Varicose veins in legs

Varicose veins in the legs are characterized by cystic dilation, serpentine-like tortuosity, increased length due to impaired blood outflow, and stagnant changes in the lower extremities in the superficial (subcutaneous) veins.

The word "varicose veins" comes from the Latin word varix, meaning "to twist, to twist."

Humans have been familiar with varicose veins since ancient times.Archaeological research conducted during the excavations of the Mastaba tomb in Egypt from 1595 to 1580.BC, a mummy was found to have signs of varicose veins and was treated for venotrophic ulcers in the legs.

The disease is rightly considered the price humans pay for the ability to walk upright.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.People at risk include women, people who are overweight, people who have occupations that put chronic pressure on the lower limbs, and people whose jobs require them to stand or sit for long periods of time.

Classification

Primary and secondary varicose veins of the legs are distinguished for various reasons, taking into account the factors that contribute to the development of the disease.

1. primary schoolWith varicose veins.With varicose veins, it is mainly the superficial veins that undergo changes, while the deep veins have normal structure and function.For a long time, superficial varicose veins presented only as a cosmetic defect, but as the disease progresses, venous outflow becomes obstructed, leading to pain in the lower limbs, swelling of the feet and legs, darkening of the skin on the lower third of the legs, inflammatory changes, and trophic ulcers.Varicose veins are a progressive disease.
2. middle schoolIt is a complication of deep vein disease, especially due to congenital malformations of the venous system (fistulas, congenital dysplasia, etc.) or after suffering from venous thrombosis.Venous thrombosis is a complex process of thrombus formation in the deep main veins of the lower limbs, with the result that blood flow through the deep veins is disrupted.Over time, the blood clot that forms becomes anchored in the vein, creating holes through which blood flow can be restricted, but the vein valves at the site of the clot can become scarred and no longer prevent the reverse flow of blood.Due to dysfunction of the deep vein valves, blood begins to move up and down through the valves and back into the superficial veins, forming secondary varicose veins.As a result, favorable conditions are created for venous stagnation, especially in the lowest parts of the limbs - the feet and calves.

Symptoms of varicose veins

For most people, varicose veins present themselves as a cosmetic blemish, most commonly appearing on the inner surface of the legs.Sometimes, varicose veins appear only as a network of veins, which form when small-diameter veins change, most commonly in the legs and less often in the face or upper limbs.Varicose veins are blue or dark purple in color and have a tortuous course.

Symptoms of varicose veins: Fatigue, heaviness, aches, burning and stinging, throbbing, itching, cramping, and anxiety.Additionally, one of the symptoms may be swelling of the legs.As varicose veins significantly expand, the blood supply to the tissues of the lower limbs may be violated, and the skin may develop defects such as darkening or redness and inflammation.In extremely severe cases of varicose veins, trophic ulcers develop.

Diagnosis of varicose veins

To make a diagnosis, doctors first examine the patient, paying special attention to the appearance and swelling of the lower limbs.You may also be asked some questions about how you are feeling to clarify the nature of the pain.Another important step is to perform a series of tests to assess the functional status of the superficial and deep veins.Finally, an ultrasound Doppler examination of the major veins of the lower extremities was performed.Ultrasound testing methods allow doctors to see the structure of lower extremity veins and assess their function, as well as identify venous blood clots.

When the first symptoms of the disease appear, you should contact a doctor who specializes in diseases of the blood vessels and veins (general surgeon, vascular surgeon and phlebologist), and if the skin is damaged, you should also see a dermatologist.Go to a beauty clinic only on the recommendation of a specialist.

