Varicose veins are vein diseases, which are manifested by their expansion, elongation with the formation of nodes and thinning of the vein wall. It can affect various vessels, but most often occurs in the lower part of the leg.
In advanced cases, it leads to trophic disorders in the affected area, the development of ulcers, eczema, and even necrosis and gangrene. Therefore, it is important to make a correct diagnosis in time and start treatment.
How do varicose veins develop?
The exact cause of this disease is unknown. But the mechanism of how varicose veins start is well understood.
The venous network on the lower part of the leg is represented by deep and peripheral veins, as well as communication (perforated) channels that connect them. Normally, blood flows through the veins towards the heart, from the periphery to the inner vessels.
This is done due to the muscle pump (contraction of the muscles of the lower leg), the tone of the vascular walls and the work of the venous valves. The circulatory system is controlled by the vasomotor center in the brain.
But in the event of a violation of at least one of these links, a reverse outflow of blood occurs. At the same time, the peripheral vessels expand, the valves stop closing, causing more stagnation of blood in the peripheral circulation.
Under blood pressure, the vein walls continue to expand, causing the vessels to lengthen and knots to form. Valve deficiency increases, edema develops.
Peripheral nerve compression sends a signal to the brain about the need to increase the tone of the vascular wall. This increases the blood pressure in the inner vessels, and blood is forced out of them into the peripheral vessels, causing them to dilate even more. The vicious circle is closing.
What causes varicose veins
The exact cause of varicose veins is unknown. But it has been proven that several factors and physiological conditions contribute to its development.
Such as:
- Pregnancy (due to the compression of veins in the abdominal cavity by the pregnant uterus, blood circulation in the lower part of the legs is difficult);
- Obesity;
- Sedentary lifestyle;
- Genetic predisposition (weak valves or decreased vascular wall tone);
- Violation of hormonal balance (leading to increased blood viscosity and difficulty in its outflow);
- Post-operative conditions (due to increased blood clotting and bed rest);
- A profession associated with staying for a long time in an upright position (on the feet).
If one of these situations occurs, it is necessary to take preventive measures to prevent the development of varicose veins. Especially if there are already any clinical manifestations.
Symptoms of varicose veins
The first signs of varicose veins are:
- Pain and heaviness in the lower part of the leg;
- Swelling of the legs in the evening;
- The appearance of spider veins on the skin;
- Visible tense veins under the skin;
- Burning and itching in the affected area;
- Cramps in the muscles of the lower legs, especially at night.
Pain with varicose veins occurs and worsens towards the end of the day. They have an explosive and painful character. At the beginning of the disease, they disappear after rest, and therefore the patient does not go to the doctor for a long time.
On examination, edema, leg pastosity, telangiectasia are revealed, tense venous trunks, often painful, are palpated. How the skin of the legs with varicose veins looks like can be seen in the photo.
In severe decompensation stages, weakness, dizziness, and fainting may occur. At the same time, trophic disorders can be seen on the skin, ulcers, dermatitis and eczema develop. With a timely visit to the doctor, severe manifestations of varicose veins can be prevented.
Types of varicose veins
There are the following types of varicose veins:
- Varicose veins on the lower leg (the most common variant);
- Varicose veins on the upper leg;
- Small pelvic varicose veins (including uterine varicose veins);
- Varicose veins of internal organs (esophagus, stomach, intestines, etc. );
- Varicose veins on the face.
The most studied type is varicose veins on the lower leg. It happens most often, and usually he is the one who is meant when talking about this disease. Most patients do not know if internal varicose veins exist and how they manifest themselves until they encounter them.
Stages of development of varicose veins:
| Disease stage | Clinical manifestation |
|---|---|
| 1 level | There are no symptoms, varicose veins are detected only during instrumental examination |
| 2 levels | Heavy leg syndrome, temporary edema, spider veins on the skin |
| 3 levels | Persistent edema, pigmentation disorders on the skin, dense veins and nodes are visible, trophic disorders in the form of eczema |
| 4 levels | There are tropic ulcers, dermatitis, necrosis |
The smaller the stage, the easier the treatment and the better the prognosis for recovery.
Diagnosis of varicose veins
To make a diagnosis, in addition to examination data and characteristic complaints, laboratory and instrumental examination of the patient is required.
Laboratory diagnostics
What tests should be taken for varicose veins:
- Complete blood count with advanced formula.
- Blood clotting test:
- freezing time;
- prothrombin test;
- determination of antithrombin III, protein S and C;
- determination of homocysteine levels;
- APTT index study;
- determination of D-dimmer levels;
- determination of von Willebrand factor activity, etc.
- Blood biochemistry.
- Hormone analysis.
- General urine analysis.
- functional test.
