The name of such a disease is based onVaricose veins of the lower extremities, lies the Latin word "varicis". It is translated as "flatulence", 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 symptoms in the form of circulatory disorders and valve dysfunction.
Medical statistics are relentless: the disease has affected most of the world's population! Clinical manifestations of varicose veins are found to varying degrees 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 being detected in school-age children!
If you have more than 80% of the symptoms listed, we strongly recommend that you seek medical advice.
Varicose veinsis a disease of the veins, the clinical manifestations of which consist in the expansion and pathological tortuosity of the veins with the formation of venous nodules and the subsequent progression of symptoms of chronic venous insufficiency of varying degrees of severity (from feeling of heaviness), fatigue of the legs, swelling of varying degrees, to the development ofsubcutaneous fatty tissue and skin, to the appearance of dermatitis, eczema and ultimately to the formation of venous trophic ulcers).
Doctors classify this pathological condition as polyetiological, since it arises as a result of the influence of various factors. The most important include:
- Congenital predisposition;
- pregnancy in women;
- Hormonal imbalances;
- obesity;
- Passive lifestyle.
A professional team of phlebologists from the family clinic network "Doctor Nearby" is always ready to help those who want to be cured of this disease. The choice of treatment is made individually, taking into account all factors. Together with the use of modern effective techniques, this allows the desiredresults are achieved.
Causes and signs of the development of varicose veins
The main pathogenetic mechanisms leading to varicose veins are:
- Increased intravenous pressure, which is determined primarily by the hydrostatic pressure in the vein arising from the action of gravity, measured by the height of the liquid column, i. e. H. the distance from the heart to the point on the leg where the measurement is taken. And the pressure in the body cavities - abdomen or pleura - when increased (pregnancy, obesity, lifting and carrying heavy objects, etc. ), the return flow 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 progressive stretching of the vein, the development of insufficiency of the venous valves, the occurrence 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 strength of the venous wall of the venous valves.
As a result of all these processes, a pathological backflow of blood through the vein occurs, which is called reflux, and venous stagnation occurs, which leads to the development of inflammation of the subcutaneous fatty tissue and skin, which, with further progression, leads to the occurrencea trophic ulcer
Symptoms of varicose veins:
- Visually noticeable expansion and tortuosity of the saphenous veins, in advanced cases - formation of venous nodules;
- Feeling of heaviness, fatigue and fullness in the calves of the lower extremities;
- Formation of telangiectasias (vascular "stars", "tissues");
- 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 on the legs themselves are more of a cosmetic problem, but can lead to unpleasant complications: chronic venous insufficiency and phlebitis, 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 varicose vein thrombophlebitis is the persistent 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 diseases. However, treatment must be started in a timely manner.
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 |
Sign |
The form of the pathology, its extent and the complications to which it led |
|
C1 |
Damage to intradermal vessels: telangiectasias (colloquially "spiders", "networks", "stars") and dilated reticular veins. |
C2 |
Dilatation, pathological tortuosity damage to 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 |
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. |
Undercompensation |
The patient experiences discomfort that manifests itself in swelling and tingling of the legs as well as nighttime cramps in the calf muscles. Swelling occurs in the evening and disappears in the morning. During the examination, varicose veins of the lower extremities are detected. |
Decompensation |
The complaints listed above complement inflammatory skin lesions and eczema. The skin looks dry and shiny and hyperpigmentation occurs. |
Dynamics of the development of varicose veins
Clinical picture of the diseasedepend on which stage of the disease progression the disease is in. 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.
Beginning of disease development
Initially, patients experience heaviness in the legs, fatigue and pain in the legs. During this period, no visual signs of pathology are visible. It often happens that the above symptoms are also absent, so patients do not seek professional medical help. During an examination by a phlebologist, he finds dilated soft veins, the skin of which has not undergone any pathological changes.
Undercompensation level
As the disease develops, patients note pain, swelling occurs when standing or sitting for a long time, which disappears after the night. During the examination, the phlebologist notices slight swelling in the ankle area.
Stage of decompensation
The progression of pathology is manifested by a constant feeling of heaviness in the lower extremities, rapid fatigue and night cramps in the calf muscles. In addition, there is severe itching in the evening.
Medical examination reveals pronounced enlargement of the veins of the lower extremities and impaired blood circulation. 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. Firstly, they represent the appearance of browning 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 has led. Depending on the situation, it may include the following examinations of the lower veins:
- Inspection;
- Duplex/Triplex scanning.
- Studies of some coagulation indicators and thrombophilia markers
Main methodDiagnosis of varicose veinsThis involves an ultrasound examination, and extensive examinations and functional tests are also carried out.
Treatment of varicose veins
Modern phlebology offers a number of effective methodsMethods for treating varicose veins. Their selection is made individually, based on the clinical case and the patient's indications.
Conservative techniques should not be in conflict with surgical techniques as they are used in combination. Sometimes conservative treatment can be carried out independently. However, 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. Elastic bandages and therapeutic compression stockings are used, which the patient wears daily for life or until the end of the surgical correction. Through the use of therapeutic compression stockings, hemodynamic disorders in the legs are corrected sufficiently and quicklyTreatmentVaricose veinsin advanced stage. |
During drug therapy, pharmacological drugs are prescribed that are aimed at eliminating discomfort in the legs or improving blood microcirculation and lymphatic drainage. The most commonly used medications are:
|
|
Surgical techniques |
|
Phlebectomy |
|
What is that? |
Surgery to remove varicose veins. |
What problems does it solve? |
Normalization of blood flow through the saphenous veins |
Hints |
|
particularities |
During the procedure, the affected veins are removed from under the skin. |
Length of time |
From 60 to 120 minutes. |
Traumaticity |
Small scars 5-10 cm in the groin 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 that? |
A technique for removing a vein using a medical laser beam. |
Hints |
|
Traumaticity |
Minimal: The operation is performed through venipuncture. Is carried out on an outpatient basis. |
Features of the recovery period |
Immediately after the operation, the patient needs to walk for 30-40 minutes. Wearing compression stockings is required for at least 2 weeks. Pain is often absent or minimal |
Sclerotherapy |
|
What is that? |
A procedure in which a special substance is introduced into the lumen of the vessel - a sclerosant, which causes the formation of a protein-erythrocyte plug with the subsequent disappearance of the vein. |
Hints |
Phlebeurysm. |
particularities |
The technique is suitable for the treatment of intradermal veins, in other cases as a supplement to the removal of small residual branches of the main trunks. |
Complications |
Complications are relatively rare. |
Prevention of varicose veins
Prevention includes:
- wearing compression stockings;
- Maintain body weight within normal limits;
- maintaining an active lifestyle;
- Avoid standing for long periods of time;
- A timely visit to a phlebologist in the event of a family history or the appearance of symptoms of the disease.
If you still notice the early signs of varicose veins, seek professional medical help quickly!