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Treatment of deep vein varicose veins

30 Jun 18

Treatment without surgery Varicose veins of the deep veins of the lower extremities

Varicose veins are a pathological expansion of the superficial or deep veins of the lower extremities , see photo. Superficial veins are more susceptible to varicose veins because they experience greater strain, unlike deep veins. Damage to the deep veins occurs as a result of a serious disorder of the blood coagulation system or lymphostasis.

Early stages of varicose veins respond well to conservative treatment with the help of pharmacological drugs and traditional medicine products.

Advanced processes are treated exclusively promptly, as there is a risk of developing thrombosis, phlebitis or thrombophlebitis. These diseases arise from an inflammatory process that actively develops in the affected vein.

Stop fooling yourself

Before reading further, I will ask you one question. Are you still looking for a varicose vein treatment that will help you?

I hasten to disappoint you , there is NOT A SINGLE CREAM that will help get rid of varicose veins.

And all the “drugs” that are sold in pharmacies and advertised on the Internet are a complete scam. Marketers are simply making huge money off your naivety.

The only drug that can somehow help you is Venorem . This drug is not sold in pharmacies and is practically not advertised on the Internet, and it costs only 1 ruble as a promotion .

So that you don’t think that they are selling you another “cream for varicose veins,” I will not describe what an effective drug it is. If interested, read all the information about Venorem yourself. Here is a link to the official Venorem website .

The main symptoms of varicose veins are pain and swelling of the lower extremities. Diseases of the superficial veins immediately make themselves felt, while varicose veins of the deep veins often occur secretly.

A painful symptom occurs during physical work or prolonged sitting. Swelling appears after sleep or at the end of the day. The skin in the vein area becomes covered with brown spots (bruises), which appear en masse after physical work or during the hot season.

Varicose veins of the deep veins of the lower extremities occur latently until an acute inflammatory process occurs. Inflammation of the deep veins causes a lot of stabbing pain and severe night cramps.

The primary cause of varicose veins of the lower extremities is a sedentary lifestyle combined with a high-calorie diet.

Physical inactivity provokes congestion and swelling. The natural rate of lymph circulation is more reduced than blood circulation, therefore, with a sedentary lifestyle, lymph accumulations occur, compressing the tissues. This condition can develop into a dangerous disease - lymphostasis or elephantiasis.

A high-calorie diet disrupts fat metabolism in liver cells and provokes the formation of fatty plaques on the venous walls (atherosclerosis). Atherosclerotic plaques close the lumen of blood vessels, thereby disrupting normal blood circulation and provoking the occurrence of varicose veins.

Malfunctions of the endocrine system increase blood clotting and contribute to the formation of small blood clots that settle on the walls of blood vessels. The use of hormonal drugs can provoke such complications, so treatment with hormones is carried out under the supervision of the attending physician.

Varicose veins can occur as a result of scarring from a puncture wound or a large burn.

Treatment of varicose veins with conservative methods

As conservative therapy, venotonics are used, drugs that help thin the blood and dissolve blood clots.

Venotonics are used to increase the resistance of the venous wall to blood flow. Thanks to these substances, the pathological deformation of the veins stops, that is, they stop expanding. Venotonics are used internally and externally. Troxevasin has proven itself well; it is produced in the form of gels and capsules.

Heparin is used to thin the blood. It is taken for excessive blood thickening, which threatens the appearance of blood clots - thrombi. Blood thickening complicates the functioning of the heart, liver and kidneys, so treating varicose veins will help relieve excess stress on these organs.

Heparin is taken under the supervision of a doctor. It is used intravenously with a dropper and externally in the form of gels and ointments. Heparin-based drugs are used for massage and physiotherapy. Electrophoresis with heparin acts gently but effectively: the medication, combined with the effects of temperature, penetrates into nearby tissues as much as possible and has a prolonged effect.

For varicose veins, it is necessary to consume tocopherol acetate (vitamin E). This component is part of the membranes of all cells and tissues of the body, and also fights the formation of free radicals, which are destructive factors for cells.

If varicose veins are accompanied by thrombus formation, then it is necessary to administer a certain dose of fibrinolytic intravenously. The fibrinolytic will dissolve small blood clots and clear the venous bed of factors blocking blood flow.

Traditional medicine for the treatment of varicose veins

Varicose veins of the legs can be treated with herbal medicine. Plant extracts have a beneficial effect on the general condition of the body and metabolism in general. Essential oils, which have a strong anti-inflammatory and venotonic effect, help strengthen the venous wall and increase its tone. A decoction of dill seeds prevents the development of pathogenic microflora, so it can be used to prevent the occurrence of trophic ulcers.

Cool calendula baths relieve tired legs , relieve swelling and hyperemia (redness of certain areas of the skin over the affected vein). Compresses have a calming and long-lasting healing effect. A compress with freshly squeezed juice from aloe vera leaves increases vascular tone and normalizes lymph circulation.

Horse chestnut extract has a strong decongestant, lymphatic drainage and venotonic effect. It is used internally and externally. Tinctures and decoctions are used for internal use. The alcohol tincture is prepared in this way: 300 g of crushed chestnut fruits and flowers are poured into 700 g of alcohol. This mixture must be kept for two weeks in a closed glass container, such as a jar. Store the tincture in a dark place at room temperature. After two weeks, the liquid is filtered and the remainder is squeezed out. The tincture is poured into a separate container and consumed 20 drops 3 times a day half an hour before meals. The course of treatment is 2 months, after which a break is taken for 2-3 weeks and treatment continues again.