Determination of the state of the blood coagulation system is very important for the choice of treatment tactics and the prognosis of the development of the disease.
Instrumental diagnosis of varicose veins
Of the instrumental research methods used:
- ultrasound examination of veins;
- dopplerography;
- ultrasound duplex scan of veins (combination of ultrasound and dopplerography);
- angiography;
- photoplethysmography (PPG);
- phlebography;
- venous occlusal plethysmography (VOP).
With this type of study, the thickness of the vascular wall is measured, the condition of the venous valves, the presence or absence of reverse blood flow in the veins, and others are studied. With the help of instrumental methods, it is possible not only to make a correct diagnosis, but also to accurately determine the extent of the disease.
Treatment of varicose veins
The fight against varicose veins includes medical (conservative and surgical treatment) and non-drug methods. The choice of specific options depends on the stage of the disease and the level of its external manifestations.
Conservative treatment of varicose veins
Therapy of this disease involves surgeons and phlebologists. At the first signs of the disease, you need to contact a doctor of this specialization. They will confirm the diagnosis and prescribe how to treat varicose veins in this case.
In conservative therapy, the following groups of drugs are used:
- antiplatelet agents for blood thinning and prevention of blood clots;
- anticoagulant direct and indirect action to improve the rheological properties of blood and prevent its thickening;
- phlebotonics to strengthen vascular walls, herbal preparations with horse chestnut extract;
- anti-inflammatory drugs if necessary (in the presence of inflammation in the vascular wall or in the surrounding tissue).
Most of these drugs are available for oral administration (in tablets and capsules) and for external use (in the form of ointments, gels, creams). The doctor will tell you which form is best for this patient, depending on the specific clinical situation.
Surgical treatment of varicose veins
Conservative therapy will help to completely cure the disease only in the early stages. In advanced cases and with symptoms of decompensation, surgical treatment of varicose veins is necessary.
Surgical intervention may consist of removing the entire vein or only the affected area through an incision along the vessel or in the inguinal fold and popliteal fossa (depending on the specific vein and its location). But whenever possible, doctors try to carry out a less traumatic procedure that causes freezing of the affected vessel, which leads to complete obstruction.
Options for prudent operation:
- sclerotherapy (introduction through a catheter into the vessel lumen of a special sclerosing drug that causes tight adhesion in it with subsequent replacement with connective tissue);
- endovascular laser freezing (freezing of the internal cavity of the vessel with a laser pulse);
- radiofrequency coagulation (gluing of the vein wall due to exposure to high-frequency current pulses);
- miniphlebectomy (removal of a vein or part of it through several punctures in the skin).
When performing coagulation in a different way, the result is the same - after gluing the vessel wall, its cavity will gradually be filled with connective tissue with the development of a complete barrier. In this case, blood movement will continue through healthy vessels, bypassing coagulated ones. The scheme for carrying out such an operation can be seen in the video in this article.
Surgical methods have an indisputable advantage - the likelihood of recurrence after them is very low. In terms of risk and effectiveness ratio, less traumatic procedures are better. But the price for them in the clinic is quite high.
Non-drug treatment of varicose veins
Strengthening the walls of blood vessels with varicose veins is quite possible without using tablets.
Of the non-medicinal means for this use:
- therapeutic exercises (to stimulate muscle pumps);
- compression socks and elastic bandages (compression of the lower part of the leg stimulates the expulsion of blood from the vessels, normalizes the function of the venous valves, strengthens the vascular walls).
Wearing compression stockings is recommended for all people at risk, especially:
- pregnant lady;
- work all day standing;
- to everyone during a long flight in an airplane;
- patients taking drugs that promote blood clotting;
- people with a sedentary lifestyle.
Prevention of varicose veins
Prevention of varicose veins is better to start before they appear. In addition, the recommended measures will help prevent other cardiovascular diseases.
Precautions:
- leave all bad habits;
- carefully monitor your diet (exclude fat, fried, smoked, sweet);
- strictly control your weight;
- lead an active lifestyle (more walking, running, cycling, rollerblading, etc. );
- wear comfortable shoes with small heels;
- daily contrast bath;
- at the end of the day, rest for 15 minutes with your feet elevated.
These measures will also help with identified varicose veins - to prevent the further development of the disease and the development of complications.
Many are interested in whether it is possible to play sports with varicose veins. The attending physician will give the exact answer to this question, but in most cases you can go in for sports, excluding the type of weight associated with power loads.
Varicose veins are a common disease. Women experience it 4 times more often than men, which is associated with the peculiarities of the hormonal background, pregnancy and a large list of women's professions, which involve spending all day working on their feet.
But timely prevention will help prevent the development of varicose veins for men and women. The main thing is not to ignore the doctor's advice and do not forget about the regularity of preventive measures.