Varicose veins in the legs

Varicose veins in the legs are characterized by the formation of dilated pockets of the superficial (subcutaneous) veins of the lower limbs, their tortuous winding, increase in length due to impaired blood flow through them, and stagnant changes in the lower limbs.

The term “varicose veins” comes from the Latin word varix, meaning “twisted, intertwined.”

Humanity has been familiar with varicose veins since ancient times.When conducting 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 was being treated for venous ulcers in her legs.

This disease is considered the price humanity justly has to 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.High-risk groups include women, overweight people, people in occupations that cause long-term stress on the lower extremities, and jobs that require them to stand or sit for long periods of time.

Classify

Taking into account the factors that influence the development of the disease, primary and secondary varicose veins of the legs are distinguished for several reasons.

1. Maindevelop with varicose veins.With varicose veins, mainly the superficial veins change, while the deep veins have normal structure and function.For a long time, superficial varicose veins manifest themselves only as cosmetic defects, but then, as the disease progresses, venous outflow disorders occur, leading to painful sensations 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 continuously progressive disease.
2. High schoolis a complication of deep vein disease, in particular, it develops due to congenital malformations of the venous system (fistula, congenital dysplasia, etc.) or after venous thrombosis.Venous thrombosis is a complex process of thrombus formation in the deep main veins of the lower limbs, as a result of which blood flow through the deep veins is interrupted.Over time, the blood clot that forms will become fixed in the vein, holes will appear, causing blood flow to be limited, but the venous valves at the clot site will become scarred and no longer prevent blood from flowing back.Due to dysfunction of the valves of the deep veins, blood begins to move up and down through them, flowing back into the superficial veins and developing secondary varicose veins.Thanks to this, favorable conditions are created for venous stagnation, especially in the lowest parts of the limbs - feet and legs.

Symptoms of varicose veins

In most people, varicose veins appear as a cosmetic defect, often appearing on the inner surface of the legs.Sometimes varicose veins may simply appear as a venous network, which is formed when small diameter veins vary, usually on the legs and less commonly on the face or upper limbs.Varicose veins are blue or dark purple in color and have a zigzag path.

Symptoms of varicose veins: fatigue, feeling of heaviness, pain, burning and tingling sensations, sharp pain, itching, cramps and anxiety.In addition, one of the symptoms may be the appearance of swelling in the legs.Due to pronounced varicose veins, a violation of blood supply to the tissues of the lower limbs may occur, skin defects may occur in the form of darkening or redness and inflammation.In extremely severe cases of varicose veins, trophic ulcers develop.

Diagnosis of varicose veins

To confirm the diagnosis, the doctor will first examine the patient, paying special attention to the appearance and swelling of the lower extremities.You may also be asked some questions regarding your feelings to clarify the nature of the pain.Another important step is to perform a series of tests to evaluate the functional status of the superficial and deep veins.And finally, conduct a Doppler ultrasound examination of the main veins of the lower extremities.Ultrasound examination allows the doctor to see the structure and evaluate the function of the veins of the lower extremities, as well as identify venous blood clots.

When the first symptoms of the disease appear, you should contact doctors who specialize in treating 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 visiting specialists according to their recommendations can you go to a cosmetic clinic.

Prevention of varicose veins

Currently, there is no method that can completely prevent the development of varicose veins.Thanks to prevention, it is possible to improve muscle tone, help improve microcirculation in tissues, as well as improve the condition and function of the veins of the lower limbs, while reducing the risk of complications.The most traditional and popular prevention methods are as follows:

1. Physical activity.Move more.Your legs must move continuously.During walking, more favorable conditions are created for blood circulation in the lower limbs.Consult your doctor.He will help you choose the most optimal type and level of physical activity.
2. Control your weight.Being overweight increases the load on the circulatory system and especially the veins.In addition, when consuming too much salt, edema increases most clearly due to the body retaining water.
3. Pay attention to what you wear.Avoid high heels.Your shoes should always be comfortable.When wearing low heel shoes, your lower limb muscles work much better, helping to improve vein flow.You should also avoid wearing tight, uncomfortable pants and skirts.
4. Lift your feet.When you raise your legs, the amount of blood flowing from the veins of the lower limbs will improve.Try to rest a few times during the day and put your feet up.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 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 with legs crossed creates unfavorable conditions for blood circulation in both lower limbs.

To prevent varicose veins, a good remedy is to wear socks, knee socks and compression socks.It can also be a good complement to primary treatment (medication or surgery).Nowadays, pharmacies offer a variety of compression garments to choose from.

Treatment of varicose veins

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

1. conservative (medication and compression therapy).
2. surgery.

Conservative treatment

Doctors consider elastic compression the most effective conservative method of treating and preventing varicose veins - using special compression hosiery (stockings, golfers, tights).When wearing this type of knitwear, uniform pressure is ensured on the lower limbs, which promotes normal blood circulation and improves blood outflow, while also forming an external framework that supports weakened vessel walls.As a result, the load on the veins is reduced, venous blood outflow improves, the rate of further progression of the disease is reduced, and the risk of developing thrombosis is also reduced.

Modern compression knitwear is divided into two types: therapeutic and preventive.Each medical product is marked in mmHg, according to which it is divided into classes I to IV.At different stages of the disease, compression of a certain intensity is used, and it is necessary to consult a doctor, because 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 lead a sedentary lifestyle, as well as during prolonged physical activity, during pregnancy or have a genetic predisposition, you should wear preventive compression stockings and tights.If even minor signs of varicose veins appear, you should immediately contact a specialized clinic.

