Varicose veins are a disease of veins that is manifested by their expansion, elongation with the formation of nodes and thinning of the vein wall. It can affect different blood vessels, but most often occurs in the lower extremities.
In advanced cases, it leads to trophic disorders in the affected area, the development of ulcers, eczema, and even necrosis and gangrene. Therefore, it is important to make a correct diagnosis and start treatment in time.
How do varicose veins occur?
The exact causes of this disease are not known. But the mechanism of varicose veins is well understood.
The venous network of the lower extremities is represented by deep and peripheral veins, as well as communicating (perforating) vessels that connect them. Normally, blood flows through the veins towards the heart, from the peripheral to the deep vessels.
This is done thanks to the muscle pump (contraction of the muscles of the lower extremities), the tone of the vascular wall and the work of the venous valves. The circulatory system regulates the vasomotor center in the brain.
But in case of violation in at least one of these connections, there is a reverse outflow of blood. At the same time, the peripheral vessels expand, the valves stop closing, causing even greater stagnation of blood in the peripheral circulation.
Under blood pressure, the vein wall continues to expand, causing the vessels to elongate and form knots. Valve insufficiency increases, edema develops.
Compression of peripheral nerves sends a signal to the brain about the need to increase the tone of the vascular wall. This increases the blood pressure in the deep vessels, and blood is forced out of them into the peripheral ones, causing them to expand even more. The vicious circle is closing.
What causes varicose veins
The true cause of varicose veins is unknown. However, it has been proven that numerous factors and physiological conditions contribute to its development.
such as:
- Pregnancy (due to the compression of the veins in the abdominal cavity by the pregnant uterus, blood circulation in the lower extremities is difficult);
- obesity;
- Sedentary lifestyle;
- Genetic predisposition (weak valves or reduced tone of vascular walls);
- Violation of hormonal balance (leads to an increase in blood viscosity and difficulty in its outflow);
- Condition after surgery (due to increased blood clotting and bed rest);
- Professions associated with a long stay in an upright position (on your feet).
In case of one of these situations, it is necessary to take preventive measures to prevent the development of varicose veins. Especially if there are already any clinical manifestations.
Symptoms of varicose veins
The first signs of varicose veins are:
- Pain and heaviness in the lower extremities;
- Swelling of the legs in the evening;
- The appearance of spider veins on the skin;
- Visible tense veins under the skin;
- A burning sensation and itching in the affected area;
- Cramps in the muscles of the lower limbs, especially at night.
The pain of varicose veins occurs and increases by the end of the day. They have a bursting, painful character. At the beginning, the diseases disappear after rest, so patients do not go to the doctor for a long time.
Examination reveals edema, pastiness of the legs, telangiectasia, tense venous trunks are palpated, often painful. What the skin of the legs with varicose veins looks like can be seen in the photo.
In the phase of severe decompensation, weakness, dizziness and fainting may occur. At the same time, trophic disorders on the skin are observed, ulcers, dermatitis and eczema develop. A timely visit to the doctor can prevent severe manifestations of varicose veins.
Types of varicose veins
There are the following types of varicose veins:
- Varicose veins of the lower extremities (the most common variant);
- Varicose veins of the upper extremities;
- Varicose veins of the small pelvis (including varicose veins of the uterus);
- Dilated veins of internal organs (esophagus, stomach, intestines, etc. );
- Varicose veins on the face.
The most studied type is varicose veins of the lower extremities. It occurs most often, and is usually thought of when talking about this disease. Most patients do not know if internal varicose veins exist and how they manifest themselves until they encounter them.
Stages of development of varicose veins:
| Stage of the disease | Clinical manifestations |
|---|---|
| 1 phase | There are no symptoms, varicose veins are detected only by an instrumental examination |
| 2 stages | Heavy legs syndrome, transient edema, spike veins on the skin |
| 3 stages | Persistent edema, skin pigmentation disorders, thick tense veins and knots are visible, trophic disorders in the form of eczema |
| 4 stages | There are trophic ulcers, dermatitis, necrosis |
The lower the stage, the easier the treatment and the better the prognosis for recovery.
Diagnosis of varicose veins
In order to establish a diagnosis, in addition to examination data and characteristic complaints, a laboratory and instrumental examination of the patient is required.
Laboratory diagnostics
What tests should be done for varicose veins:
- Complete blood count with extended formula.
- Blood clotting tests:
- clotting time;
- prothrombin test;
- determination of antithrombin III, proteins S and C;
- determination of homocysteine level;
- APTT index study;
- determination of D-dimer level;
- determination of von Willebrand factor activity, etc.
- Blood biochemistry.
- Hormonal analysis.
- General urinalysis.
- functional tests.
