The name of such a disease is based onvaricose veins of the lower extremities, lies the Latin word "varicis". It is translated as "bloating, " 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.
Medical statistics are inexorable: the disease has affected most of the world's population! Thus, 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 getting younger - and today there are reports that it is being detected even in school-age children!
If you have more than 80% of the listed 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 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, to the development of subcutaneous compactions). fatty tissue and skin, the appearance of dermatitis, eczema and the eventual formation of venous trophic ulcers).
Doctors classify this pathological condition as polyetiological, since it occurs due to the influence of various factors. The main ones include:
- Congenital predisposition;
- Pregnancy in women;
- Hormonal imbalances;
- Excess weight;
- Passive lifestyle.
A professional team of phlebologists from the "Doctor Nearby" family clinic network is always ready to help those who want to be cured of this disease. The selection of a course of treatment is carried out on an individual basis, taking into account all factors. Along with the use of modern 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 fluid column, i. e. 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 increased (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 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 occurrence 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 down 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 - the formation of venous nodes;
- Feeling of heaviness, fatigue, fullness in the calves in the lower extremities;
- Formation of telangiectasia (vascular "stars", "webs");
- Cramps of the calf muscles at night;
- Swelling of the feet and legs;
- Itching, dryness, hyperpigmentation and bluishness of the skin
- The appearance of trophic, weeping, poorly healing ulcers.
Risks of varicose veins
Varicose veins in the legs themselves are more of a cosmetic problem, but 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 varicthrombophlebitis is the continued growth of the blood clot and its spread into 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 table below.
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", "networks", "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 fat 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. |
Subcompensation |
The patient experiences discomfort, which is expressed in swelling and "pins and needles" of the legs, as well as cramps of the calf muscles at night. The condition is accompanied by swelling in the evenings, which disappears in the morning. On examination, varicose veins of the lower extremities are revealed. |
Decompensation |
The discomfort listed above complements inflammatory skin lesions and eczema. The skin looks dry and shiny, and hyperpigmentation appears. |
Dynamics of development of varicose veins
Clinical picture of the diseasedepend on what stage of progression the disease is at. 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.
Beginning of disease development
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 absent, so patients do not seek professional medical help. During an examination by a phlebologist, he identifies dilated soft veins, the skin over which has not undergone pathological changes.
Subcompensation stage
As the disease develops, patients note pain, swelling appears when standing or sitting for long periods of time, which goes away after night. During the examination, the phlebologist notes slight swelling in the ankle area.
Stage of decompensation
The progression of the pathology is expressed in a constant feeling of heaviness in the lower extremities, rapid fatigue, and cramps of the calf muscles at night. In addition, severe itching occurs in the evenings.
When examined by a doctor, a pronounced dilatation of the veins of the lower extremities and impaired 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 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 compaction of subcutaneous fatty 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 conduct a full range of tests and take functional tests.
Treatment of varicose veins
Modern phlebology offers a number of effectivemethods of treating varicose veins. Their selection is carried out on an individual basis, based 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 lead to a 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 on your own? |
|
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 lymph drainage. In the process, elastic bandages and therapeutic compression hosiery are used, which the patient wears daily throughout his life or until the end of surgical correction. The use of therapeutic compression hosiery adequately and quickly corrects hemodynamic disorders in the legs even withtreatmentvaricose veinsat advanced stages. |
Drug therapy involves the prescription of pharmacological drugs that are aimed at eliminating discomfort in the legs or improving blood microcirculation and lymph 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. |
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 aimed at eliminating a vein using a medical laser beam. |
Indications |
|
Traumaticity |
Minimal, The operation is performed through a vein puncture. Performed on an outpatient basis. |
Features of the recovery period |
Immediately after surgery, the patient needs to 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 lumen of the vessel - sclerosant, which causes the formation of a protein-erythrocyte plug with the subsequent disappearance of the vein. |
Indications |
Phlebeurysm. |
Peculiarities |
The technique is effective for the treatment of intradermal veins, in other cases - as a supplement for the removal of 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;
- 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, rush to seek professional medical help!