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Varicose veins of the lower extremities

18 Sep 18

All about varicose veins of the deep veins of the lower extremities: symptoms and treatment

Deep veins differ from superficial veins in that they do not lie between the muscles and the skin, but in the thickness of the muscle tissue. This includes vessels such as the tibia, tibia, gastrocnemius, soleus and others. Most of the blood flow to the heart passes through the deep veins, which makes disruption of their functioning especially painful.

Varicose veins are characterized by a malfunction of the venous valves, in which reverse blood flow (reflux) occurs, causing congestion.

Stagnation of blood in the vessels leads to increased pressure on their walls, reaching maximum values ​​at the lower points of the veins.

With further development of the disease, venous nodes (“stars”) appear, which aggravate its course.

The following factors contribute to increasing the likelihood of the development of such processes:

  • heredity: congenital weakness of venous walls and valves;
  • sedentary lifestyle;
  • constant standing;
  • overweight;
  • allergies and dermatitis;
  • neuroendocrine disorders;
  • pregnancy;
  • deep vein thrombosis;
  • taking hormonal medications.
  • Symptoms of varicose veins of the deep veins of the lower extremities

    Since the deep veins run through muscle tissue, a person cannot detect any disturbances in their functioning with a simple external examination.

    But reflux in this group of vessels, as a rule, accompanies varicose veins of the superficial veins, that is, the expansion of deep veins manifests itself with clearly visible external signs.

    Varicose veins affect your well-being. A person experiences sensations of swelling in the lower extremities, the more precise localization of which depends on which vessels are damaged.

    Swelling increases as the legs become tired and reaches its peak in the evening. At night, cramps may occur, especially often in the calf muscles.

    With further development of the disease, the frequency of pain increases, it becomes aching and dull.

    With concomitant reflux in the superficial veins, all the standard signs of varicose veins are observed:

  • the appearance of bluish spider veins;
  • their increase in size;
  • atrophy of the skin;
  • the appearance of ulcers.
  • Varicose veins are not life-threatening in themselves, but the diseases they provoke can be fatal. If left untreated, thrombophlebitis develops - inflammation of the inner wall of the vein. It is characterized by the formation of blood clots that break off from the walls of blood vessels and block their lumen.

    They can also enter the pulmonary artery, causing thromboembolism, a condition with serious consequences including death.

    Thrombophlebitis of the internal veins is especially dangerous because the volume of blood passing through them is an order of magnitude greater than the blood flow of the external vessels.

    A phlebologist is responsible for studying the condition of blood vessels, and it is he who refers the patient to diagnostic measures.

    Manual palpation is not useful in determining the dilatation of internal veins, but it is used to look for accompanying external varicose veins.

    In any case, the patient is prescribed standard tests:

  • general and biochemical blood test;
  • Analysis of urine.
  • The most common diagnostic method is ultrasound of the veins of the lower extremities. Ultrasound can detect inflammation in both internal and superficial veins. Ultrasound has two types: Dopplerography and angioscanning. Doppler sonography is prescribed to patients in general cases; a referral for angioscanning is given to clarify the diagnosis.

    Additional diagnostic methods include sonography, revasographic examination, occlusive plethysmography, photoplethysmography, and venography.

    The most effective (but relatively painful) treatment method is surgery.

    Surgical intervention is necessary in cases where conservative methods do not produce results, and varicose veins tend to develop into serious complications.

    Important: operations are not performed in the presence of coronary disease, severe infectious processes, pregnant women and the elderly.

    Currently, the treatment of varicose veins of the deep veins of the lower extremities (and not only) is eliminated by the following types of interventions:

  • Phlebectomy. It involves removing the affected area of ​​the vein. Although phlebectomy is performed mainly for varicose veins of the superficial veins, modern microsurgical methods make it possible to perform operations on the internal venous system;
  • Radiofrequency obliteration. Under the influence of radiation, the vein sticks together and dissolves. This is a minimally invasive and painless method, but it is effective only for small scale varicose veins;
  • Laser intravascular coagulation. The method is similar to the previous one in its minimal invasiveness; here, reflux of venous blood is prevented due to the destruction and collapse of the vascular wall under thermal influence on it;
  • Sclerotherapy. The method involves the introduction of an adhesive substance into the vein, which leads to complete closure of its lumen and the disappearance of the vessel, followed by its replacement with connective tissue. Although this operation is painless, it is ineffective in treating severe forms of varicose veins.
  • For deep vein varicose veins, the use of external agents is necessary only to eliminate the concomitant reflux of superficial vessels, but they will not be able to penetrate the muscle tissue and affect the main area of ​​localization of the disease.