To prepare the decoction, take the same amount of product, only pour 500 g of boiling water over it. This mixture is infused in a closed enamel or ceramic container for an hour. After an hour, the broth is filtered and the plant residues are squeezed out. The decoction is good for 2-3 days if stored in the refrigerator. Take 150 g half an hour before meals or an hour after, 3-4 times a day. The course of treatment is 1-2 months.

Diet therapy for varicose veins

To effectively treat varicose veins in the legs, it is important to follow certain nutritional rules. Excess weight puts enormous stress on the lower limbs, so to prevent further complications it is necessary to get rid of excess body weight. The patient's diet should be complete, but certain restrictions are imposed on the consumption of fats and carbohydrates.

Fats are consumed in the form of polyunsaturated fatty acids. These bioactive substances are part of natural vegetable oils (unrefined sunflower, olive, corn). You can eat 2 boiled or steamed eggs per day. Vegetables can be consumed both boiled and raw.

A complete fiber content in the diet will help improve the functioning of the gastrointestinal tract and improve the absorption of nutrients and vitamins. The drinking regime varies within normal limits, the daily intake of free liquid is 1.5-2 liters.

Compliance with certain rules and recommendations during the treatment of varicose veins of the legs will help speed up the healing process and prevent the further occurrence of this disease.

First of all, it is necessary to wear special compression stockings, the main function of which is to maintain the natural anatomical shape of the lower leg and optimal pressure in the lower extremities. Wearing these devices blocks lymph stagnation and prevents the formation of edema.

It is also worth paying attention to physical activity. During the acute phase, the patient is prescribed bed rest, but during the period of remission, short walks are introduced, the duration of which increases during the recovery process.

After recovery, physical activity and walks in the fresh air should become a daily rule. After all, as the famous Haruki Murakami said: I am moving. So I exist.

We conducted an investigation, studied a bunch of materials and, most importantly, tested most of the creams and medications for varicose veins. The verdict is:

All the remedies, if any, gave only temporary results.

In addition, advertised creams are addictive, and if you stop using one or another drug, the disease will sharply worsen.

Remember! There is NOT ONE CREAM that will help you quickly get rid of varicose veins.

The newfangled means that the entire Internet is replete with also did not produce results. As it turned out, all this is a deception of marketers who earn huge money from the fact that you fall for their advertising.

The only drug that has given significant results is Venorem .

You may ask, why doesn’t everyone use this “magic” remedy? The answer is simple, Venorem is not sold in pharmacies, it is not advertised on TV or on the Internet. And if they advertise, then it’s a FAKE.

There is good news, we have contacted the manufacturers and will share with you a link to the official Venorem website.

By the way, manufacturers are not trying to profit from people suffering from varicose veins; the promotional price of Venorem is only 1 ruble .

Signs and treatment of varicose veins of the lower extremities

There are many diseases that cause pain and have unsightly visual manifestations. Enlarged veins in the legs are one of the most common ailments included in this category. Unfortunately, most patients turn to doctors for treatment of varicose veins of the deep veins of the lower extremities in the final stages, when the disease has reached its apogee, and its manifestations have reached the point of no return. But is surgery always the only option? We'll find out in this article.

Six stages of the disease

The international community of doctors has identified 6 stages of varicose veins, systematizing the signs of dilated veins in the legs. The document they adopted - CEAP (Clinical Etiology Anatomy Pathology) - lists six stages of the disease.

Stage 0. There is swelling, heaviness in the legs, in some cases developing into acute aching pain, cramps at night. A person experiences these inconveniences, but the symptoms of varicose veins of the lower extremities are not detected during examination; the disease is phantom in nature.

Stage 1. The legs are dotted with vascular “stars”; individual clusters or an entire vascular network can be seen. Visual signs may be accompanied by symptoms of the previous stage.

Fact: There is debate in scientific circles about stages 0 and 1; some doctors do not recognize them, believing that “real” clinical varicose veins begin with the next stage.

Stage 2. The patient can independently detect an increase in the volume of the veins, bluish nodes growing in diameter after squeezing the vessels (from prolonged sitting or many hours of walking in high heels). Such signs are visible to the naked eye. The danger is that starting from this stage, thrombosis is possible.

Stage 3. Manifestations of stages 0-2 of the disease are accompanied by prolonged swelling, swelling is acutely felt at the end of the day. The problem may subside in the morning, but in the evening the swelling of the legs bothers you again.

Stage 4. Due to stretching of the veins and lack of oxygen supply to the limbs, trophic changes are activated. The skin becomes abnormally dark in color (from brown to black). Inflammation of the skin develops, manifested by slight redness up to weeping eczema, affecting large areas of the skin. The result can be skin atrophy - the appearance of whitish, sunken, sagging areas. Such problems can lead to ulcers.

Stage 5. Problems inherent in the course of the disease at stages 0-4 are accompanied by a healed trophic type ulcer.

Stage 6. At this stage, the symptoms of varicose veins of the deep veins of the lower extremities are the most deplorable - an active, painful trophic ulcer develops. A non-healing wound is static.