Prevent varicose veins

Currently, there is no way to completely prevent the development of varicose veins.Through prevention, muscle tone can be improved, thereby helping to improve microcirculation in the tissues, as well as improving the condition and function of the veins in the lower extremities and reducing the risk of complications.The traditional and most common prevention methods are as follows:

1. Physical activity.Move more.Your legs should be in constant motion.When walking, it creates more favorable conditions for blood circulation in the lower limbs.Please consult your doctor.He will help you choose the best type and level of physical activity.
2. Control your weight.Being overweight increases the load on the circulatory system, especially on the veins.In addition, if you consume too much salt, edema will increase more significantly due to fluid retention in the body.
3. Pay attention to what you wear.Avoid wearing high heels.Your shoes should always be comfortable.Your lower body muscles work better when wearing low-heeled shoes, which helps improve venous outflow.You should also avoid wearing uncomfortable and tight pants and skirts.
4. Lift your feet.When you lift your legs, blood flow from the veins in your lower limbs improves.Try taking breaks and putting your feet up a few times throughout the day.For example, lie on your back with your feet on a pillow.
5. Avoid standing or walking for long periods of time.To improve blood circulation, try to change your body's position as often as possible.Try getting up and walking every 30 minutes.
6. Don't sit cross-legged.Sitting cross-legged can create unfavorable conditions for blood flow in both lower limbs.

A good remedy to prevent varicose veins is to wear stockings, knee-high socks and compression socks.It can also serve as a good supplement to primary (drug or surgical) treatment.Currently, pharmacies offer a variety of compression garments to choose from.

Treatment of varicose veins

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

1. Conservative treatment (drugs and pressure therapy).
2. surgical.

Conservative treatment

Doctors consider elastic compression to be the most effective conservative method of treating and preventing varicose veins - using special compression stockings (stockings, golf socks, tights).When wearing this kind of knitwear, it ensures even pressure on the lower limbs, thereby promoting normal blood circulation and improving its outflow, while forming an outer frame that supports weak blood vessel walls.As a result, the load on the veins is reduced, venous blood outflow is improved, the rate of further progression of the disease is reduced, and the risk of thrombosis is reduced.

Modern compression stockings are divided into two types: therapeutic and preventive.Every medical product is labeled in millimeters of mercury and classified into categories I to IV based on millimeters of mercury.At different stages of the disease, a certain intensity of pressure is used, and consultation with a doctor is required, since only a doctor can prescribe and choose the right compression stockings, taking into account the nature of the pathology and based on certain personal criteria.

Preventive compression stockings and compression garments are recommended if you have a sedentary lifestyle, are involved in prolonged physical activity, are pregnant, or have a genetic predisposition.Even at the slightest sign of varicose veins, a professional clinic should be contacted immediately.

Medical therapy can reduce the clinical manifestations of the disease - pain, swelling, discomfort, cramping, etc., but cannot completely prevent the progression of the disease and is currently only used as part of complex treatment during primary surgical treatment.Unfortunately, despite their theoretical feasibility for reasonable use, the effectiveness of most of the drugs available on the pharmaceutical market today for the treatment of varicose veins is rather low.One reason is that the body's absorption rate of the medicinal substances of these drugs is low.In this case, increasing the dose of the medication may help, but this increases the risk of complications and side effects.Another reason for the low efficacy of these drugs is that they have a relatively narrow spectrum of action and target a specific link involved in the onset and progression of the disease.To achieve the best results, a comprehensive approach to the disease and the use of a variety of drugs is required.The ideal drug to treat venous insufficiency and varicose veins should affect as many of the causes of chronic venous insufficiency as possible, have minimal side effects, and be well absorbed by the body.

surgical treatment

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

The following surgical treatments are available:

