Varicose veins on legs

Varicose veins of the legs are characterized by an increase in length due to the saccular expansion and serpentine twisting of the superficial (subcutaneous) veins of the lower limbs, impaired blood flow through them and stagnant changes in the lower limbs.

The term "varicosis" comes from the Latin word varix, which means "twist, entanglement".

Varicose veins have been known to mankind since ancient times.During archaeological research during the Mastaba burial excavations in Egypt between 1595-1580.BC, a mummy was found with signs of varicose veins and the treatment of a venous trophic ulcer of the leg.

This disease is rightly seen as the price humanity pays for the ability to walk upright.In economically developed countries, on average, about 15% of men and up to 25% of women (including pregnant women) suffer from varicose veins.Women, overweight people, and people with long-term stress on the lower limbs, who have to stand or sit for a long time during their work, are in the group at increased risk.

Classification

Taking into account the factors predisposing to the development of the disease, primary and secondary varicose veins of the legs are distinguished for different reasons.

1. Primarydevelops with varicose veins.In the case of varicose veins, mainly the superficial veins change, while the structure and function of the deep veins are normal.For a long time, the varicose veins of the superficial veins manifest themselves only as a cosmetic defect, but later, as the disease progresses, disorders of the venous outflow occur, resulting in painful sensations in the lower limbs, swelling of the legs and feet, darkening of the skin in the lower third of the legs, inflammatory changes and trophic ulcers.Varicose veins are a constantly progressive disease.
2. Secondaryit develops as a complication of deep vein disease, especially congenital abnormalities of the venous system (fistulas, congenital dysplasia, etc.) or phlebothrombosis.Phlebothrombosis is a complex process of thrombus formation in the deep main veins of the lower limbs, as a result of which the blood flow through the deep veins is interrupted.Over time, the resulting blood clot becomes fixed in the vein, holes appear in it through which blood flow is limited, but the venous valves at the site of the blood clot become scarred and no longer prevent the reverse flow of blood.As a result of malfunctioning of the valves of the deep veins, the blood moves up and down through them, flows back into the superficial veins and secondary varicose veins develop.As a result, favorable conditions are created for venous stasis, especially in the lowest parts of the limb - the feet and legs.

Symptoms of varicose veins

In most people, varicose veins appear as a cosmetic defect, most often on the inner surface of the legs.Sometimes varicose veins can appear only in the form of venous webs, which are formed when small diameter veins change, most often on the legs, less often on the face or upper limbs.Varicose veins turn blue or dark purple in color and have a tortuous course.

Symptoms of varicose veins: fatigue, heaviness, aching pain, burning and tingling, throbbing, itching, cramps and anxiety.In addition, one of the symptoms may be swelling of the legs.As a result of the pronounced expansion of varicose veins, a violation of the blood supply to the tissues of the lower limbs may occur, skin defects may appear in the form of darkening or redness of the skin, as well as inflammations.In extremely advanced cases of varicose veins, trophic ulcers develop.

Diagnosis of varicose veins

To make a diagnosis, the doctor first examines the patient, paying particular attention to the appearance and swelling of the lower limbs.They may also ask you a number of questions about your feelings to clarify the nature of your pain.Another important step is to perform a series of tests to assess the functional state of the superficial and deep veins.And finally, an ultrasound Doppler examination of the main veins of the lower limbs.The ultrasound examination method allows the doctor to see the structure of the veins of the lower limbs and evaluate their functioning, as well as to identify venous blood clots.

When the first symptoms of the disease appear, you should first consult doctors dealing with vascular and venous diseases (general surgeon, vascular surgeon, phlebologist), and in case of skin damage, also a dermatologist.You can go to a cosmetic clinic only after visiting specialists and on their recommendation.