The classification of the stages of the disease is partly based on symptoms, but let’s look at the manifestations of varicose veins in more detail.

The most obvious sign of varicose veins is “heavy” legs, visible abnormally dilated veins that either show through the skin or protrude above its surface. Affected areas can appear as individual varicose veins or grow into huge conglomerates that occupy a large area under the skin.

At night, the calf muscles may cramp. Swelling, a dull bursting pain in the calves, intensifying with prolonged standing and subsiding when lying down is a clear sign.

Important: if bulging veins disappear when you change position (if you lie down, stretching your legs, or lift them higher than your body) and swell, protruding above the skin level, in a standing position, you should go to a phlebologist.

A burning sensation in the lower extremities is a less common side effect.

Swelling is noted not only in the calves; it can also appear in soft tissues. Swelling is localized in the feet, ankles, and lower legs.

Prolonged or incorrect treatment of varicose veins of the lower extremities, a long course of the disease or a complete lack of medical care lead to the progression of the disease:

  • On the legs and feet, the skin atrophies, and induration (hardening of the skin) occurs.
  • Pigmentation (dark-colored freckled spots) appears on the legs.
  • The skin dries out and acquires a bluish tint.
  • Edema worries the patient more and more often.
  • Due to impaired blood flow in the legs, ulcers appear on the inside of the ankle and above. Localization is associated with the characteristics of the skin of the ankle area.
  • to contents ^

    Regardless of the cause of the manifestation, the symptoms of varicose veins of the lower extremities require complex treatment. Healing is possible only after procedures aimed at soldering (gluing) the affected veins; in severe cases, excision (removal) of the dilated vein is performed.

    Phlebotonics and cooling ointments are prescribed for topical use. This course of treatment forces the vessels to contract, increasing their tone.

    Choosing a method according to the stages of the disease

    The degree of development of the disease determines the method of treatment.

    In the initial stages, a “basic effect” is used, including phlebotropic medications that strengthen and tonify the venous walls. They can be prescribed in the form of tablets, ointments and gels. Doctors also recommend that the patient use class 1 compression support hosiery during periods of time that are dangerous for the veins:

  • during increased physical activity and when putting stress on the legs;
  • with forced prolonged sitting (long flights, sedentary work).
  • At later stages of development of varicose veins, basic treatment is used in combination with procedures that eliminate the expansion: laser coagulation, sclerotherapy. Large vessels are removed through surgery (phlebectomy).

    Important: Even if the unsightly symptoms of varicose veins of the lower extremities do not interfere with your life, it is necessary to remove irreversibly atrophied, affected veins. Ignoring them risks complications - the formation of blood clots, phlebitis, thrombophlebitis. These diseases are not to be trifled with - possible blockage of blood vessels in the legs, pulmonary thromboembolism, and death.

    Drug and non-drug treatment

    Treatment with medications is effective in the early stages of the disease and is also used as maintenance therapy for severe symptoms. Phlebotics are used to increase the tone of the walls of blood vessels (Deralex, Ginkor-Fort, Aescusan, etc.)

  • Compression procedures. The therapy is effective for mild varicose veins and is used in addition to the treatment of more complex cases. Elastic bandage, workwear (knitwear). The principle of action is to weaken the manifestations of venous insufficiency.
  • Sclerotherapy. The method has been known since the time of Hippocrates. Chemically active substances are injected into the vein, which, upon entering the vein, damage its internal walls with a chemical burn. As a result, the vessels “stick together” and become overgrown. Sclerosant substances (ethoxysclerol, fibrovein, thrombovar) are used for sclerotherapy. After administering the medicine, the leg is bandaged (or the patient is put on a compression stocking) to evenly distribute the fluid throughout the vascular system. The method does not protect against relapse.
  • Operation Troyanov-Trendelenburg. The method involves removing the affected veins on the thighs. The leg area is bandaged, an incision is made, and the dilated veins are removed.
  • Linton and Coquet method. The leg is incised in the calf area, the perforating veins are ligated under the fascia. Effective for post-thrombotic disease.
  • Stripping. Removal of affected veins with a probe. The vein is dissected at both ends, a probe is inserted, and the vein is removed.
  • Microphlebectomy. Removal of dilated veins is carried out using skin punctures, without incisions.
  • Phlebectomy. An incision is made along the length of the vein for extraction.
  • Radiofrequency and laser coagulation. The principle of operation is the treatment of varicose veins with radio frequency or laser radiation.
  • The choice of treatment method depends on a number of factors:

  • health status (comorbidities);
  • the stage of development of the disease at which the patient presents;
  • forms of the disease, symptoms, presence/absence of complications.
  • Each method has advantages and disadvantages: cosmetic, physiological, and associated with the risk of relapse.

    Let the grandmothers on the benches say that treatment of reticular varicose veins of the lower extremities is possible with folk remedies. It's up to you whether to believe it or not. But be prudent - if the disease manifests itself, do not expect that spells, ointments and masks from what is in the refrigerator will solve your problem. Use white magic and vegetable masks for your health, but before that, go to the doctor whose office door says “phlebologist.”

    And if trouble has not yet touched you, engage in prevention. You need sports, quitting smoking and alcohol, healthy food. Swim, run, ride a bike.

