflammation and thickening of subcutaneous adipose tissue). |
C5 |
Healed trophic ulcer |
C6 |
"Open" trophic ulcer |
Stages of development of a pathological condition according to Savelyev. |
|
Compensation |
There are no symptoms or complaints; Examination reveals dilated veins in one or both lower extremities. |
Undercompensation |
The patient experiences discomfort, which is expressed in swelling and tingling in the legs, as well as cramps in the calf muscles at night. The condition is accompanied by swelling at night, which disappears in the morning. During the examination, varicose veins of the lower extremities are revealed. |
Decompensation |
The discomforts mentioned above are complemented by inflammatory skin lesions and eczema. The skin appears dry and shiny, and hyperpigmentation appears. |
Dynamics of the development of varicose veins.
Clinical picture of the disease.It depends on what stage of progression the disease is in. At the same time, doctors identify the main clinical sign that determined the name of the disease: the dilation of the saphenous veins of the lower extremities.
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 not present, so patients do not seek professional medical help. During an examination by a phlebologist, he identifies soft dilated veins, the skin of which has not undergone pathological changes.
Subcompensation stage
As the disease progresses, patients notice pain, swelling appears when standing or sitting for long periods of time, which disappears after night. During the examination, the phlebologist notices slight swelling in the ankle area.
Decompensation stage
The progression of pathology is expressed in a constant feeling of heaviness in the lower extremities, rapid fatigue and cramps in the calf muscles at night. In addition, intense itching occurs at night.
When examined by a doctor, pronounced dilation of the veins of the lower extremities and poor blood flow are revealed. 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 of all, they represent the appearance of a brown coloration of the skin, the development of inflammation: dermatitis or eczema, the appearance of compaction of the subcutaneous adipose tissue, against the background of which trophic ulcers subsequently begin to form and progress.
Diagnosis of varicose veins.
Treatment of varicose veinsprescribed after the patient has undergone a comprehensive diagnostic study, which makes it possible to accurately determine the stage of development of the disease and the pathological changes to which it led. Depending on the situation, it may include the following studies of the lower veins:
- Inspection;
- Duplex/triplex scanning.
- Studies of some coagulation indicators, thrombophilia markers.
main methoddiagnosis of varicose veinsis an ultrasound examination, in addition to which they also perform a wide range of tests and functional tests.
Treatment of varicose veins
Modern phlebology offers a number of effective methods.methods to treat varicose veins. Its selection is made individually, depending on the clinical case and the patient's indications.
Conservative techniques should not be opposed to surgical ones, since they are used in combination. Sometimes conservative treatment can be carried out independently, but it is important to understand that it cannot cure, although it slows down the development of pathology and also has a positive effect on the patient's condition.
Conservative therapy |
|
When to use it alone? |
|
Problems that can be solved |
|
Techniques used |
Compression therapy, which reduces the diameter of the veins and eliminates reflux, in addition to stimulating the return of venous blood to the heart and lymphatic drainage. In the process, elastic bandages and therapeutic compression stockings are used, which the patient wears daily throughout 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 involves the prescription of pharmacological medications aimed at eliminating discomfort in the legs or improving blood microcirculation and lymphatic drainage. The most used drugs are:
|
|
Surgical techniques |
|
Phlebectomy |
|
What is this? |
Surgery to remove varicose veins. |
What problems does it solve? |
Normalization of blood flow through the saphenous veins. |
Indications |
|
Peculiarities |
The procedure involves removing the affected veins located under the skin. |
Duration |
From 60 to 120 minutes. |
Trauma |
Small scars of 5 to 10 cm in the groin area and 0. 5 to 4 cm on the legs. The patient remains in the hospital between 1 and 7 days. Sick leave up to 24 days. |
Coagulation/obliteration of varicose veins with intravenous laser (EVLK/EVLO) |
|
What is this? |
Technique intended to eliminate a vein using a medical laser beam. |
Indications |
|
Trauma |
Minimum, the operation is performed by venipuncture. It is done on an outpatient basis. |
Features of the recovery period |
Immediately after surgery, the patient should walk for 30 to 40 minutes. It is necessary to wear compression stockings for at least 2 weeks. Pain is usually absent or minimal. |
Sclerotherapy |
|
What is this? |
A procedure that involves the introduction of a special substance into the lumen of the vessel - a sclerosant, which causes the formation of a protein and erythrocyte plug with the subsequent disappearance of the vein. |
Indications |
Phlebeurism. |
Peculiarities |
The technique is effective for the treatment of intradermal veins, in other cases, as a complement to the elimination of small residual branches of the main trunks. |
Complications |
Complications are relatively rare. |
Prevention of varicose veins
Prevention includes:
- Wear compression stockings;
- Maintain body weight within normal limits;
- Maintain an active lifestyle;
- avoid standing for long periods of time;
- A timely visit to a phlebologist in case of family history or appearance of symptoms of the disease.
If you still notice the first signs of varicose veins, hurry to seek professional medical help!