Varicose veins in the legs

Varicose veins in the legs are characterized by the formation of saccular expansions of the superficial (subcutaneous) veins of the lower extremities, their serpentine tortuosity, an increase in length due to impaired blood flow through them, and stagnant changes in the lower extremities.

The term "varicose vein" comes from the Latin word varix, which means "twisted, intertwined".

Mankind has been familiar with varicose veins since ancient times.While conducting archaeological research during the excavations of the Mastaba burial in Egypt from 1595-1580.BC a mummy was found with signs of varicose veins and treatment for a venous trophic ulcer of the leg.

This disease is rightly considered the price humanity pays for the ability to walk uprightly.On average, about 15% of men and up to 25% of women (including pregnant women) in economically developed countries suffer from varicose veins in the legs.The high-risk group includes women, overweight people, people with an occupation that involves long-term stress on the lower limbs and whose work requires them to stand or sit for long periods of time.

Distribution

Considering the predisposing factors for the development of the disease, primary and secondary varicose veins in the legs are distinguished for different reasons.

1. PRIMARYdevelops with varicose veins.With varicose veins, it is mainly the superficial veins that change, while the deep veins have normal structure and function.For a long time, superficial varicose veins are manifested only as a cosmetic defect, but later, with the progression of the disease, disturbances in venous outflow occur, resulting in painful sensations in the lower extremities, swelling of the legs and feet, darkening of the skin in the lower third of the leg, inflammatory and inflammatory changes of the leg.Varicose veins are a constantly progressive disease.
2. Mediumis a complication of deep vein disease, in particular, it develops either as a result of congenital malformations of the venous system (fistula, congenital dysplasia, etc.), or after suffering from phlebothrombosis.Phlebothrombosis is a complex process of thrombus formation in the main deep veins of the lower extremities, as a result of which the blood flow through the deep veins is interrupted.Over time, the blood clot that forms is fixed in the vein, holes appear in it through which limited blood circulation is possible, but the venous valves at the location of the blood clot become scarred and no longer prevent the reverse flow of blood.As a result of the malfunction of the valves of the deep veins, blood begins to move 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 stagnation, especially in the lower parts of the limbs - the leg and lower leg.

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 a venous network, which is formed when small diameter veins change, more often in the legs and less often in the face or upper extremities.Varicose veins are blue or dark purple in color and have a tortuous course.

Symptoms of varicose veins: fatigue, heaviness, aching pain, burning and tingling sensations, throbbing, itching, cramps and anxiety.Also, one of the symptoms can be the appearance of 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 extremities may develop, skin defects may appear in the form of darkening or redness and inflammation.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 special attention to the appearance and swelling of the lower extremities.You may also be asked a series of questions about your sensations to clarify the nature of the pain.Another important step is to perform a series of tests to assess the functional state of the superficial and deep veins.And finally, conducting a Doppler ultrasound examination of the main veins of the lower extremities.The ultrasound examination method allows the doctor to see the structure and evaluate the function of the veins of the lower extremities, as well as to identify venous blood clots.

When the first symptoms of the disease appear, you should contact doctors who deal with diseases of blood vessels and veins in particular (general surgeon, vascular surgeon and phlebologist) and if the skin is damaged you should also visit a dermatologist.Only after you have visited specialist doctors with their recommendation, you can go to a cosmetic clinic.