    Unfortunately, if you start the problem, the path through the six described stages to the surgeon's table will be completed very quickly. Take care of yourself, be healthy.

    Signs and treatment of deep vein varicose veins

    Signs of deep vein varicose veins indicate the presence of a serious pathology. The deep veins themselves play a significant role in the circulatory system, and disruption of their patency can cause dangerous complications. Symptoms of deep vein varicose veins give quite characteristic manifestations, which allows timely detection of the disease. In turn, timely and effective treatment eliminates complications and relapses.

    Varicose veins (or more precisely, varicose veins) is a progressive disease caused by irreversible deformation of the veins as a result of their expansion, lengthening of vessels and stenotic thinning with the formation of nodes in the affected areas. The mechanism of injury is most often associated with dysfunction of the venous valve system.

    Varicose veins are considered a fairly common pathology. Varicose veins of the superficial veins are most often observed, but varicose veins of the deep veins are most dangerous in terms of their impact on the functioning of the entire circulatory system. These veins carry almost 90% of all blood flow to the heart. The deep venous system includes the following deep vessels: large and small tibial, dorsal (feet and soles), popliteal, gastrocnemius, soleus, deep and common femoral veins.

    Normal venous blood flow is directed from bottom to top, for which 3 main factors are involved: arterial blood pressure (least influence); contraction of the muscles of the lower extremities, working like a pump; venous valves that block reverse blood flow. The main cause of the development of pathology is considered to be a dysfunction of the valves, which leads to blood reflux. Signs of valvular dysfunction are associated with an imbalance in the physiological balance between muscle cells, collagen and elastic stenotic tissues. Hereditary factors are most often to blame for the formation of such a mechanism, but provoking factors can also affect it.

    As a result of reflux, the blood venous flow becomes chaotic, stagnant zones appear, where internal pressure sharply increases. Under the influence of excess load, the veins expand, which, accordingly, leads to thinning and elongation of the tissue walls. When a person stays on his feet for a long time, the so-called muscle pump builds up additional pressure, which aggravates the situation.

    The provoking causes of varicose veins can be factors that increase pressure in the venous lumen and factors that disrupt the functioning of the valve system. Such provoking reasons include:

  • arterial hypertension;
  • pathologies of a neuroendocrine nature, mechanical obstacles to blood flow;
  • allergic process, immune system disorder;
  • diseases with impaired hemodynamics;
  • hereditary and age factors;
  • hormonal imbalance;
  • pregnancy;
  • prolonged exposure to extreme temperatures (overheating or hypothermia).
  • One common reason is work that involves walking or standing for long periods of time. The situation becomes more complicated if you have excess body weight, which increases the load on your legs. Varicose veins can become a complication of cellulite and dermatitis.

    Manifestation of pathology

    To provide treatment for pathology that is not associated with surgery, it is important to recognize varicose veins already at the initial stage of development. The initial signs of deep vein varicose veins are expressed by the following manifestations:

  • the appearance of swelling of the soft tissues of the legs at the end of the working day, which is especially evident on the feet, ankles, and lower legs;
  • a feeling of heaviness in the calf area after prolonged walking or standing (can also occur after prolonged sitting in one position).
  • Initial symptoms usually disappear after proper rest, which dulls attention to them, although it is at the stage of manifestation of these signs that treatment should begin.

    The development of pathology leads to the appearance of a number of characteristic signs of the disease. The main symptoms include:

  • sensitive pain syndrome in the calf muscles, which is aching in nature;
  • a feeling of local burning and heaviness;
  • dry skin of the lower extremities;
  • pigment spots and skin thickening;
  • cramps in the legs at night;
  • spider veins;
  • expansion of the veins up to the formation of an external protrusion in the shape of a bunch of grapes;
  • small ulcers with long healing.
  • In addition to the formation of venous nodes, the pathology leads to irreversible dysfunction of the venous valves. In the absence of effective treatment, deep vein varicose veins in an advanced stage can manifest themselves as deformation of the muscle tissue of the legs, and the structure of the skin and bones in the affected area changes. Painful, long-lasting trophic ulcers may appear. A very dangerous complicating factor is the formation of blood clots, which is facilitated by the appearance of stagnant zones and slowing down blood flow.

    Varicose veins can affect not only the veins of the lower extremities. In some cases, varicose veins of the stomach, esophagus, pelvis, testicles and spermatic cord are noted. Varicose veins of the pelvis are one of the causes of hemorrhoids, and varicose veins in the genital area can result in infertility.

    Principles of pathology treatment

    The objectives of treating deep varicose veins can be considered the elimination of stagnant zones (venous nodes), normalization of blood flow in the veins, restoration of the functionality of venous valves, and normalization of pressure in the veins.

    As the disease develops, the vessels become irreversibly deformed, which precludes their restoration by therapeutic methods.

    The method of treating the pathology depends on the degree of damage.

    At the initial stage, when the vessels have not yet received significant deformation, compression and drug therapy are used. The goal of treatment at this stage is to normalize blood circulation to eliminate stagnant zones. Compression therapy is provided by wearing special knitted underwear: stockings, knee socks, tights. Drug treatment is aimed at strengthening the venous walls - venotonic drugs. The following drugs are most widely used to affect the deep veins: Ginkor-fort, Anavenol, Detralex, Phlebodia-600.

