The name of such a disease is based onvaricose veins of the lower limbs, the Latin word "varicis" is found. It translates as "swelling", which fully reflects the main symptom of this pathology, characterized by abnormal dilation of the veins. It is accompanied 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! Therefore, 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 becoming younger and today it has been found that it is detected even in school-age children!
If you have more than 80% of the symptoms listed, we strongly recommend that you see 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 severity (from a feeling of heaviness, leg fatigue , swelling of various degrees, up to the development of compaction of the adipose tissue and skin, appearance of dermatitis, eczema and possible 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 network of family clinics "Doctor Near" is always ready to help those who want to recover from this disease. The selection of a course of treatment is carried out on an individual basis, taking into account all factors. Together 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 that lead to varicose veins are:
- Increased intravenous 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 fluid, i. e. the distance from the heart to the point of the leg where the measurement is taken. 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 determined genetically, but can sometimes change under the influence of inflammatory processes in the vein.
The interaction of these factors leads to progressive lengthening 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 provocative 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 along the vein occurs, 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;
- Sensation of heaviness, tiredness, fullness in the calves of the lower limbs;
- Formation of telangiectasias ("vascular" stars, "cobwebs");
- Cramps in the calf muscles at night;
- Swelling of the feet and legs;
- Itching, dryness, hyperpigmentation and bluish skin
- The appearance of trophic, weeping and 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, called acute varicothrombophlebitis. Acute varicothrombophlebitis is a pathological condition that occurs due to 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 several classifications of varicose veins, 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: telangiectasias (colloquially - "spiders", "nets", "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 adipose tissue. |
C5 |
Trophic ulcer healed |
C6 |
"Open" trophic ulcer. |
Phases of development of a pathological condition according to Savelyev |
|
Compensation |
There are no symptoms or disorders; examination reveals dilated veins in one or both lower extremities. |
Undercompensation |
The patient feels discomfort, which is expressed in swelling and "pins and needles" of the legs, as well as cramps in the calf muscles at night. The condition is accompanied by swelling in the evening, which disappears in the morning. On examination, varicose veins of the lower extremities are revealed. |
Decompensation |
The discomfort listed above is added to inflammatory skin lesions and eczema. The skin appears dry and shiny and hyperpigmentation appears. |
Dynamics of the development of varicose veins
Clinical picture of the diseaseit depends on the stage of progression the disease is in. At the same time, doctors identify the main clinical sign that determined the name of the disease - the dilation 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, visual signs of pathology are not visible. There are often cases where even the above symptoms are absent, so patients do not seek professional medical help. During a visit to a phlebologist, he identifies dilated soft veins, the skin of which has not undergone pathological changes.
Undercompensation phase
As the disease develops, patients experience pain, swelling appears when standing or sitting for long periods of time, which disappears after night. During the examination the phlebologist notices a 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 and cramps in the calf muscles during the 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 a violation of blood flow is 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. Firstly, they represent the appearance of brown discoloration of the skin, the development of inflammation - dermatitis or eczema, the appearance of compaction of the subcutaneous adipose 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 allows you 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;
- Double-sided/triplex scanning.
- Studies on some coagulation indicators, thrombophilia markers
Main methoddiagnosis of varicose veinsis an ultrasound examination, in addition to which a comprehensive series of tests is performed and functional tests are performed.
Treatment of varicose veins
Modern phlebology offers a number of effectivemethods of treatment of varicose veins. Their selection is made on an individual basis, based on the clinical case and the patient's indications.
Conservative techniques should not be contrasted with 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 it alone? |
|
Problems that can be solved |
|
Techniques used |
Compression therapy, which reduces the diameter of the veins and eliminates reflux, as well as 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 veinsin advanced stages. |
Drug therapy involves the prescription of 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 the saphenous veins |
Directions |
|
Peculiarities |
The procedure involves removing the affected veins located under the skin. |
Duration |
From 60 to 120 minutes. |
Traumatism |
Small scars of 5–10 cm in the groin area and 0. 5–4 cm on the legs. The patient remains in 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. |
Directions |
|
Traumatism |
Minimum, the operation is performed through a vein puncture. Performed on an outpatient basis. |
Features of the recovery period |
Immediately after surgery, the patient should walk for 30-40 minutes. You must 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. |
Directions |
Phlebeurism. |
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:
- Wear compression stockings;
- Maintain body weight within normal limits;
- Maintain an active lifestyle;
- avoid standing for long periods of time;
- A timely visit to a phlebologist in case of family history or the appearance of symptoms of the disease.
If you still notice the first signs of varicose veins, hurry to seek professional medical help!