Prevention of varicose veins

Currently, there is no method that would completely prevent the development of varicose veins.Thanks to prevention, it is possible to improve muscle tone, which helps improve microcirculation in the tissues, as well as improves the condition and function of the veins of the lower extremities and reduces the risk of complications.The traditional and most widespread methods of prevention are as follows:

1. Physical activity.Move more.Your feet should be constantly moving.During a walk, more favorable conditions are created for blood circulation in the lower extremities.Consult your doctor.It will help you choose the most optimal type and level of physical activity.
2. Check your weight.Being overweight increases the load on the circulatory system and especially on the veins.Also, with excessive salt consumption, edema increases mostly as a result of fluid retention in the body.
3. Pay attention to what you wear.Avoid high heels.Your shoes should always be comfortable.When wearing low-heeled shoes, the muscles of the lower limbs work much better, which helps improve venous flow.You should also avoid wearing uncomfortable and tight pants and skirts.
4. Raise your legs.When you raise your legs, venous blood flow from the lower extremities improves.Try to take several breaks throughout the day and put your feet up.For example, lie on your back with your feet on a pillow.
5. Avoid long periods of 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. Don't sit cross-legged.Sitting cross-legged creates unfavorable conditions for blood flow in both lower extremities.

To prevent varicose veins, a good remedy is to wear stockings, knee socks and stockings with a compression effect.It can also be a good adjunct to the main treatment (drug or surgery).Currently, pharmacies offer a wide range of compression garments to choose from.

Treatment of varicose veins

There are several generally accepted methods for treating varicose veins in the legs:

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

Conservative treatment

Doctors consider elastic compression as the most effective conservative tool for the treatment and prevention of varicose veins - the use of special compression stockings (socks, golf, tights).When wearing this knitwear, uniform pressure is provided on the lower extremities, which promotes normal blood circulation and improves its flow, forming, so to speak, an external frame that supports the weakened vascular walls.As a result, the load on the veins decreases, venous blood flow improves, the rate of further progression of the disease decreases and the risk of developing thrombosis decreases.

Modern compression stockings are divided into two types: therapeutic and preventive.Each medical product is marked in mmHg, according to which it is divided into classes from I to IV.At different stages of the disease, compression of a certain hardness is used and it is necessary to consult a doctor, since only a doctor can prescribe and choose the right compression stockings, taking into account the nature of the pathology and according to certain individual standards.

If you have a sedentary lifestyle, as well as during prolonged physical activity, during pregnancy or with a hereditary predisposition, it is recommended to wear preventive socks and tights.If even small signs of varicose veins appear, you should immediately contact a specialized clinic.

Drug therapy can reduce the clinical manifestations of the disease - pain, swelling, discomfort, cramps, etc., but it cannot completely stop the progression of the disease and is used today only as part of complex therapy during the main surgical treatment.Unfortunately, most of the drugs available today on the pharmaceutical market for the treatment of varicose veins have a rather low effectiveness, regardless of the theoretically justified practice of use.One of the reasons for this is the low absorption by the body of the medicinal substances underlying these drugs.It is possible that in this situation, increasing the dose of the drug taken would help, but this is associated with 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 targets a specific link involved in the development and progression of the disease.And to achieve the optimal effect, a complex effect on the disease and the use of several drugs is necessary.An ideal drug for the treatment of venous insufficiency and varicose veins should affect as many pathogenic links of chronic venous insufficiency as possible, while having a minimal number of side effects and being well absorbed by the body.

Surgical treatment

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

The following methods of surgical treatment are available:

1. Sclerotherapy.During this procedure, a solution is injected, under the influence of which a scar is formed at the site of the damaged vein.This method is only applicable for small and medium sized varicose veins.Occasionally, not one but several injections of a sclerosing solution may be needed to make the vein disappear completely.Sclerotherapy is quite effective when performed correctly, is low traumatic, leads to good therapeutic and cosmetic effects and an important advantage is that sclerotherapy is performed under local anesthesia (ie without anesthesia), directly in the doctor's office.
2. Laser surgery.Laser radiation can be used to remove varicose veins of any diameter and, in particular, the venous network.The essence of the method is the irradiation of the inner surface of the vein with a laser beam.Through a small puncture of the skin and vein wall, a special device is inserted - a light guide, through which a laser beam passes under ultrasound control.The inner surface of the vein is irradiated with a laser, then glued together.When this method is used, the doctor directs a laser beam at the vein to be removed, it slowly whitens and the complete disappearance of the vein occurs.An important advantage of this method is that no incision is made in the soft tissue or skin.Using the laser method, it is possible to eliminate damaged veins and heal trophic ulcers of the lower part 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 of the leg are ligated.When using this technique, anesthesia is a necessary condition.This method is used to remove large varicose veins.
4. Ambulatory 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 incisions in the skin under local anesthesia.The marks formed after removal are small and almost invisible.
5. Endoscopic removal of varicose veins.This method is particularly suitable for the formation of skin defects in the form of ulcers.During this method, a special micro-camera is inserted into the container, which allows you to see the container from the inside and observe the entire removal procedure.The vein is then removed under observation through this camera.