Prevention of varicose veins

Currently, there is no method that can completely prevent the formation of varicose veins.Thanks to prevention, muscle tone can be improved, which helps to improve the microcirculation of the tissues, as well as to improve the condition and functioning of the veins of the lower limbs, as well as to reduce the risk of complications.The traditional and most common prevention methods are as follows:

1. Physical activity.Move more.The legs must be constantly in motion.While walking, more favorable conditions are created for the blood circulation of the lower limbs.Consult your doctor.He will help you choose the most optimal type and level of physical activity.
2. Control your weight.Being overweight increases the load on the circulatory system and especially on the veins.In addition, in case of excessive salt consumption, edema increases most markedly due to fluid retention in the body.
3. Be careful what you wear.Avoid high heels.Your shoes should always be comfortable.When wearing low-heeled shoes, the muscles of the lower limb work much better, which improves venous outflow.Also avoid wearing uncomfortable and tight pants and skirts.
4. Raise your legs.When you raise your legs, the venous outflow of blood from the lower limbs improves.Try to take a few breaks throughout the day and put your feet up.For example, lie on your back with your feet on a pillow.
5. Avoid prolonged standing or walking.To improve blood circulation, try to change the position of the body as often as possible.Try to get up and walk every 30 minutes.
6. Do not sit with your legs crossed.Crossed legs create unfavorable conditions for blood flow in both lower limbs.

A good remedy for preventing varicose veins is to wear tights, knee socks and compression socks.It can also be a good supplement to the main (medicinal or surgical) treatment.Currently, pharmacies offer a wide selection of compression garments.

Treatment of varicose veins

There are several commonly accepted methods of treating varicose veins of the legs:

1. conservative (drug and compression therapy).
2. surgical.

Conservative treatment

Doctors consider elastic compression to be the most effective conservative tool for the treatment and prevention of varicose veins - the use of special compression stockings (stockings, golf, stockings).When wearing this knitwear, they provide even pressure on the lower limbs, which promotes normal blood circulation and improves its outflow, while forming a kind of outer frame that supports the weakened vessel walls.As a result, the load on the veins decreases, the flow of venous blood improves, the rate of further progression of the disease decreases, and the risk of thrombosis decreases.

Modern compression stockings are divided into two types: therapeutic and preventive.All medicinal products are marked in mm Hg and are classified accordingly from I to IV.At different stages of the disease, compression of a certain strength is used, and a doctor should be consulted, since only a doctor can prescribe and select the appropriate compression stockings, taking into account the nature of the pathology and according to certain individual standards.

If you lead a sedentary lifestyle, as well as long-term physical activity, during pregnancy or in case of hereditary predisposition, it is recommended to wear preventive compression stockings and tights.If even minor signs of varicose veins appear, contact a specialist clinic immediately.

Drug therapy can reduce the clinical manifestations of the disease - pain, swelling, discomfort, convulsions and so on, but it cannot completely stop the progression of the disease, and today it is used only as part of complex therapy during the main surgical treatment.Unfortunately, most of the drugs offered on the pharmaceutical market today for the treatment of varicose veins are of rather low efficiency, despite the theoretically justified possibility of application.One of the reasons for this is the low absorption of the medicinal substances on which these drugs are based in the body.It is possible that in this situation, increasing the dose of the medicine taken would help, but this involves an increased risk of complications and side effects.Another reason for the low effectiveness of these drugs is that their spectrum of action is relatively narrow and directed at a certain relationship involved in the development and progression of the disease.In order to achieve the optimal effect, a complex effect on the disease and the use of several drugs are required.An ideal drug for the treatment of venous insufficiency and varicose veins should affect as many pathogenetic chains of chronic venous insufficiency as possible, while having a minimum number of side effects and being well absorbed by the body.

Surgical treatment

Today, surgical treatment of varicose veins of the legs does not require a long hospital stay.Thanks to the use of modern invasive treatment methods, the removal of varicose veins can be performed not only under anesthesia, with the patient completely switched off, but also under local anesthesia, when only the pain sensitivity of the lower limbs is turned off when the patient is conscious.Varicose veins disappear on their own within 3 months after delivery without treatment.

The following surgical treatment methods are available:

