The name of such a disease is based onvaricose veins of the lower limbs, lies the Latin word "varicis". It translates as "bloating", which fully reflects the main symptom of this pathology 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 nearly 90% of women and more than 65% of men. Unfortunately, the disease is getting younger and younger - and today it is reported to be detected even in school-age children!
If you experience 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 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 of the legs, more or less significant swelling, development of subcutaneous and cutaneous fatty compactions, appearance of dermatitis, eczema and possibly formation of venous trophic ulcers).
Doctors classify this pathological condition as polyetiological, since it occurs under 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 network of family clinics "Doctor Nearby" is always ready to help those who want to cure this disease. The choice of treatment is carried out on an individual basis, taking into account all factors. Along 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 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, that is, the distance from the heart to the leg pointwhere the measurement is taken. And the pressure inside the body cavities - abdominal or pleural, when it increases (pregnancy, overweight, lifting and carrying heavy objects, etc. ) the return of venous blood to the heart worsens.
- Relative weakness of the vein 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 provoking factors, inflammatory processes develop, which, as they develop, affect and weaken the resistance of the venous wall of the venous valves.
As a result of all these processes, a pathological reverse blood flow occurs in the vein, 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 in the lower limbs;
- Formation of telangiectasias ("stars", vascular "webs");
- Calf muscle cramps at night;
- Swelling of feet and legs;
- Itching, dryness, hyperpigmentation and bluing of the skin
- The appearance of trophic, oozing and poorly healing ulcers.
Risks of varicose veins
Varicose veins in the legs themselves are rather an aesthetic problem, but can lead to unpleasant complications: chronic venous insufficiency and inflammation of the vein, called acute varicothrombophlebitis. Acute varicothrombophlebitis is a pathological condition resulting from inflammation of the vein wall and the appearance of a blood clot in the lumen. A dangerous complication of varicthrombophlebitis is the continued growth of the blood clot and its spread into the deep veins. Therefore, this condition requires mandatory medical monitoring 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 initiated promptly.
Classification of varicose veins
There are different classifications of varicose veins, shown in the table below.
Type/stage/class of varicose veins according to CEAP |
Panels |
The form of the pathology, its degree and the complications to which it led |
|
C1 |
Damage to intradermal vessels: telangiectasia (colloquially - "spiders", "networks", "asterisks") and dilated reticular veins. |
C2 |
Dilation, pathological tortuosity Lesion of 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) The development of lipodermatosclerosis (inflammation and thickening of subcutaneous fatty tissue. |
C5 |
Trophic ulcer healed |
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 by swelling and "tingling" in the legs, as well as cramps in the calf muscles at night. The disease is accompanied by swelling in the evening, which disappears in the morning. On examination, varicose veins of the lower extremities are revealed. |
Decompensation |
The discomforts listed above complement inflammatory skin lesions and eczema. The skin appears dry and shiny and hyperpigmentation appears. |
Dynamics of development of varicose veins
Clinical picture of the diseaseit depends on the stage of progression of the disease. At the same time, doctors identify the main clinical sign that determined the name of the disease - dilation of the saphenous veins of the lower extremities.
Onset of disease development
At first, patients feel heaviness in the legs, fatigue and leg pain. During this period, visual signs of pathology are not visible. It often happens that the above symptoms are also absent, so patients do not seek professional medical help. During examination by a phlebologist, he identifies dilated soft veins, the skin of which has not undergone pathological changes.
Subcompensation stage
As the disease develops, patients notice pain, swelling appears when standing or sitting for long periods of time, which disappears after nighttime. During the examination, the phlebologist notices slight swelling in the ankle area.
Decompensation stage
The progression of the pathology results in a constant feeling of heaviness in the lower limbs, rapid fatigue and cramps in the calf muscles at night. In addition, severe itching occurs in the evening.
When examined by a doctor, a pronounced dilation of the veins of the lower extremities and impaired blood flow are revealed. There is tension in the veins, adhesion of their walls to the skin, hyperpigmentation, cyanosis, roughness and dryness of the skin.
Skin changes appear in the lower third of the leg. Firstly, they represent the appearance of brown discoloration of the skin, the development of inflammation - dermatitis or eczema, the appearance of compaction of subcutaneous fatty tissue, against the background of which trophic ulcers subsequently beginto train and progress.
Diagnosis of varicose veins
Treatment of varicose veinsprescribed after the patient has undergone a thorough diagnostic study, which allows you to accurately determine the stage of development of the disease and the pathological changes to which it led. Depending on the situation, this may include the following studies of the lower veins:
- Inspection;
- Duplex/triplex scanning.
- Studies of certain coagulation indicators, thrombophilia markers
Main methoddiagnosis of varicose veinsThis is an ultrasound scan, in addition to which they also perform a full range of tests and pass functional tests.
Treatment of varicose veins
Modern phlebology offers a number of effective methodsmethods of treating varicose veins. Their selection is made on a case-by-case basis, depending on the clinical case and the patient's indications.
Conservative techniques should not be pitted against surgical techniques, since they are used in combination. Sometimes conservative treatment can be carried out independently, but it is important to understand that it cannot lead to 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, while 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 surgical correction. The use of therapeutic compression stockings adequately and quickly corrects hemodynamic disorders of the legs, even withtreatmentvaricose veinsat advanced stages. |
Drug therapy involves the prescription of pharmacological drugs aimed at eliminating leg discomfort or improving blood microcirculation and lymphatic drainage. The most commonly used medications are:
|
|
Surgical techniques |
|
Phlebectomy |
|
What is this? |
Surgery to remove varicose veins. |
What problems does this solve? |
Normalization of blood flow in the saphenous veins |
Indications |
|
Special features |
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 and 0. 5 to 4 cm on the legs. The patient stays in the hospital for 1 to 7 days. Sick leave up to 24 days |
Endovenous Laser Coagulation/Varicose Obliteration (EVLK/EVLO) |
|
What is this? |
Technique aimed at eliminating a vein using a medical laser beam. |
Indications |
|
Trauma |
Minimal, the operation is carried out by venipuncture. Performed on an outpatient basis. |
Features of the recovery period |
Immediately after the operation, the patient should walk for 30 to 40 minutes. It is necessary to wear support 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 - sclerosing, which causes the formation of a protein-erythrocyte plug with the subsequent disappearance of the vein. |
Indications |
Phlebeurism. |
Special features |
The technique is effective for the treatment of intradermal veins, in other cases - as an adjunct for the elimination of small residual branches of the main trunks. |
Complications |
Complications are relatively rare. |
Varicose vein prevention
Prevention includes:
- Wear support stockings;
- Maintain body weight within normal limits;
- Maintain an active lifestyle;
- avoid standing for long periods;
- A timely visit to a phlebologist in case of a family history or the appearance of symptoms of the disease.
If you still notice the first signs of varicose veins, hurry to consult a professional doctor!