Thanks to the use of modern treatment methods, it is possible to achieve a complete cure and a good cosmetic effect.But it should be remembered that varicose veins can appear again.

Complications of varicose veins

Occasionally, changes from pronounced darkening to ulcerative skin defects can occur in the skin around varicose veins as a result of impaired blood microcirculation.If these changes occur, you should immediately consult a doctor.

Another more serious complication of varicose veins is the development of blood clots in the deep and superficial veins.This complication is called thrombophlebitis.When it appears, acute unbearable pain, swelling and redness appear.In this situation, you should also consult a doctor immediately.

Causes of varicose veins

The true nature of varicose veins is not quite clear.According to most scientists, varicose veins are hereditary, genetically determined.Its main cause is the weakness of the vein wall and dysfunction of the venous valves.Venous valves originate from the vein wall and normally have 2 leaflets facing the heart.With normal valve closure, blood from the upper part of the vein cannot penetrate to the lower part.When valve function is impaired and the valves do not close completely, blood moves up and down, resulting in venous stagnation and dilation of the veins located below the valve with impaired function.Initially, in the place where there is a valve with damaged function, a varicose appears and the blood flows in the direction from the deep veins to the external ones, the overflowing vein stretches and expands, which leads to stretching and disruption of the function of the lower valve, etc.Disturbances gradually develop in the venous outflow of blood from the lower extremity to the heart, as a result of which the microcirculation of blood in the tissues of the lower extremities is disrupted, which is manifested by edema, increased pigmentation, thrombophlebitis and trophic ulcers.

Factors in the development of varicose veins

Factors that contribute to varicose veins may include:

1. Genetic predisposition - thin and weak wall of superficial veins.
2. Increased load on the veins: sedentary work, long standing, wearing uncomfortable shoes with high heels, lifting heavy objects, lack of movement of the lower leg muscles.Also, a trigger factor for the development of varicose veins is pregnancy and childbirth.With sudden physical exertion, there is a strong increase in hydrostatic pressure in the veins of the lower extremities, which triggers the process of varicose veins.

Risk factors for developing varicose veins also include:

1. Age.With age, the vein wall, as well as the valves, become thinner, which leads to a natural breakdown of their function.
2. Floor.Women are more likely to suffer from varicose veins.It is possible that this is due to a variety of hormonal reactions.Female sex hormones affect the relaxation process of the venous wall.Significant hormonal changes in the female body occur during pregnancy and childbirth, during the menstrual cycle and during menopause, which cannot but affect the function of the venous system.It is also impossible to exclude the influence of taking hormonal contraceptives on the process of varicose veins.
3. Obesity.With overweight and obesity, the load on the veins of the lower extremities increases.
4. Pregnancy and childbirth.In pregnant women, the volume load on the body increases, but at the same time, the rate of blood flow from the lower extremities to the pelvic cavity to the inferior vena cava system and to the heart decreases.This creates favorable conditions for the development of varicose veins.Changes in the blood circulation system in a woman's body ensure the development of the fetus, but at the same time they cause the development of varicose veins.As pregnancy progresses or during childbirth, varicose veins can develop not only in the lower extremities, but also in the hemorrhoidal veins around the anus.