    For this reason, the basis of drug therapy should be systemic venotonics (Detralex, Ginkor Fort, Venoruton, Aescusan, etc.). To prevent the development of thrombophlebitis, medications with antiplatelet (Lioton, Venolife) and anticoagulant (Heparin) effects are prescribed.

    Non-outpatient therapy for varicose veins includes:

  • taking preventive measures: healthy lifestyle, regular physical activity;
  • diet: avoiding too fatty foods, consuming foods with fiber and vitamins;
  • wearing compression garments that maintain venous tone;
  • application of compresses. Although they are not particularly effective in the treatment of internal venous disease, their use may provide modest benefit (as part of basic outpatient therapy). The most popular means for compresses are herbal decoctions (chamomile, wormwood, willow).
  • Varicose veins of the deep veins of the lower extremities are much less common than dilatation of superficial vessels. In some cases, these forms of the disease accompany each other. Since more blood passes through the internal vessels, varicose veins are more painful, and potential complications can lead to fatal consequences.

    Varicose veins of the lower extremities: treatment, causes, operations

    Varicose veins, the symptoms of which are detected in every fourth inhabitant of the planet, are not just a cosmetic defect, manifested in the form of a blue tree-like mesh on the legs, thighs or back of the feet, heaviness in the legs, pain during static loads or long walking, convulsive twitching in the muscles of the legs , but also a high risk of thrombosis in the inferior vena cava system.

    Thrombotic complications lead to trophic ulcers on the legs, acute blood flow disorders with blue discoloration of the extremities and the risk of necrosis. Having broken away from the vascular wall, blood clots from the legs often begin a journey that ends in the heart (leading to a heart attack) or the blood vessels of the brain (causing a stroke). It is this circumstance, and not at all the spoiled appearance of once attractive legs, that requires the earliest possible attention to the treatment (or better yet, prevention) of varicose veins.

    Since the disease, having appeared, is not static, but gradually progresses, capturing more and more sections of the external or internal venous network of the legs, the analysis of treatment should begin with a description of prevention. It is reasonable preventive measures that will make it possible to at least somewhat slow down the process that has developed against the background of hereditary incompetence of the valve apparatus of the veins of the lower extremities.

    Prevention of varicose veins

    The veins of the lower extremities have very weak walls, practically devoid of muscle elements that could push blood through contraction. Therefore, special valves are provided in the veins to prevent the reverse flow of blood and its stagnation in the veins. In some people, these valves are hereditarily incompetent or become so with age:

  • during heavy physical activity
  • increases in intra-abdominal pressure
  • constipation
  • frequent pregnancies.
  • First, the process affects the external veins. And then the collector veins and deep venous network are affected. Varicose veins of the extremities develop over several (sometimes decades) years and its speed varies depending on lifestyle, intensity of physical activity and the strength of the walls of blood vessels.

  • Therefore, the first task of prevention is to minimize increases in intra-abdominal pressure (fight constipation, avoid excessive overload).
  • The second task is to create conditions for passive outflow of venous blood from the legs. Be sure to do this at the end of the day or several times a day. For this purpose, the legs are placed from the foot to the thigh on the surface at an angle of 45 degrees to the horizontal. You should lie in this position for at least half an hour. Persons for whom varicose veins in the legs are a medical fait accompli are advised to sleep with their legs elevated as often as possible.
  • If you have varicose veins, it is recommended not to use tight shoes or socks with tight elastic bands - that is, not to create additional obstacles to blood circulation in the legs (see also what to do if your legs swell).
  • You should also not sit cross-legged, and when sitting for a long time, rest your legs on a support and give them a horizontal (or slightly higher) position. This pose can sometimes be seen in gangster films about tough mafiosi who, sitting in a chair, put their legs on the table.
  • Of course, in the office, if you are not the owner of the company, you will have to come up with something less provocative. You can, for example, place a cardboard box under your desk and rest your feet on it, or use a tall plastic waste paper basket with a flat top lid for the same purpose. Any questions about an unusual way to sit at your desk should be answered honestly to avoid ridicule or being labeled a weirdo. Please remember that none of the giggling staff will be actively involved in your treatment. Therefore, you should adequately perceive the opinions of others and not neglect the prevention of the disease.
  • If you are at home, try to take a horizontal position whenever possible and use several pillows to position your legs above your head. This is necessary in order to improve conditions for venous outflow (see treatment of varicose veins at home).
  • Conservative treatment

    The non-surgical treatment program includes diet, compression and drug therapy.