    As the disease progresses, removal of the affected area is required. At this stage, 2 methods become the main ones: sclerotherapy and surgical treatment. Sclerotherapy is a non-invasive treatment that involves blocking the affected blood vessel. A special sclerosing composition is injected into the venous lumen and glues the walls, blocking the damaged vein. In this case, blood is able to move normally through neighboring healthy vessels. Although the method is not a surgical operation, it is performed under anesthesia.

    Surgical treatment is a radical, but the most reliable method of treatment for serious vascular lesions. Surgery involves removing the affected section of the vein.

    Treatment of varicose veins of deep veins can also be carried out using folk remedies based on herbal preparations. It is also advisable to coordinate such treatment with your doctor. The following proven recipes are recommended:

    1. Decoction from the collection: birch bark, horse chestnut and oak bark (3 tablespoons each), horsetail, Icelandic moss (2 tablespoons each), astragalus, blackberry root (90-100 g each), immortelle, rhubarb root (2 tablespoons each) is poured with boiling water (500 ml) and cooked for 6-7 minutes. Use 90-100 ml 3-4 times a day.
    2. Decoction: hop cones are crushed and filled with water at the rate of 1 tbsp. l. for 250 ml of water. Keep in a water bath for 14-17 minutes. Used as a compress.
    3. Varicose veins of the deep veins are a dangerous disease, as they affect very important blood lines. Such a disease must be identified at the earliest stages, when treatment can be carried out using a conservative method. Otherwise, you will have to resort to surgery.

      Thrombophlebitis of the deep veins of the lower extremities - photos, symptoms and treatment

      Inflammation of the walls of the deep veins located under the layer of muscles in the legs with the simultaneous formation of blood clots in them is called thrombophlebitis of the deep veins of the lower extremities. This pathology is a complication of varicose veins.

      Statistics say that most often thrombophlebitis of the lower extremities occurs in women. Doctors associate this fact with wearing uncomfortable shoes and using hormonal contraception.

      Pregnancy can also provoke the occurrence of thrombophlebitis. Depending on the nature of the course, acute, subacute and chronic forms of thrombophlebitis are distinguished.

      Why does thrombophlebitis occur, and what is it? Thrombophlebitis of the deep veins of the lower extremities is an inflammatory process, a complication of varicose veins (its next stage in case of neglect). This area becomes inflamed due to the formation of a blood clot. Quite often, this disease is unilateral: only one lower leg or thigh is affected.

      Factors predisposing to the disease:

    4. hereditary predisposition;
    5. prolonged standing or sitting;
    6. strict bed rest for a long time;
    7. a history of varicose veins;
    8. tendency to increased blood clotting;
    9. oncological diseases;
    10. pregnancy period;
    11. overweight;
    12. elderly and senile age.
    13. Thrombophlebitis can also be classified according to the form of its course:

    14. Acute thrombophlebitis develops very quickly, in just a few hours;
    15. Chronic thrombophlebitis develops unnoticed and gradually, and periods of exacerbation occur rarely;
    16. Migrating thrombophlebitis affects several vessels at once. New foci of inflammation appear regularly, but completely disappear over time, leaving no traces.
    17. It must be remembered that this disease is extremely dangerous, since two bad things can happen to the patient: blockage of a blood vessel and the separation of a blood clot with its subsequent transfer into the bloodstream. The consequences of such phenomena can be fatal for a person.

      With thrombophlebitis of the deep veins of the lower extremities, symptoms and treatment are interrelated. In most cases, the patient exhibits the following symptoms:

    18. Pain in the leg where thrombophlebitis develops. Often the temperature of the diseased limb is lower than that of the healthy one.
    19. Body temperature rises significantly, sometimes the thermometer mark can reach 40 degrees.
    20. Swelling of the lower limb occurs.
    21. The skin becomes pale, the skin becomes taut and tense.
    22. The localization of thrombosis can also be different - lower leg, ankle, thigh. Occasionally, the disease develops without visible symptoms - this leads to a serious complication, and in the long term - to an unexpected death.

      What thrombophlebitis of the deep veins of the lower extremities looks like, we offer detailed photos of clinical manifestations for viewing.

      Before treating thrombophlebitis of the deep veins of the lower extremities, it is necessary to conduct a competent diagnosis. The leading method is duplex scanning. If the scan does not give the desired results, radiopaque venography is used. Compared to ultrasound, the effectiveness of these methods is considered higher.

      Treatment of deep vein thrombophlebitis

      When symptoms of thrombophlebitis of the deep veins of the lower extremities appear, treatment can be either conservative or surgical, taking into account the individual characteristics of the body and the course of the disease.

