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 various vessels, but most often occurs in the lower limbs.
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 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 limbs is represented by deep and peripheral veins, as well as communicating (perforating) vessels that connect them. Normally, blood flows through the veins to the heart, from peripheral to deep vessels.
This is due to the muscle pump (contraction of the muscles of the lower limbs), 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 violations at least in 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 stasis of blood in the peripheral circulation.
Under blood pressure, the venous wall continues to expand, causing the vessels to stretch and knot to form. Insufficiency of the valve increases, edema develops.
Compression of the 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 the blood is expelled from them into the peripheral ones, causing them to expand even more. A vicious circle closes.
What are the causes of varicose veins
The true cause of varicose veins is not known. But a number of physiological factors and conditions have been shown to contribute to its development.
How:
- Pregnancy (due to the compression of the veins in the abdominal cavity by the pregnant uterus, blood circulation in the lower limbs is difficult);
- Obesity;
- Sedentary lifestyle;
- Genetic predisposition (weak valves or decreased tone of the vascular walls);
- Violation of hormonal balance (leads to an increase in blood viscosity and difficulty in its outflow);
- 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 case of any of these situations, it is necessary to take preventive measures to prevent the development of varicose veins. Especially if there are already clinical manifestations.
Symptoms of varicose veins
The first signs of varicose veins are:
- Pain and heaviness in the lower limbs;
- Swelling of the legs in the evening;
- The appearance of varicose veins on the skin;
- Tense veins visible under the skin;
- Sensation of burning and itching in the affected area;
- Cramps in the muscles of the lower limbs, especially at night.
Pain with varicose veins occurs and intensifies by the end of the day. They have a bursting and aching character. At the onset of the disease, they disappear after rest, and therefore patients do not go to the doctor for a long time.
Examination reveals edema, pastiness of the lower limbs, telangiectasias, tense venous trunks are palpated, often painful. In the photo you can see what the skin of the legs with varicose veins looks like.
In the phase of severe decompensation, weakness, dizziness and fainting can occur. At the same time, trophic disorders on the skin are noted, ulcers, dermatitis and eczema develop. With a timely visit to the doctor, severe manifestations of varicose veins can be prevented.
Types of varicose veins
There are the following types of varicose veins:
- Varicose veins of the lower limbs (the most common variant);
- Varicose veins of the upper limbs;
- 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 limbs. It occurs more often and it is usually he who is meant when talking about this disease. Most patients don't know if internal varicose veins exist and how they manifest until they encounter them.
Stages of development of varicose veins:
| Stage of the disease | Clinical manifestations |
|---|---|
| 1 stage | There are no symptoms, varicose veins are detected only during instrumental examination |
| 2 stages | Heavy legs syndrome, transient edema, varicose veins on the skin |
| 3 stages | Persistent edema, pigmentation disorders on the skin, dense and tense veins and nodes are visible, trophic disorders in the form of eczema |
| 4 stages | There are trophic ulcers, dermatitis, necrosis |
The smaller the stage, the easier the treatment and the better the prognosis for recovery.
Diagnosis of varicose veins
To make a diagnosis, in addition to the 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 an extended formula.
- Blood clotting test:
- clotting time;
- prothrombin test;
- determination of antithrombin III, protein S and C;
- determination of the homocysteine level;
- study of the APTT index;
- determination of the level of the D-dimmer;
- determination of the von Willebrand factor activity, etc.
- Blood biochemistry.
- Hormonal analysis.
- General urine analysis.
- 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 the veins;
- dopplerography;
- duplex ultrasound scan of the veins (combination of ultrasound and dopplerography);
- angiography;
- photoplethysmography (PPG);
- phlebography;
- occlusal venous 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. are studied. 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.
Treatment of varicose veins
The fight against varicose veins includes medical (conservative and surgical treatments) and non-drug methods. The choice of 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, 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.
In conservative therapy, the following groups of drugs are used:
- antiplatelet agents to thin the blood and prevent blood clots;
- anticoagulants with direct and indirect action to improve the rheological properties of the 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 of 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.
Surgery may consist in the removal of the entire vein or only of the affected area through incisions along the vessel or in the inguinal fold 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, leading to its complete obstruction.
Savings options:
- 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 with connective tissue);
- endovascular laser coagulation (coagulation of the internal cavity of the vessel with a laser pulse);
- radiofrequency coagulation (sticking of the walls of a vein as a result of exposure to a high-frequency current pulse);
- miniflebectomy (removal of a vein or its section through several skin punctures).
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 a complete obstruction. In this case, the movement of blood will continue through the healthy vessels, bypassing the coagulated ones. Schemes for performing such operations can be seen in the video in this article.
Surgical methods have an indisputable advantage - the likelihood of relapse after them is very low. In terms of the relationship between risk and effectiveness, less traumatic procedures are better. But the price for them in the 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 tablets.
From non-pharmacological means for this use:
- therapeutic exercises (to stimulate the muscle pump);
- compression stockings and elastic bandages (compression of the lower limbs stimulates the expulsion of blood from the vessels, normalizes the functioning of the venous valves, strengthens the vascular wall).
The use of compression stockings is recommended for all people at risk, in particular:
- pregnant women;
- work all day on your feet;
- to all people during long plane flights;
- patients taking drugs that promote blood clotting;
- people with a sedentary lifestyle.
Prevention of varicose veins
Varicose vein prevention is best started before it appears. In addition, the recommended measures will help prevent other cardiovascular diseases.
Instructions for prevention:
- giving up all bad habits;
- carefully monitor your diet (exclude fatty, fried, smoked, sweet);
- strictly control your weight;
- lead an active lifestyle (plus walking, running, cycling, skating, etc. );
- wear comfortable shoes with small heels;
- daily contrast shower;
- at the end of the day, rest 15 minutes with your legs raised.
These measures will also help with the identified varicose veins, to prevent further progression of the disease 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 its heavy types associated with power loads.
Varicose veins are a common disease. Women suffer from it 4 times more often 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 their 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.