    Dietary measures are mandatory, since excess weight is one of the risk factors for the development of varicose veins. Nutrition should be calorie-compensated (energy consumption should not exceed energy needs that correlate with the nature of the load or lack thereof). In addition, you will have to exclude hot seasonings, pepper, marinades, excess salt, smoked foods from the menu, and reduce the consumption of fried foods. It is also recommended not to drink alcohol.

    The menu should contain a sufficient amount of vegetables and fruits rich in vitamin C, dishes rich in fiber, wholemeal bread, and seafood. Frequent (at least 4 times a day) fractional meals are indicated. As for the trend that was fashionable just a few years ago to limit yourself to any animal fats, you should forget about it. Of course, exorbitant numbers of triglycerides and cholesterol are not the point. But in reasonable quantities, cholesterol helps to patch up the vascular wall, reducing the risks of secondary thrombotic complications and sudden ruptures of veins.

    Quitting smoking

    Smoking is the most harmful habit for varicose veins. If you choose between drinking a moderate amount of alcohol and smoking, then the first one can still be tolerated. But the second one will have to be categorically excluded. Not only do tars clog blood vessels, but carbon dioxide spasms them, increasing the risk of blood clots and secondary complications (heart attacks, strokes, pulmonary embolism). Those who have varicose veins (or are predisposed to them), take hormonal medications (including oral contraceptives) and still manage to smoke should be especially careful.

    Compression underwear (stockings, knee socks, tights)

    This is a good option for the prevention and treatment of early stages of varicose veins, as they have different parameters of pressure on soft tissues, model options and color solutions. You need to put on underwear in the morning, without getting out of bed, while the venous system is not yet overflowing with blood. There is one problem with this method - prohibitive price tags on the territory of the Russian Federation, limiting the purchase of anti-varicose knitwear by the general public. As a rule, people who start using underwear are not those for whom it can still help at the pre-illness stage, but people with severe forms of varicose veins, often complicated by thrombotic processes, for whom surgical treatment is indicated, and compression hosiery as a secondary prevention.

    Varicose veins: treatment with drugs

    Medicines are not a panacea. They are not able to completely stop or cure varicose veins.

    Venotonics - ointments and gels

    Venotonics manage to protect the walls of veins, stimulate venous outflow and somewhat improve microcirculation. These drugs can reduce the severity of pain and swelling, subject to a course of treatment. Courses are shown twice a year with a duration of at least 2 months.

    The most useless (but also safe) are ointments or gels. They do not penetrate further than the skin and cannot have any significant effect on the blood vessels. They are recommended in the early stages of the disease, when it is unknown why the swelling and heaviness in the legs may actually go away: from medications or simple postural drainage and the end of physical activity. Often the manufacturer’s trick comes down to recommending the use of a local remedy along with a tablet one.

  • Troxevasin is an ointment based on derivatives of the flavonoid rutin. Improved drainage is achieved by taking tablets (see direct anticoagulants).
  • Venitan - the ointment, which is recommended topically twice a day, contains horse chestnut extract.
  • Antistax is the active principle of the gel or spray Antistax is an extract from grape leaves. The manufacturer promises the effect of treatment no earlier than after 6 weeks of use. There are also Antistax capsules, taken on an empty stomach in the amount of two pieces.
  • Venotonics in tablets

    Tablet venotonics are used in cases of deep vein varicose veins.

  • Saponin derivatives are prepared on the basis of horse chestnut, which contains the plant bioflavanoid escin. The drug Aescusan is sold in tablets or drops.
  • The most effective drugs: Detralex and Phlebodia 600 are based on diosmin. It is a powerful venotonic. Detralex is taken one tablet twice a day. Phlebodia 600 – one tablet in the morning. The course of treatment is from 2 months to six months.
  • Rutosides were the first venotonics. They improve microcirculation and have an anti-inflammatory effect.

    — Natural rutosides include Venoruton in the form of soluble tablets and capsules.

    - To semi-synthetic ones: Venolan, Troxevasin, Troxerutin. Combined rutosides are Ginkor forte. It combines troxerutin and ginkgo biloba extract. The drug is taken 2 capsules in the morning and evening for a month. If necessary, the course is extended.