      The principles of conservative therapy are the following:

    23. Creating rest for a sore leg.
    24. Elevated position of the limb.
    25. In the treatment of thrombophlebitis, anticoagulants are mandatory, which dissolve the blood clot and prevent the formation of new clots. These include warfarin tablets and heparin or fraxiparin injections. When using them, hemostasis parameters must be monitored.
    26. Improving microcirculation (pentoxifylline is prescribed for this purpose).
    27. They also use painkillers, anti-inflammatory, antibacterial drugs, solutions that improve the rheological (fluid) properties of blood (reopolyglucin), vitamins and antioxidants.
    28. Ointments and gels can reduce inflammation, relieve pain, and reduce blood clotting. But for thrombophlebitis of the deep veins of the lower extremities, they are ineffective, so additional medications are prescribed in tablets and injections.
    29. The next point of treatment for a patient diagnosed with thrombophlebitis of the lower extremities is the use of compression hosiery and active movements. When using elastic bandaging, the symptoms of deep thrombosis are significantly reduced: swelling and pain. Typically, stockings with compression from 23 to 32 mmHg are used, and the length is adjusted depending on the topic of thrombosis. Thus, a patient with thrombophlebitis of the femoral veins and pelvic vessels requires stockings up to the inguinal folds; if worn constantly, regardless of the location of the cause of the disease, knee-length stockings are recommended.
    30. Combination therapy of the listed methods in combination with active movements brings great results. The intensity of pain and swelling are significantly reduced. The progression of the thrombus formation process is facilitated by hypo- and adynamia. Therefore, the patient is advised to walk until pain in the legs appears, if there are no contraindications.

      There are several methods of physiotherapeutic treatment used for DVT of the legs.

    31. UHF - under the influence of high-frequency electric fields in the affected areas, lymph outflow, blood circulation, and regeneration processes in general are stimulated.
    32. Electrophoresis - drugs are administered through the skin using an electric current.
    33. Magnetotherapy - under the influence of a magnetic field, the characteristics of blood composition improve.
    34. Paraffin applications are useful when there is a threat of the formation of trophic ulcers. The technique is not used for acute thrombophlebitis.

    Also, for acute thrombophlebitis of the deep veins of the lower extremities, hirudotherapy (leech treatment) can be used.

    Surgical treatment of thrombophlebitis of the deep veins of the lower extremities is carried out when drug therapy is ineffective, there is a high risk of embolic complications and ascending thrombosis. For this, open and endovascular operations can be used.

  • Vava filters are installed in the vein in case of floating blood clots. Implantation of a vena cava filter is indicated for patients with contraindications to the use of anticoagulants. The inferior vena cava is the main arterial vessel through which blood moves from the lower extremities, internal organs of the pelvic cavity and abdominal cavity, to the heart and lungs. Therefore, if drug treatment for thrombosis is ineffective, you may be recommended to implant a filter into the inferior vena cava to prevent the development of thromboembolism (migration of pieces of blood clot through the inferior vena cava system). The inferior vena cava filter is usually inserted through the femoral vein, but can also be inserted through the superior vena cava system (veins of the neck and upper extremities).
  • The inferior vena cava is sutured if it is not possible to implant a filter. And also in case of multiple blood clots or relapse of the disease. In this case, a “clip” (special clamp) is applied to the affected area of ​​the vessel and stitched. This allows you to partially block the channel, leaving a certain gap for blood flow. Disadvantage: deterioration of blood outflow from the veins of the lower limb.
  • After surgery (any of these), you should wear a compression bandage or stockings. In this case, for the first three days, it is generally not allowed to remove them, since there is a high probability of the formation of new phleboliths.

    Preventive measures are as follows:

  • wearing comfortable shoes and clothing that do not constrict the limb area;
  • rejection of bad habits;
  • playing sports;
  • losing excess weight;
  • rest, especially for the legs, it is advisable to sometimes sleep with your legs elevated and do a massage.
  • So, thrombophlebitis should not be taken lightly, as the complications of this disease can be very serious. It is important to stop self-medicating and start following the advice of doctors. This will help you continue to remain a physically active person.

    Details about the treatment of deep vein thrombosis of the lower extremities

    Today, the question of methods and treatment regimens for patients with an established diagnosis of deep vein thrombosis of the lower extremities is raised with particular urgency. This is due to the frequent development of the disease during active working age.

    Of particular concern to doctors is the disability of a large part of patients after suffering from the disease and the subsequent development of post-thrombotic syndrome, progression of chronic venous insufficiency, and most importantly, the high threat of death of patients if acute pulmonary embolism occurs.

    The main tasks that active therapy solves for deep vein thrombosis are the following:

  • prevention of the development of pulmonary embolism, ischemic stroke and infarction-pneumonia with a detached embolus;
  • interrupting the process of formation of pathological blood clots;
  • decreased blood clotting rates;
  • restoration of recanalization and vascular patency;
  • exclusion of factors for the formation of blood clots;
  • prevention of postthrombotic syndrome.
  • Conservative therapy

    The main method of treating an acute thrombotic process is conservative therapy, carried out in the surgery department where the patient is admitted. A patient with thick blood masses in the venous bed from the moment of admission to a medical institution is considered as a potential patient at risk of developing pulmonary embolism.

    If the diagnosis is established, treatment begins immediately. Depending on the severity of the symptoms and the stage of the disease, it is carried out either in the hospital (at stage I) or on an outpatient basis (during the stabilization period) .

    Before conducting an ultrasound examination and determining the shape and location of the blood clot, as well as before identifying the threat of embolism, patients are prescribed strict bed rest .

    At the same time, mandatory compression of the affected limb with an elastic bandage is required. To normalize venous outflow, the end of the bed is raised by 20° or the leg is fixed in a special conductor for immobilization.