1. Sclerotherapy.During this procedure, a solution is injected, under the influence of which scarring occurs at the site of the damaged vein.This method is only suitable for small and medium-sized varicose veins.Sometimes, it may take multiple injections of the sclerosing solution instead of just one to make the vein disappear completely.If performed correctly, sclerotherapy is highly effective, minimally invasive, with good therapeutic and cosmetic results, and a significant 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, especially the venous network.The essence of this method is to illuminate the inner surface of the vein with a laser beam.Through a small puncture in the skin and vein wall, a special device - a light guide - is inserted, through which a laser beam is passed under the control of ultrasound waves.A laser is shined on the inner surface of the vein, which is then bonded together.With this method, the doctor targets the laser beam at the vein that needs to be removed, and the vein slowly changes color and disappears completely.An important advantage of this approach is that no incisions are made in the soft tissue or skin.Damaged veins can be eliminated and trophic ulcers of the lower legs can be healed using laser methods.
3. Surgery to remove varicose veins.During surgical excision, a series of small incisions are made in the skin and soft tissue through which damaged veins are removed and insufficient perforating veins in the leg are ligated.Anesthesia is necessary when using this technique.This method is used to remove large varicose veins.
4. Outpatient phlebectomy (removal of varicose veins).This method is suitable for removing smaller diameter veins.With this method, the vein is removed through several small incisions in the skin under local anesthesia.The scar formed after removal is small and almost invisible.
5. Endoscopic removal of varicose veins.This method is particularly suitable for skin defects that form ulcers.In this method, a special video microcamera is inserted into the container, allowing you to see the container from the inside and observe the entire removal process.The vein is then removed under observation through this camera.

Thanks to modern treatment methods, complete healing and good cosmetic results can be achieved.But it should be remembered that varicose veins may reappear.

Complications of varicose veins

Sometimes, due to impaired blood microcirculation, the skin around varicose veins may show changes from noticeable darkening to ulcerated defects.If these changes occur, you should consult your doctor immediately.

Another more 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, there is severe, unbearable pain, swelling, and redness.In this case, you should also consult your doctor immediately.

causes of varicose veins

The true nature of varicose veins is less clear.Most scientists believe that varicose veins are hereditary and determined by genes.The main causes are weak vein walls and venous valve dysfunction.Venous valves originate from the walls of the veins and usually have 2 leaflets that face toward the heart.When the valve is closed normally, blood from the upper part of the vein cannot penetrate into the lower part.When the valve's function is compromised and the valve does not close completely, blood flows up and down, causing the veins beneath the compromised valve to stagnate and dilate.Initially, varicose veins will appear where the valve function is damaged. Blood is drained from the deep veins to the external veins. The overfilled veins stretch and expand, causing the function of the underlying valve to be stretched and destroyed.The venous flow of blood from the lower limbs to the heart is gradually disrupted, resulting in disturbance of blood microcirculation in the tissues of the lower limbs, manifested by edema, increased pigmentation, thrombophlebitis and trophic ulcers.

Factors causing varicose veins

Factors causing varicose veins may include:

1. Genetic predisposition – Weak walls of superficial veins.
2. Increased venous load: sedentary work, standing for long periods of time, wearing uncomfortable high heels, lifting heavy objects, lack of exercise in the calf muscles.In addition, pregnancy and childbirth are also triggers for the development of varicose veins.With sudden physical overexertion, the hydrostatic pressure in the veins of the lower limbs increases sharply, triggering the process of varicose veins.

Risk factors for developing varicose veins also include:

1. age.As we age, vein walls and valves become thinner, causing a natural disruption of their function.
2. ground.Women are more likely to develop varicose veins.This can be due to a number of hormonal reactions.Female sex hormones influence the relaxation process of vein walls.During pregnancy, childbirth, the menstrual cycle, and menopause, women undergo significant hormonal changes that inevitably affect the function of the venous system.It is also impossible to exclude the influence of taking hormonal contraceptives on the progression of varicose veins.
3. obesity.With overweight and obesity, the load on the veins of the lower extremities increases.
4. Pregnancy and childbirth.The volume load in a pregnant woman's body increases, but at the same time the rate of blood outflow from the lower extremities to the pelvis, into the inferior vena cava system, and the heart decreases.This creates favorable conditions for the occurrence of varicose veins.Changes in the circulatory system of women ensure the development of the fetus, but they can also lead to the occurrence of varicose veins.As pregnancy progresses or during delivery, varicose veins may develop not only in the lower limbs but also in the hemorrhoidal veins around the anus.