Determining the state of the blood coagulation system is of decisive importance for the choice of treatment tactics and the prognosis of the development of the disease.
Instrumental diagnosis of varicose veins
Of the instrumental research methods used:
- ultrasound examination of veins;
- dopplerography;
- ultrasound duplex scanning of veins (combination of ultrasound and dopplerography);
- angiography;
- photoplethysmography (PPG);
- phlebography;
- venous occlusal plethysmography (VOP).
These types of studies measure the thickness of the vascular wall, study the state of the venous valves, the presence or absence of reverse blood flow in the veins, etc. With the help of instrumental methods, it is possible not only to make a correct diagnosis, but also to accurately determine the stage of the disease.
Treatment of varicose veins
The fight against varicose veins includes medical (conservative and surgical treatment) and non-medical methods. The choice of a particular option depends on the stage of the disease and the degree of its external manifestations.
Conservative treatment of varicose veins
Surgeons and phlebologists are involved in the treatment of this disease. At the first signs of the disease, it is necessary to contact the doctors of these specializations. They will confirm the diagnosis and prescribe how to treat varicose veins in this case.
The following groups of drugs are used in conservative therapy:
- antiplatelet agents for blood thinning and prevention of blood clots;
- anticoagulants of direct and indirect action to improve the rheological properties of blood and prevent its thickening;
- phlebotonics for strengthening the vascular wall, herbal preparations with horse chestnut extract;
- anti-inflammatory drugs if necessary (in the presence of inflammation in the vascular wall or in the surrounding tissues).
Most of these drugs are available for oral use (in tablets and capsules) and for external use (in the form of ointments, gels, creams). The doctor will tell you which form is best for this patient, depending on the specific clinical situation.
Surgical treatment of varicose veins
Conservative therapy will help to completely cure the disease only in the early stages. In advanced cases and with symptoms of decompensation, surgical treatment of varicose veins is necessary.
Surgical intervention may consist of removing the entire vein or only the affected area through incisions along the vein or in the inguinal fold and popliteal fossa (depending on the specific vein and its location). But whenever possible, doctors try to carry out a less traumatic procedure that causes coagulation of the affected vessel, which leads to its complete obstruction.
Options for Lean Operations:
- sclerotherapy (introduction through a catheter into the vessel lumen of special sclerosing drugs that cause firm adhesions in it with their subsequent replacement by connective tissue);
- endovasal laser coagulation (coagulation of the inner vessel cavity with a laser pulse);
- radiofrequency coagulation (gluing of the vein walls as a result of exposure to a high-frequency current pulse);
- miniphlebectomy (removal of a vein or its section through several punctures in the skin).
When coagulation is carried out in different ways, the result is the same - after gluing the walls of the vessel, its cavity will gradually be filled with connective tissue with the development of complete obstruction. In this case, the movement of blood will continue through healthy vessels, bypassing the clotted ones. Schemes for performing such operations can be seen in the video in this article.
Surgical methods have an indisputable advantage - the probability of recurrence after them is very low. In terms of risk-effectiveness, less traumatic procedures are better. But the price for them in clinics is quite high.
Treatment of varicose veins without drugs
Strengthening the walls of blood vessels with varicose veins is quite possible without the use of pills.
Of the non-medicinal means for this use:
- therapeutic exercises (to stimulate the muscle pump);
- compression stockings and elastic bandages (compression of the lower extremities stimulates the ejection of blood from blood vessels, normalizes the work of venous valves, strengthens the vascular wall).
Wearing compression stockings is recommended for all at-risk people, especially:
- pregnant women;
- work all day standing;
- to all people during long flights in airplanes;
- patients taking drugs that promote blood clotting;
- people with a sedentary lifestyle.
Prevention of varicose veins
Prevention of varicose veins is better to start before they appear. Moreover, the recommended measures will help prevent other cardiovascular diseases.
Instructions for prevention:
- give up all bad habits;
- carefully monitor your diet (exclude fatty, fried, smoked, sweet);
- strictly control your weight;
- lead an active lifestyle (more walking, running, cycling, rollerblading, etc. );
- wear comfortable shoes with small heels;
- daily contrast shower;
- at the end of the day, rest for 15 minutes with your feet elevated.
These measures will also help with identified varicose veins - to prevent further progression of the disease and the development of complications.
Many are interested in whether it is possible to do sports with varicose veins. The attending physician will give the correct answer to this question, but in most cases you can do sports, excluding its heavy types associated with load.
Varicose veins are a common disease. Women suffer from it 4 times more often than men, which is related to the peculiarities of the hormonal background, pregnancy and a large list of female professions, which involve spending the entire working day on your feet.
But timely prevention will help prevent the development of varicose veins in both men and women. The main thing is not to ignore the doctor's advice and do not forget about the regularity of preventive measures.