    The need for physical rest and a state of psychological comfort for the patient during this period is due to:

  • threat of separation of a dense clot and rapid transfer through the bloodstream to any organ;
  • the possibility of developing pulmonary thromboembolism with subsequent death.
  • thrombosis of the following forms is diagnosed during ultrasound angioscanning :

  • parietal form, when the body of the thrombus fits tightly to the wall of the vessel;
  • occlusive, when thrombotic masses block the lumen of the vein.
  • This means that there is no flotation (movement) of the thrombus in the venous bed. However, even under these conditions, if there is pain and swelling of the leg, bed rest is indicated.

    As the manifestations of these symptoms decrease, patients are allowed activity with bandaging of the limb to the groin for a period of up to 10 days . This time is usually enough for the threat of pulmonary embolism to decrease and for the blood clot to attach to the vein wall. To stimulate blood flow in the veins, patients can stand up and walk a little.

    Patients can get up and move only after active therapy and complete removal of the threat to their life.

    Drugs and treatment regimens

    Therapy for thrombosis involves, first of all, the use of direct-acting anticoagulants, and primarily heparin, which quickly reduces blood clotting by deactivating the thrombin enzyme and suppresses the formation of new pathological clots.

    Heparin therapy in hospital

    First of all, the patient is given a single dose of heparin intravenously - 5 thousand units.

    Next, droppers are used to administer the medication per hour (infusion rate up to 1200 units/hour). In the subsequent days of treatment, heparin is injected subcutaneously into the abdominal area at a dose of 5 thousand units up to 6 times a day. The use of heparin in its pure form is possible only in a hospital , due to possible complications when using it in the required dosage and the need for constant monitoring.

    The effectiveness of heparin therapy is confirmed by the indicator of blood clotting duration, which should be 1.5 - 3 times greater than the primary indicator.

    In general, adequate heparin therapy involves daily administration of 30,000 - 40,000 units of the drug. With this treatment, the risk of recurrent thrombosis is reduced to 2 - 1.5%.

    If the dynamics are positive, on days 4–7 in this treatment regimen, instead of the usual form of heparin, they begin to use low molecular weight fraxiporin in ready-made syringes, which is injected subcutaneously into the abdominal area only 1–2 times a day.

    Rheological therapy

    It lasts up to 15 days and is aimed at:

  • on changes in blood and plasma viscosity;
  • to correct hematocrit indicators (the number of red blood cells in the blood that can carry oxygen);
  • to counteract the aggregation (sticking together) of red blood cells.
  • administration of drugs such as:

  • Reopoliglucin (drip, daily dose 400 – 800 ml). A plasma replacement agent that normalizes hemodynamics, improves blood circulation in blood vessels, increases the volume of fluid in the circulatory system, and prevents platelets and red blood cells from sticking together.
  • Pentoxifylline is an antiplatelet drug that reduces blood viscosity and activates microcirculation in areas where blood supply is impaired. The medicine is administered intravenously or drip using a solution of sodium chloride (0.9%) and for up to 180 minutes.
  • Nicotinic acid , which is administered intramuscularly at 4–6 ml per day, and has a vasodilator and weak anticoagulant effect.
  • Treatment is indicated for severe inflammatory symptoms of deep vein thrombosis of the lower extremities, duration - 5 - 7 days. Antibiotics are used: ciprofloxacin - in tablets; cefazolin, lincomycin, cefotaxime - in the form of intramuscular injections.

    Compression garments and bandages

    Elastic compression is included as a mandatory element of therapy for thrombosis. For this purpose, elastic bandages are used, covering the affected limb from the fingers to the crease of the groin. With this type of therapy:

  • venous outflow improves;
  • a network of bypass vessels is actively developing, ensuring the outflow of venous blood instead of the main blocked vein (the so-called collaterals);
  • the destruction of venous valves is prevented;
  • the speed of blood movement through the deep veins increases;
  • lymphatic drainage functions improve.
  • You can learn about the selection of compression garments from this article.

    How to treat: basic medications

    Approximately 6–10 days after the start of heparin therapy, the treatment regimen involves switching to tableted indirect-acting anticoagulants and disaggregants - agents that prevent platelet clumping.

    Warfarin is classified as a long-term anticoagulant that inhibits the synthesis of vitamin K, which is a strong coagulant.

    It is taken once a day at a certain time. When using warfarin, monitoring of the INR is required, to determine which a blood test is done every 10 days. Warfarin has many contraindications, so it is used only after a doctor has selected a specific dose and under strict laboratory control .

    Currently, Western pharmaceutical companies are conducting research on drugs with even more narrowly targeted anticoagulant action, which do not require constant testing. This makes it possible to use low molecular weight heparins for therapy on an outpatient basis.

    Acetylsalicylic acid, taken 50 mg per day , helps keep blood viscosity low enough to prevent the re-formation of pathological blood clots. For problems with the gastrointestinal tract, depending on the dynamics of the disease, it is advisable to take film-coated tablets for 4 to 8 weeks.

    It is recommended to take venotonics that help increase the tone of the veins, strengthen the walls of blood vessels, improve microcirculation and normalize blood flow: aescusan, detralex, phlebodia.

    The results of compression therapy, which continues on an outpatient basis, are more pronounced if the site of the inflammatory process is lubricated with special phlebotropic ointments and gels: Troxevasin, Venoruton, Venitan, Aescusan, Lyoton-gel, Reparil-gel . These agents have excellent venotonic and anti-inflammatory effects.

