The name of such a disease is based onvaricose veins of the lower extremities, the Latin word "varicis" lies. It is translated as "flatulence", which fully reflects the main symptom of this pathology, which is characterized by abnormal expansion of veins. It is followed by other, no less unpleasant manifestations in the form of blood flow disorders and valve dysfunction.
Medical statistics are inexorable: the disease has affected the majority of the world's population! Thus, the clinical manifestations of varicose veins, expressed in varying degrees, are found in almost 90% of women and more than 65% of men. Unfortunately, the disease is getting younger and younger – and today there are reports of it being detected even in school-aged children!
If you have more than 80% of the above symptoms, 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 curvature 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, to the development of subcutaneous compaction of fatty tissue and skin, occurrence of dermatitis, eczema and possible formation of venous trophic ulcers).
Doctors classify this pathological condition as polyetiological, because it arises under the influence of various factors. Among the main ones are:
- Congenital predisposition;
- Pregnancy in women;
- Hormonal imbalances;
- Excess weight;
- Passive lifestyle.
A professional team of phlebologists from the network of family clinics "Doctor nearby" is always ready to help those who want to be cured of this disease. The selection of the course of treatment is made on an individual basis, taking into account all factors. With the use of modern effective techniques, itenables you to achieve the desired results.
Causes and signs of the development of varicose veins
The main pathogenetic mechanisms that lead to varicose veins are:
- Increased intravenous pressure, which is mainly determined by the hydrostatic pressure in the vein, which is created by 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. ), the return of venous blood to the heart worsens.
- 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 the 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 long-term exposure to provoking factors, inflammatory processes develop, which with their development influence and weaken the strength of the venous wall of the venous valves.
As a result of all these processes, there is a pathological reverse flow of blood down the vein, which is called reflux, and venous stagnation occurs, which leads to the development of inflammation of the subcutaneous fat tissue and skin, which further leads to the appearance of a trophic ulcer.
Symptoms of varicose veins:
- Visually noticeable expansion and tortuosity of saphenous veins, in advanced cases - formation of venous nodes;
- Feeling of heaviness, fatigue, fullness in the calves in the lower extremities;
- Formation of telangiectasias (vascular "stars", "nets");
- Calf muscle spasms at night;
- Swelling of feet and legs;
- Itching, dryness, hyperpigmentation and bluish skin
- Appearance of trophic, weeping, poorly healing ulcers.
Risks of varicose veins
Varicose veins on 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 vein wall and the appearance of a blood clot in the lumen. A dangerous complication of varithrombophlebitis is the continuous growth of a blood clot and its spread into 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 on time.
Classification of varicose veins
There are different classifications of varicose veins which are shown in the table below.
Type/stage/class of varicose veins according to CEAP |
Signs |
The form of the pathology, its degree and the complications it led to |
|
C1 |
Damage to intradermal vessels: telangiectasia (colloquially - "spiders", "webs", "stars") and dilated reticular veins. |
C2 |
Dilatation, pathological tortuosity. Saphenous vein damage. |
C3 |
Saphenous vein damage, accompanied by edema |
C4a S4b |
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 a pathological condition according to Saveljev |
|
Compensation |
There are no symptoms or complaints, the examination reveals varicose veins on one or both lower extremities. |
Subcompensation |
The patient feels discomfort expressed in swelling and "needles" of the legs, as well as leg muscle spasms at night. The condition is accompanied by swelling in the evening, which disappears in the morning. An examination reveals enlarged veins of the lower extremities. |
Decompensation |
The above discomfort is complemented by inflammatory skin lesions and eczema. The skin looks dry and shiny, and hyperpigmentation appears. |
Dynamics of the development of varicose veins
Clinical picture of the diseaseit depends on the stage 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
At first, patients feel heaviness in the legs, fatigue and pain in the legs. During this period, visual signs of pathology are not visible. There are frequent cases when the above-mentioned symptoms are also absent, so patients do not seek professional medical help. During the examination by a phlebologist, he identifies dilated soft veins, over which the skin has not undergone pathological changes.
Subcompensation phase
As the disease develops, patients notice pain, swelling appears when standing or sitting for a long time, which disappears after night. During the examination, the phlebologist notes a slight swelling in the area of the ankle joint.
Decompensation phase
The progression of the pathology is expressed in a constant feeling of heaviness in the lower extremities, rapid fatigue and calf muscle spasms at night. In addition, severe itching occurs in the evening.
During the examination by the doctor, pronounced dilatation 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 noticed.
Skin changes occur in the lower third of the leg. First, they represent the appearance of brown skin, the development of inflammation - dermatitis or eczema, the appearance of compaction of subcutaneous fatty tissue, against the background of which trophic ulcers begin to form and progress later.
Diagnosis of varicose veins
Treatment of varicose veinsit is prescribed after the patient has undergone a comprehensive diagnostic study, which enables accurate determination of the stage of disease development and the pathological changes it has led to. 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 veinsis an ultrasound examination, in addition to which they conduct a whole series of 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 on an individual basis, based on the clinical case and the patient's indications.
Conservative techniques should not be opposed to surgical ones, because 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 alone? |
|
Problems that can be solved |
|
Techniques used |
Compression therapy, which reduces the diameter of the veins and eliminates reflux, as well as stimulates the return of venous blood to the heart and lymphatic drainage. In doing so, 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 intreatmentvaricose veinsin advanced stages. |
Drug therapy involves prescribing 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 flow through saphenous veins |
Indications |
|
Peculiarities |
The procedure involves removing the affected veins located under the skin. |
Duration |
From 60 to 120 minutes. |
Traumaticity |
Small scars 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 that aims to eliminate the vein using a medical laser beam. |
Indications |
|
Traumaticity |
Minimally, the operation is performed through a venipuncture. 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 vein lumen - a sclerosant, which causes the formation of a protein-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 an adjunct for removing small residual branches of the main trunks. |
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;
- Timely visit to a phlebologist in case of family history or symptoms of the disease.
If you do notice the first signs of varicose veins, hurry to seek professional medical help!