  • Phlebosclerosing drugs

    This is a way to turn off different veins from the bloodstream without surgery. Connective tissue gradually closes the lumen of blood vessels. Its growth is stimulated by the coagulation of endothelial proteins and irritation of the fluid muscle components of the vascular wall.

  • The simplest option is Hepatothrombin G ointment. Its effect is weak. As an at least somewhat acceptable option, injection solutions are used. There are quite a lot of them.
  • Synthetic products: Aethoxysclerol (Germany), Trombovar (France), Sotradecol (Great Britain), Decylate (Russia).
  • Iodine-containing products: Variglobin, Vistarin. Based on animal proteins - Varicocid. The drugs are used on small vessels in order to selectively close only the affected areas of the veins. Practitioners most often use Thrombovar and Ethoxysklerol, as they are safer, do not cause vascular thrombosis, but only burn the vascular wall at the endothelial level.
  • Phlebosclerosing therapy includes the administration of drugs or elastic bandaging. Its simplicity, preservation of the aesthetic appearance of the limbs, lack of influence on the general well-being of the patient and low pain attract both doctors and patients to this technique.

    But isolated sclerotherapy does not bring lasting results and is not able to stop the progression of the disease. In most cases, it still needs to be combined with surgical treatment. Before therapy, an ultrasound examination of the lower extremities must be carried out, excluding extensive lesions of the subcutaneous or deep veins of the legs.

    Contraindications to phlebosclerosis are: allergies to drugs, atherosclerosis of the great vessels with the presence of ischemia, diabetic angiopathy, obliterating endarteritis, lesions of the blood coagulation system, acute or recent thrombophlebitis of the legs, pregnancy.

    Additional medicines

  • Drugs that improve blood microcirculation: Pentoxifylline, low molecular weight dextrans. These agents reduce blood viscosity, stimulate platelet breakdown and increase the elasticity of red blood cells. All this contributes to better blood supply to tissues and oxidative processes in them.
  • Anticoagulants of direct (heparins) or indirect (coumarin and phenindione derivatives) action. Reduce the risk of thrombosis. Analogs of hirudin (Danaparoid, Lepirudin) and heparinoids (Pentosan polysulfate, Dermatan, Sulodexide) are also used. A very popular local remedy is heparin ointment and Lyoton gel, which provide anti-edematous, antithrombotic and anti-inflammatory effects.
  • Nonsteroidal anti-inflammatory drugs relieve pain and suppress inflammatory reactions.
  • Phlebosclerosing therapy options

  • Preoperative – vein sclerosis can be used preoperatively to reduce the risks of bleeding and thrombosis in the postoperative period
  • during surgery, replacing vein removal
  • after surgery to close the remaining unoperated veins.
  • The puncture method of administering drugs can be used at any time, the catheter method - only during surgery.

    If it is not used in the operating room, it is performed in a specialized surgical room, in compliance with all aseptic rules. The larger veins close first, then the smaller ones. In this case, drugs are usually administered from top to bottom. The vein is punctured in a standing patient, and he is laid down before administering the drug. If an extended vessel or vessels of the entire circumference of the leg falls into the field of interest, then several therapy sessions are performed. After sclerosing procedures, the patient should be observed by a phlebologist for three years from the date of the last injection.

  • After administration of the sclerosing drug, elastic bandaging of the limb is performed, which is repeated for 2 weeks. In this case, the bandage is not removed during the first week.
  • The patient must walk for half an hour after the procedure.
  • Every day the patient needs to sleep with the leg end elevated, and during the day avoid prolonged sitting or standing and walk a lot.
  • Radiofrequency ablation of veins

    Obliteration of veins using a radiofrequency emitter is a new direction in phlebology. This method of getting rid of varicose veins minimizes trauma to the vessel, the risk of complications, and pain. The effectiveness of the method is very high. Radiofrequency radiation destroys the inner lining of the vascular wall. In this case, the surrounding tissues are practically not affected, and the lumen of the vein collapses and disappears.

    The procedure is performed on an outpatient basis under local anesthesia. To accurately perform the manipulation, it is controlled by duplex angioscanning.

    After the administration of anesthetics, a vein puncture is performed (in the upper third of the leg in case of pathology of the great saphenous vein or in the lower third of the leg in case of damage to the small saphenous vein). A disposable catheter equipped with an emitter is inserted into the vein. It is advanced to the point where the saphenous vein flows into the deep venous system. During the gradual removal of the catheter, the vessel is irradiated from the inside. After the session, the puncture site is covered with an aseptic bandage. An elastic stocking is put on the leg. After a dosed half-hour of walking, the patient is allowed to go home. A patient who does not engage in heavy physical labor is able to work the next day after the procedure.