    Surgery

    The choice of therapy for thrombosis is directly dependent on the degree of its “embologenicity,” that is, on the ability of a floating thrombus to break away from the wall and penetrate through the bloodstream into the lungs, heart or brain, causing an embolism.

    Surgical treatment is usually indicated in two cases :

  • in case of a floating thrombus and a threat to the patient’s life;
  • with a segmental form of thrombosis and a recent period of clot formation in the absence of severe pathologies in the patient.
  • The type of surgical intervention depends on the location of the blood clot blocking the vessel. Apply :

  • Surgery to remove a blood clot or surgical thrombectomy with the extraction of dense blood masses from a vein through a small incision. The procedure is used only for serious forms of the disease, when the likelihood of tissue necrosis is determined.

    However, experts believe that thrombectomy performed after 10 days of thrombus formation is ineffective due to its tight fusion with the vascular wall and destruction of the valves.

  • Vein ligation.
  • Application of an arteriovenous shunt . Currently, it is used very rarely due to the procedure being performed under general anesthesia, the impossibility of performing it in case of pronounced trophic changes in the tissues and the difficulty of repeated access due to the development of scar tissue.
  • Installation of a self-fixing “cava filter” . This is a device for stopping moving blood clots (emboli) on their way to important organs (lungs, heart, brain). It is implanted into the lumen of the vein using the endovascular method (through a vessel). The method is used only if it is impossible to use anticoagulants.
  • Vascular suturing or plication . Used when it is impossible to use a vena cava filter. In this procedure, the wall of the vena cava is sutured with metal staples.
  • Dissolution of thrombotic masses , or thrombolysis.
  • Thrombolysis is a procedure in which blood clots are resolved . The vascular surgeon injects into a vein blocked by a dense clot, into which a special dissolving thrombolytic agent is supplied using a catheter.

    Is it worth turning to traditional medicine?

    Treatment of the disease can be supplemented with traditional medicine recipes, but only on the recommendation of a phlebologist .

    • Fish fat. Fish oil contains glycerides and special fatty acids that have the properties of destroying fibrin, a protein that takes part in the formation of a blood clot. In addition, they help thin the blood.

    For the purpose of prevention, drink 1 tablespoon of fish oil two to three times a day . But a more rational way is to use fish oil in capsules, which do not have an unpleasant odor and are much more convenient to use. The usual dose is 1 – 2 capsules up to 3 times a day with food. Contraindications: allergic reactions, cholelithiasis and urolithiasis, pathology of the thyroid gland.

  • Baths with infusion of marsh marsh grass for feet . Dry cucumber grass in an amount of 150 g is poured with boiling water in a volume of 10 liters. Leave for 60 minutes. Keep your feet in a warm infusion for half an hour before going to bed.
  • Curd or clay compresses . Daily heel massage using cottage cheese or clay has a very good effect on venous blood flow. In areas of inflammation and painful areas, do not massage the legs, but simply apply warm cottage cheese or clay in the form of a compress for 2 to 3 hours.
  • You should not violate the prescribed regimen. Early rise and walking in the presence of a floating thrombus in a vein of the lower extremity can lead to its detachment and rapid development of pulmonary embolism.

    It is prohibited to take any medications or herbal infusions without consulting a doctor. Taking anticoagulants, the ability of blood to quickly clot and form clots, imposes certain restrictions on any procedures and medications.

    For example, many medications reduce the effect of warfarin or, on the contrary, increase it , which means there is a high probability of bleeding, hemorrhagic strokes, or vice versa - blood thickening and re-formation of blood clots. The same applies to any folk remedies. Thus, very useful nettle contains a lot of vitamin K, and uncontrolled drinking of decoctions can contribute to severe blood thickening.

    It must be taken into account that relapses of thrombosis are possible over a long period (from 1 to 9 years) . According to statistics, after 3 years, 40–65% of patients who do not comply with the prevention and prescribed treatment become disabled due to chronic venous insufficiency.

    In this regard, it is mandatory :

  • compliance with all medical prescriptions and medications;
  • use of compression hosiery;
  • examination for blood clotting while taking oral contraceptives (for women of reproductive age);
  • regular laboratory tests for blood clotting INR;
  • to give up smoking;
  • compliance with the correct regime of physical activity , the following are unacceptable: standing on your feet for a long time, sitting, a sharp transition from intense physical activity to prolonged fixation of the limbs (for example, after sports training - a long trip in a car, when the legs are practically motionless);
  • eating certain foods (onions, apples, green tea, oranges, natural red wine in small doses) that contain chemicals that help prevent thrombotic formations.
  • The main task of modern medicine in the field of treatment and prevention of deep vein thrombosis of the lower extremities (leg, thigh or other vessel) is to prevent or quickly stop the development of this dangerous disease , which occurs during prolonged bed rest in bedridden elderly people and young women taking contraceptives, pregnant women, women giving birth, and even among students who abuse smoking.

    Preventing the formation and growth of blood clots in the deep veins significantly reduces the risk of heart attack, embolism, stroke, and therefore preserves life and health .

    Watch a video on how to recognize the disease and what to do to save your life:

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