Drug treatment can reduce the clinical manifestations of the disease - pain, swelling, discomfort, cramps, etc., but cannot completely stop the progression of the disease and is today 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 effectiveness, although the feasibility of use has been theoretically proven.One of the reasons for this is that the body poorly absorbs the medicinal substances contained in these drugs.It may be beneficial in this situation to increase the dose of medication used, 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 optimal effect, it is necessary to have a complex effect on the disease and use several drugs.An ideal drug for the treatment of venous insufficiency and varicose veins should affect as many of the pathogenetic links of chronic venous insufficiency as possible, while having the fewest side effects and being well absorbed by the body.

Surgical treatment

Today, surgery to treat varicose veins in the legs does not require a long hospital stay.Thanks to the use of modern invasive treatment methods, the removal of varicose veins can be carried out not only under anesthesia with the patient completely turned off, but also with local anesthesia, which, when the patient is awake, turns off the pain sensation only in the lower limbs.Varicose veins will disappear on their own within 3 months after giving birth without treatment.

The following surgical treatments are available:

1. Sclerotherapy.During this procedure, a solution is injected, under its influence, a scar will form at the site of the damaged vein.This method only applies to small and medium-sized varicose veins.Sometimes it takes not one but several injections of a sclerosing solution for the vein to disappear completely.Sclerotherapy is quite effective when performed properly, causes little trauma, provides good therapeutic and cosmetic results, and a significant advantage is that sclerotherapy is performed under local anesthesia (i.e. without anesthesia), directly in the doctor's office.
2. Laser surgery.Laser radiation can be used to remove varicose veins of any diameter and especially vein mesh.The essence of this method is to irradiate the inner surface of the vein with a laser beam.Through a small puncture in the skin and vein wall, a special device is inserted - a light guide, through which a laser beam is passed under ultrasound control.The inner surface of the vein is exposed to a laser, then glued together.When using this method, the doctor will shine a laser beam into the vein that needs to be removed, the vein will slowly change color and disappear completely.The important advantage of this method is that it does not make incisions into soft tissue or skin.Using the laser method, it is possible to remove damaged veins and heal trophic ulcers on the lower legs.
3. Surgical removal of 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 inadequately penetrated veins in the leg are ligated.When using this technique, anesthesia is a necessary condition.This method is used to eliminate large varicose veins.
4. Outpatient phlebectomy (removal of varicose veins).This method is suitable for removing small diameter veins.With this method, the vein is removed through several small incisions in the skin under local anesthesia.The scars that form after removal are small and almost invisible.
5. Endoscopic removal of varicose veins.This method is especially suitable for the formation of skin defects in the form of ulcers.In this method, a special video micro-camera is installed into the vessel, allowing you to see the vessel 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, the disease can be completely cured and bring good cosmetic results.But remember that varicose veins can reappear.

Complications of varicose veins

Sometimes, changes ranging from pronounced darkening of the skin to ulcerative skin defects may occur on the skin around the varicose veins due to impaired blood microcirculation.If these changes occur, you should consult your doctor immediately.

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

Causes of varicose veins

The true nature of varicose veins is not yet clear enough.According to most scientists, varicose veins are hereditary, genetically determined.Its main cause is weak vein walls and dysfunction of venous valves.Venous valves originate from the vein wall and usually have 2 valve leaflets facing the heart.With normal closure of the valves, blood from the upper part of the vein cannot enter the lower part.When the function of the valves is impaired and the valve does not close completely, blood moves up and down, leading to venous stagnation and dilation of the veins located below the impaired valve.Initially, varicose veins appear at the site of impaired valve function, blood flows in the direction from the deep veins outward, the overstretched veins will stretch and dilate, leading to dilatation and dysfunction of the underlying valve, etc.Disturbances in the flow of venous blood from the lower limbs to the heart gradually develop, as a result of which blood microcirculation in the tissues of the lower limbs is disrupted, manifested by edema, hyperpigmentation, thrombophlebitis and trophic ulcers.

Factors in the development of varicose veins

Factors contributing to varicose veins may include:

1. Genetic predisposition – thin and weak walls of superficial veins.
2. Increased load on veins: sedentary work, standing for long periods of time, wearing uncomfortable high heels, lifting heavy objects, lack of calf muscle mobility.In addition, a factor that triggers the development of varicose veins is pregnancy and childbirth.During sudden overexertion, hydrostatic pressure in the veins of the lower limbs will increase sharply, causing varicose veins.

Risk factors for developing varicose veins also include:

1. Year old.With age, vein walls as well as valves become thinner, leading to a natural disruption of their function.
2. Floor.Women are more likely to get varicose veins.It's possible this is due to some hormonal reaction.Female sex hormones influence the relaxation of vein walls.Marked hormonal changes in the female body occur during pregnancy and childbirth, during the menstrual cycle and during menopause, which cannot affect the function of the venous system.The influence of taking hormonal contraceptives on the process of varicose veins cannot also be excluded.
3. Obesity.With overweight and obesity, the load on the veins of the lower limbs increases.
4. Pregnancy and childbirth.In pregnant women, the volume load in the body increases, but at the same time the rate of blood flowing from the lower limbs to the pelvic cavity into the inferior vena cava system and to the heart decreases.Thus, creating favorable conditions for varicose veins to develop.Changes in the circulatory system in the woman's body ensure the development of the fetus but at the same time cause varicose veins.As pregnancy progresses or during childbirth, varicose veins can develop not only in the lower limbs but also in the hemorrhoidal veins around the anus.