The name of such a disease is based onvaricose veins of the lower extremities, hides the Latin word "varicis". It is translated as "swelling of the abdomen", which fully reflects the main symptom of this pathology, which is characterized by an unusual expansion of the veins. It is accompanied by other, no less unpleasant manifestations in the form of impaired blood flow and valve dysfunction.
Medical statistics are relentless: the disease has affected the majority of the world's population! Thus, the clinical manifestations of varicose veins, expressed to varying degrees, occur in almost 90% of women and more than 65% of men. Unfortunately, the disease is becoming younger and younger - and today there are reports that it is even found 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 twisting of the veins, with the formation of venous nodes and the subsequent progression of symptoms of chronic venous insufficiency with varying degrees of severity (from a feeling of heaviness, fatigue in the legs, varying degrees of swelling, to the development of subcutaneous fatty tissue and skin, the appearance of dermatitis, eczema and 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;
- 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 be cured of this disease. The choice of a course of treatment is made individually, taking into account all factors. Along with the use ofmodern effective 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 venous pressure, which is determined mainly by the hydrostatic pressure in the vein, resulting from the action of gravity, measured by the height of the column of liquid, i. e. the distance from the heart to the point of the leg where the measurement is made. And the pressure in the body cavities - abdominal or pleural, when increased (pregnancy, overweight, lifting and carrying heavy objects, etc. ) worsens the return of venous blood to the heart.
- 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, 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 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 through the vein occurs, which is called reflux, and venous stasis develops, which leads to the development of inflammation of the subcutaneous fatty tissue and skin, which, with further progression, leads to the appearance of a trophic ulcer
Symptoms of varicose veins:
- Visually noticeable expansion and distortion of the saphenous veins, in advanced cases - formation of venous nodes;
- A feeling of heaviness, fatigue, fullness in the calves of the lower limbs;
- Formation of telangiectasias (vascular "stars", "cobwebs");
- Calf muscle cramps at night;
- Swelling of the feet and legs;
- Itching, dryness, hyperpigmentation and bluish skin
- The appearance of trophic, weeping, poorly healing ulcers.
Risks of varicose veins
Varicose veins of 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 continued growth of the blood clot and its spread in the deep veins. That is why this condition requires mandatory medical supervision and treatment, and sometimes emergency surgery is required. Modern medicine offers a number of effective techniques that can help eliminate the risk of developing such conditions, but treatment must be started promptly.
Classification of varicose veins
There are different classifications of varicose veins which are presented 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 curvature Damage to the saphenous veins. |
C3 |
Damage to the saphenous veins, accompanied by edema |
C4a C4b |
The appearance of hyperpigmentation (dark brown color) on the lower leg or eczema (inflammation of the skin, dermatitis) The development of lipodermatosclerosis (inflammation and thickening of the subcutaneous fatty tissue. |
C5 |
Healed trophic ulcer |
C6 |
"Open" trophic ulcer |
Stages of development of a pathological condition according to Saveliev |
|
Compensation |
There are no symptoms or complaints, an examination reveals varicose veins on one or both lower limbs. |
Subcompensation |
The patient experiences discomfort, which is expressed in swelling and "tingling" of the legs, as well as spasms of the calf muscles at night. The condition is accompanied by swelling in the evening, which disappears in the morning. An examination reveals varicose veins of the lower limbs. |
Decompensation |
The discomfort listed above complements inflammatory skin lesions and eczema. The skin looks dry and shiny, hyperpigmentation appears. |
Dynamics of development of varicose veins
Clinical picture of the diseasedepends on the stage of development of the disease. At the same time, doctors identified the main clinical sign that determines the name of the disease - expansion 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, no visual signs of pathology are 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 identified dilated soft veins, the skin above which had not undergone pathological changes.
Stage of subcompensation
As the disease progresses, patients note pain, swelling appears when standing or sitting for a long time, which disappears after night. During the examination, the phlebologist notes slight swelling in the ankle area.
Decompensation stage
The progression of the pathology is expressed in a constant feeling of heaviness in the lower limbs, rapid fatigue, calf muscle spasms at night. In addition, severe itching occurs in the evening.
During examination by a doctor, pronounced dilatation of the veins of the lower limbs and impaired blood flow were found. Tension of the veins, adhesion of their walls to the skin, hyperpigmentation, cyanosis, roughness and dryness of the skin are noted.
Skin changes appear in the lower third of the leg. First, they represent the appearance of a brown coloration of the skin, the development of inflammation - dermatitis or eczema, the appearance of thickening of the subcutaneous fatty tissue, against the background of which trophic ulcers subsequently begin to form and progress.
Diagnosis of varicose veins
Treatment of varicose veinsit is prescribed after the patient has undergone a comprehensive diagnostic examination, which makes it possible to accurately determine the stage of development of the disease and the pathological changes it has led to. Depending on the situation, it may include the following investigations of the lower veins:
- inspection;
- Duplex/Triplex scanning.
- Investigation of some coagulation indicators, markers of thrombophilia
Basic methoddiagnosis of varicose veinsis an ultrasound examination, in addition to which they also conduct a full range of examinations and perform functional examinations.
Treatment of varicose veins
Modern phlebology offers a number of effectivemethods of treating varicose veins. Their selection is made individually, 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 alone? |
|
Problems that can be solved |
|
Techniques used |
Compression therapy that reduces the diameter of the veins and eliminates reflux, as well as stimulates the return of venous blood to the heart and lymphatic drainage. The process uses elastic bandages and therapeutic compression hosiery, which the patient wears daily throughout their life or until the end of surgical correction. The use of therapeutic compression hosiery adequately and quickly corrects hemodynamic disturbances in the legs even withtreatmentvaricose veinsin an advanced stage. |
Drug therapy includes the prescription of pharmacological drugs that are 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 the saphenous veins |
Indications |
|
Peculiarities |
The procedure involves removing the affected veins located under the skin. |
Duration |
From 60 to 120 minutes. |
traumatic |
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 aimed at eliminating a vein using a medical laser beam. |
Indications |
|
traumatic |
Minimal. The operation is performed by venipuncture. It is performed on an outpatient basis. |
Features of the recovery period |
Immediately after the operation, the patient should walk for 30-40 minutes. Compression stockings should be worn 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 - a sclerosant, which causes the formation of a protein-erythrocyte plug with subsequent disappearance of the vein. |
Indications |
Fleberism. |
Peculiarities |
The technique is effective for the treatment of intradermal veins, in other cases - as an adjunct for removing small residual branches from 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 burden or appearance of symptoms of the disease.
If you still notice the first signs of varicose veins, hurry to seek professional medical help!