1. Sclerotherapy.During the procedure, a solution is injected, as a result of which a scar is formed at the site of the damaged vein.This method can only be used for small and medium caliber varicose veins.In some cases, not one, but several injections of sclerosing solution may be needed to make the vein disappear completely.Sclerotherapy, performed correctly, is quite effective, non-traumatic, has a good therapeutic and cosmetic effect, and a significant advantage is that sclerotherapy is performed under local anesthesia (that is, without anesthesia), directly in the doctor's office.
2. Laser surgery.Varicose veins of any diameter and especially the venous network can be removed with laser radiation.The essence of the method is to irradiate the inner surface of the vein with a laser beam.By making a small puncture of the skin and the wall of the vein, a special device is inserted - a light guide, through which a laser beam is passed under ultrasound control.The inner surface of the vein is irradiated with a laser and then glued together.When applying the method, the doctor directs a laser beam at the vein to be removed, it slowly discolors and the vein disappears completely.An important advantage of this method is that no incision is made in soft tissue or skin.With the laser method, it is possible to remove damaged veins and heal trophic ulcers of the leg.
3. Surgical removal of varicose veins.During surgical removal, a series of small incisions are made in the skin and soft tissue through which the damaged vein is removed and the insufficient perforating veins in the leg are ligated.When using this technique, anesthesia is a necessary condition.This method is used to remove large varicose veins.
4. Outpatient phlebectomy (removal of varicose veins).This method is suitable for removing veins of small diameter.With this method, the vein is removed through several small skin incisions under local anesthesia.The scars formed after removal are small and almost invisible.
5. Endoscopic removal of varicose veins.This method is particularly suitable for the development of ulcerative skin defects.During the method, a special video micro-camera is inserted into the vein, which allows you to see the inside of the vein and observe the entire removal process.The vein is then removed under observation through this camera.

Thanks to the use of modern treatment methods, a complete recovery and a good cosmetic effect can be achieved.But it must be remembered that varicose veins can appear again.

Complications of varicose veins

Changes in the skin around the varicose veins can sometimes occur as a result of damage to the blood microcirculation, from marked darkening to ulcerated skin defects.If these changes occur, consult a doctor immediately.

Another serious complication of varicose veins is the formation of blood clots in the deep and superficial veins.This complication is called thrombophlebitis.When it occurs, acute, excruciating pain, swelling, and redness occur.In this situation, you should consult a doctor immediately.

Causes of varicose veins

The true nature of varicose veins is not clear enough.According to most scientists, varicose veins are hereditary, genetically determined.The main reason for this is the weakness of the vein wall and the dysfunction of the venous valves.Venous valves originate from the wall of the veins and usually have 2 leaflets oriented towards the heart.When the valves are closed normally, blood from the overlying section of the vein cannot penetrate into the section below it.When the function of the valves is impaired and the valves do not close completely, the blood moves up and down, resulting in venous stasis and dilation of the veins located below the valve with impaired function.Initially, varicose veins appear in the place where the valve is damaged, and the blood leaves the deep veins in external directions, the overfilled vein stretches and expands, which leads to the stretching of the underlying valve, its malfunction, etc.Disorders of the venous outflow of blood from the lower limb to the heart develop gradually, as a result of which the microcirculation of blood in the tissues of the lower limbs is disturbed, which manifests itself in edema, increased pigmentation, thrombophlebitis and trophic ulcers.

Factors affecting the development of varicose veins

Factors contributing to the development of varicose veins may include:

1. Genetic predisposition - thin and weak walls of superficial veins.
2. Increased load on the veins: sedentary work, prolonged standing, wearing uncomfortable high-heeled shoes, lifting heavy objects, lack of movement of the lower leg muscles.In addition, the trigger factor for the development of varicose veins is pregnancy and childbirth.In case of sudden physical overload, the hydrostatic pressure in the veins of the lower limbs increases strongly, which starts the process of varicose veins.

Risk factors for developing varicose veins include:

1. Age.With advancing age, the walls of the veins and the valves become thinner, which leads to a natural disruption of their function.
2. Floor.Women are more likely to suffer from varicose veins.This may be due to a number of hormonal reactions.Female sex hormones influence the relaxation process of the venous wall.In the female body, pronounced hormonal changes occur during pregnancy and childbirth, the menstrual cycle and menopause, which do not affect the functioning of the venous system.It is also impossible to rule out the effect of taking hormonal contraceptives on the process of varicose veins.
3. Obesity.In case of overweight and obesity, the load on the veins of the lower limbs increases.
4. Pregnancy and childbirth.In pregnant women, the volume load on the body increases, but at the same time, the speed of blood flow from the lower limbs to the pelvic cavity to the inferior vena cava system and to the heart decreases.This creates favorable conditions for the formation of varicose veins.Changes in the circulatory system in the female body ensure the development of the fetus, but at the same time cause the formation of varicose veins.As pregnancy progresses or during childbirth, varicose veins can develop not only in the lower limbs, but also in the hemorrhoidal veins around the anus.