Varicose veins are a disease of the veins, manifested by their expansion, elongation with the formation of nodes and thinning of the venous wall. It can affect several vessels, but most often occurs in the lower extremities.
In advanced cases, it leads to trophic disorders in the affected area, development of ulcers, eczema, and even necrosis and gangrene. Therefore, it is important to make the correct diagnosis in time and start treatment.
How do varicose veins develop?
The exact causes of this disease are not known. But the mechanism of how varicose veins start 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 due to the muscular 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 is regulated by the vasomotor center in the brain.
But in case of violation of at least one of these links, a reverse outflow of blood occurs. At the same time, the peripheral vessels expand, the valves stop closing, causing even more blood stasis in the peripheral circulation.
Under blood pressure, the venous wall continues to expand, causing the vessels to elongate and form knots. Valve insufficiency increases, edema develops.
The compression of peripheral nerves sends a signal to the brain about the need to increase the tone of the vascular wall. This raises the blood pressure in the deep vessels, and blood is forced out of them to the peripheral ones, causing them to expand further. A vicious circle is closing.
what causes varicose veins
The true cause of varicose veins is not known. But it has been proven that a number of factors and physiological conditions contribute to its development.
Such as:
- Pregnancy (due to 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 decreased tone of vascular walls);
- Violation of hormonal balance (leads to an increase in blood viscosity and difficulty in its exit);
- Condition after operations (due to increased blood clotting and bed rest);
- Professions associated with a long stay in an upright position (on the legs).
In the 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 clinical manifestations.
varicose veins symptoms
The first signs of varicose veins are:
- Pain and heaviness in the lower extremities;
- Swelling of the legs at night;
- The appearance of spider veins on the skin;
- Tense veins visible under the skin;
- Burning and itching sensation in the affected area;
- Cramps in the muscles of the lower extremities, especially at night.
Pain with varicose veins occurs and intensifies later in the day. They have an explosive and painful character. At the beginning of the disease, they disappear after rest, and therefore patients do not go to the doctor for a long time.
On examination, edema, pastiness of the legs, telangiectasia are revealed, tense, often painful, venous trunks are palpated. What the skin of the legs with varicose veins looks like can be seen in the photo.
In the stage of severe decompensation, weakness, dizziness, and fainting may occur. At the same time, trophic disorders are noticeable on the skin, ulcers, dermatitis and eczema develop. With a timely visit to the doctor, serious manifestations of varicose veins can be avoided.
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);
- Varicose veins of internal organs (esophagus, stomach, intestines, etc. );
- Varicose veins on the face.
The most studied type are varicose veins of the lower extremities. It occurs more often, and it is usually he who refers when talking about this disease. Most patients do not know if there are internal varicose veins and how they manifest themselves until they find them.
Stages of varicose veins development:
| disease stage | Clinical manifestations |
|---|---|
| 1 stage | There are no symptoms, varicose veins are only detected during instrumental examination |
| 2 stages | Heavy legs syndrome, transient edema, spider veins on the skin |
| 3 stages | Persistent edema, skin pigmentation disorders, dense tight veins and nodules 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.
varicose vein diagnosis
To make a diagnosis, in addition to the examination data and characteristic complaints, a laboratory and instrumental examination of the patient is necessary.
laboratory diagnosis
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, protein S and C;
- determination of homocysteine level;
- APTT index study;
- determination of the D-dimmer level;
- determination of von Willebrand factor activity, etc.
- Blood biochemistry.
- Hormonal analysis.
- General analysis of urine.
- functional tests.
Determining the state of the blood clotting 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 the veins;
- dopplerography;
- duplex ultrasound vein scan (combination of ultrasound and dopplerography);
- angiography;
- photoplethysmography (PPG);
- phlebography;
- Venous occlusal plethysmography (VOP).
With these types of studies, the thickness of the vascular wall is measured, the condition 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 the correct diagnosis, but also to accurately determine the stage of the disease.
varicose veins treatment
The fight against varicose veins includes medical (conservative and surgical treatment) and non-drug methods. Choosing a specific option depends on the stage of the disease and the degree of its external manifestations.
Conservative treatment of varicose veins
The therapy of this disease involved surgeons and phlebologists. At the first signs of the disease, you need to contact the doctors of these specializations. They will confirm the diagnosis and prescribe how to treat varicose veins in this case.
In conservative therapy, the following groups of drugs are used:
- antiplatelet agents for blood thinning and preventing blood clots;
- anticoagulants of direct and indirect action to improve the rheological properties of blood and prevent its thickening;
- phlebotonics to strengthen the vascular wall, herbal preparations with horse chestnut extract;
- anti-inflammatory drugs, if necessary (in the presence of inflammation in the vascular wall or surrounding tissues).
Most of these drugs are available both for oral administration (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 just the affected area through incisions along the vessel or in the inguinal crease and popliteal fossa (depending on the specific vein and its location). But whenever possible, doctors try to perform a less traumatic procedure that causes the affected vessel to clot, which leads to its complete obstruction.
Options for booking operations:
- sclerotherapy (introduction through a catheter into the lumen of the vessel of special sclerosing drugs that cause tight adhesions in it with their subsequent replacement by connective tissue);
- endovascular laser coagulation (coagulation of the vessel's internal cavity with a laser pulse);
- radiofrequency clotting (sticking together the walls of a vein as a result of exposure to a pulse of high-frequency current);
- miniphlebectomy (removal of a vein or its section through several skin punctures).
When carrying out coagulation in different ways, the result is the same - after gluing the walls of the vessel, its cavity will gradually fill with connective tissue with the development of complete obstruction. In this case, blood movement will continue through the healthy vessels, bypassing the clotted ones. Schemes for carrying out such operations can be seen in the video of this article.
Surgical methods have an indisputable advantage - the probability of recurrence after them is very low. In terms of risk and effectiveness, less traumatic procedures are better. But their price in clinics is quite high.
Non-drug treatment of varicose veins
Strengthening the walls of blood vessels with varicose veins is quite possible without the use of pills.
Of non-drug means for this use:
- therapeutic exercises (to stimulate the muscle pump);
- compression stockings and elastic bandages (compression of the lower extremities stimulates the expulsion of blood from the vessels, normalizes the functioning of venous valves, strengthens the vascular wall).
The use of compression stockings is recommended for all people at risk, especially:
- pregnant women;
- working all day standing up;
- to all people during long flights in planes;
- patients taking drugs that promote blood clotting;
- people with a sedentary lifestyle.
varicose veins prevention
Prevention of varicose veins is best started before it appears. In addition, the recommended measures will help to prevent other cardiovascular diseases.
Prevention instructions:
- 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 15 minutes with your legs elevated.
These measures will also help with identified varicose veins - to prevent disease progression and the development of complications.
Many are interested in whether it is possible to play sports with varicose veins. The attending physician will give the exact answer to this question, but in most cases you can play sports, excluding their heavy types associated with energy loads.
Varicose veins are a common disease. Women suffer from it 4 times more than men, which is associated with 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 for both men and women. The main thing is not to neglect the advice of a doctor and not to forget about the regularity of preventive measures.