Varicose veins on the legs

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

The term "varicose veins" comes from the Latin word varix, which means "twisting, intertwined".

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

This disease is rightly considered the price humanity pays 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 on the legs.The risk group includes women, overweight people, people who have a profession that involves long-term stress on the lower limbs, and whose work requires them to stand or sit for a long time.

Classification

Taking into account the factors that predispose to the occurrence of the disease, primary and secondary varicose veins on the legs are distinguished for different reasons.

1. Primarydevelops with varicose veins.In the case of varicose veins, superficial veins primarily change, while deep veins have a normal structure and function.Varicose veins of the superficial veins are manifested for a long time only as a cosmetic defect, but later, as the disease progresses, venous outflow disorders occur, resulting in painful sensations in the lower extremities, swelling of the feet and legs, darkening of the skin in the lower third of the leg, inflammatory changes and trophic changes.Varicose veins are a disease that continuously progresses.
2. Secondaryis a complication of deep vein disease, especially developing either as a result of congenital malformations of the venous system (fistula, congenital dysplasia, etc.), or after a history of phlebothrombosis.Phlebothrombosis is a complex process of thrombus formation in the deep main veins of the lower extremities, due to which the blood flow through the deep veins is disturbed.Over time, the blood clot that forms is fixed in the vein, holes appear in it through which limited blood flow is possible, but the venous valves at the place of the blood clot become scars and no longer prevent the reverse flow of blood.As a result of the dysfunction 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 lowest parts of the extremities - the feet and lower 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 a venous network, which is formed by the change of small-diameter veins, most often on the legs, and less often on the face or upper extremities.Dilated veins become blue or dark purple in color and have a tortuous course.

Symptoms of varicose veins: fatigue, heaviness, pain, burning and stinging, throbbing, itching, cramps and anxiety.Also, one of the symptoms can be the appearance of leg swelling.As a result of 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 occur.

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 number of questions about your feelings 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 an ultrasound Doppler examination of the main veins of the lower extremities.The method of ultrasound examination 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, visit a dermatologist.You can go to the cosmetic surgery only after visiting specialist doctors on their recommendation.

Prevention of varicose veins

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

1. Physical activity.Move more.Your legs should be constantly moving.During a walk, more favorable conditions are created for blood circulation in the lower extremities.Consult your doctor.He will help you choose the most optimal type and level of physical activity.
2. Control your weight.Excess weight increases the load on the circulatory system, and especially on the veins.Also, with excessive salt consumption, edema increases most significantly 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 you wear low-heeled shoes, the muscles of the lower extremities work much better, which helps improve venous outflow.You should also avoid wearing uncomfortable and tight pants and skirts.
4. Put your feet up.When you raise your legs, the venous outflow of blood from the lower extremities improves.Try to take a few breaks during the day and put your feet up.For example, lie on your back with your feet on a pillow.
5. Avoid prolonged periods of standing or walking.To improve blood circulation, try to change your body position as often as possible.Try to get up and walk every 30 minutes.
6. Don't sit with your legs crossed.Sitting with crossed legs creates unfavorable conditions for blood flow in both lower extremities.

For the prevention of varicose veins, a good remedy is to wear stockings, knee highs and stockings with a compression effect.It can also be a good addition to the main (drug or surgical) treatment.Currently, pharmacies offer a wide variety of compression garments to choose from.

Treatment of varicose veins

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

1. conservative (drugs and compressive therapy).
2. surgical.

Conservative treatment

Doctors believe that elastic compression is the most effective conservative means for the treatment and prevention of varicose veins - the use of special compression stockings (socks, golf, tights).When wearing this knitwear, even pressure is ensured on the lower extremities, which promotes normal blood circulation and improves its outflow, forming, as it were, an outer frame that supports weakened vascular walls.As a result, the load on the veins is reduced, the outflow of venous blood is improved, the rate of further progression of the disease is reduced and the risk of developing thrombosis is reduced.

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.In different stages of the disease, compression of a certain strength is used and it is necessary to consult a doctor, because only a doctor can prescribe and choose the correct 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 compression socks 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, spasms, etc., 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 have a rather low efficiency, despite the theoretically justified feasibility of use.One of the reasons for this is the low absorption of medicinal substances that are the basis of these medicines by the body.It is possible that an increase in the dose of the drug taken would help in this situation, 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 is directed at one particular link that is involved in the development and progression of the disease.And in order to achieve the optimal effect, a complex action on the disease and the use of several drugs is required.An ideal drug for the treatment of venous insufficiency and varicose veins should act on as many pathogenetic links of chronic venous insufficiency as possible, have a minimum number of side effects and be well absorbed by the body.

Surgical treatment

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

The following surgical treatment methods 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 applicable only for varicose veins of small and medium caliber.Occasionally, not one, but several injections of the sclerosing solution may be needed to make the vein disappear completely.Sclerotherapy is quite effective when performed correctly, low-traumatic, has good therapeutic and cosmetic effects, 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 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 introduced - 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.When applying this method, the doctor directs the laser beam at the vein that needs to be removed, slowly there is a change in color and the complete disappearance of the vein.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 lower legs.
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 insufficiently perforating leg veins are ligated.When this technique is used, 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 incisions in the skin under local anesthesia.The scars 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 video micro camera is inserted into the container, which allows you to see the container from the inside and observe the entire removal process.The vein is then removed under the supervision of this camera.

Thanks to the application of modern treatment methods, it is possible to achieve complete healing and a good cosmetic effect.But it should be remembered that varicose veins can reappear.

Complications of varicose veins

Occasionally, the skin around the varicose veins may show changes ranging from pronounced darkening to ulcerative skin defects as a result of impaired blood microcirculation.If these changes occur, contact your doctor immediately.

Another more serious complication of varicose veins is the formation of blood clots in deep and superficial veins.This complication is called thrombophlebitis.When it appears, there is acute unbearable pain, swelling and redness.In this situation, you should also 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.Its main cause is 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 into the lower part of the vein.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 below the valve with impaired function.Initially, an enlarged vein appears at the place where the valve with impaired function is located, and blood is ejected in the direction from the deep veins to the outer ones, the overfilled vein stretches and expands, which leads to stretching and impairment of the function of the lower valve, etc.Disorders of the venous outflow of blood from the lower extremities to the heart gradually develop, due to which the blood microcirculation in the tissues of the lower extremities is disturbed, 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: sitting, standing for long periods, wearing uncomfortable shoes with high heels, lifting heavy objects, lack of movement of the lower leg muscles.Also, the trigger for varicose veins is pregnancy and childbirth.With sudden physical overexertion, 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 varicose veins also include:

1. Old age.With age, the wall of the veins, as well as the valves, become thinner, which leads to a natural disruption of their function.
2. Cat.Women suffer from varicose veins more often.It is possible that this is due to a series of hormonal reactions.Female sex hormones influence the process of relaxation of the vein wall.Pronounced 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 rule out 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 in the body increases, but at the same time, the speed of blood outflow from the lower extremities into the pelvic cavity, into the inferior vena cava system, and into the heart decreases.This creates favorable conditions for the development 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 appearance 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.