    Varicose veins: surgery

    The decision on the advisability of surgical intervention is made by a phlebologist or vascular surgeon.

    Often, women with damage to the superficial veins and who decide to undergo surgery solely because of a cosmetic defect are advised to postpone the operation if subsequent childbearing is planned (since during pregnancy, varicose veins, as a rule, progress, and the achieved result may disappear and require repeated surgical treatment) .

    Combined phlebectomy

    The most common surgical option for solving the problem of varicose veins of the lower extremities is combined phlebectomy. The operation is performed under general anesthesia or using epidural anesthesia. We try to make all cuts and punctures as small as possible. For example, to remove the great saphenous vein, a half-tarascentimeter incision is made in the groin area. Through it, a phlebextractor probe with a tip is inserted into the vein. The probe is then removed and a vein is removed from the mid-calf to the groin. Ducts and small veins are removed through small ducts. This part of the operation is called a miniphlebectomy. After surgery, compression is used (a bandage or stocking on the leg).

    Endovasal electrocoagulation

    It involves removing the saphenous veins by exposing them to current. The method is more dangerous than radiofrequency obliteration or classical surgery.

    Cryosurgery allows veins to be removed using low temperatures. With modern equipment and a trained specialist, the method is safe. It is not always possible to calculate the depth of freezing without damaging surrounding tissues or leaving “excess.” This method is not common in the Russian Federation.

    Intraoperative scleroobliteration

    Involves the use of catheter injection of sclerosing substances into the saphenous veins. Before surgery, the saphenous veins and altered areas of the veins are marked on the leg. During surgery on the great saphenous vein, the anastomosis of the great saphenous and femoral veins is exposed using a supra-inguinal approach and the tributaries of the great saphenous vein are ligated. The saphenous vein is crossed and ligated 1 cm from the femoral vein. The perforating veins are ligated (suprafascial ligation of the perforating veins) from separate incisions. A catheter is inserted into the cut off saphenous vein, the vein is sutured, and the wound is bandaged. A gauze roller is placed along the drawn projection of the saphenous vein and pressed along the entire length of the leg. Simultaneously with pulling out the catheter, a venosclerotic drug is administered.

    Endoscopic dissection

    Endoscopic dissection of perforating veins allows the veins to be ligated and excluded from the bloodstream. Connecting the subcutaneous and deep network of the legs. In this case, endoscopic probes are used. A variant of the method is transillumination phlebectomy.

    Laser coagulation requires a doctor to be highly qualified and experienced in working with laser equipment. The vein is sealed with a laser from the inside and excluded from the blood circulation.

    Home treatment for varicose veins

    Varicose veins can be treated at home with systemic medications (as prescribed by a doctor), ointments and gels, leeches (treatment of varicose veins with leeches) and cabbage leaves, apple cider vinegar. Also suitable for the home part of the program are compression garments and elastic bandages (selected and recommended by a phlebologist). For advanced stages of the disease, all these efforts will be in vain without radical surgical treatment.

    Thus, today only surgical methods, often combined with sclerotherapy or compression techniques, can be considered the cardinal method of getting rid of varicose veins.

    Varicose veins of the lower extremities: symptoms and treatment

    Varicose veins of the lower extremities occur for a number of reasons, which can be classified into 3 groups: blood clotting disorders, damage to the vessel wall, stagnant changes in surrounding tissues. The etiological factor influences the treatment, but medications are not able to narrow the dilated section of the vein.

    Venotonics maintain vascular tone, but are not able to restore functional valve insufficiency, leading to stagnation.

    Varicose veins: causes

    With increased blood clotting, the prerequisites for the formation of blood clots are created. Hormonal changes lead to disturbances in heart rhythm, decreased tone of the venous wall, and congestive changes.

    Damage to the venous wall can be traumatic, physical, chemical, or bacterial. In autoimmune diseases, thinning of the venous wall occurs due to damage by antibodies. With minor physical activity, barriers to blood accumulation should be identified.

    An increase in pressure inside the vessel can occur due to the compression pressure of surrounding tissues. Varicose veins with this combination become more complicated. The formation of trophic ulcers is likely.

    Provoking factors for varicose veins of the lower extremities:

  • Obesity is a negative prognostic factor for varicose veins. Excess fat increases pressure on the veins and promotes stagnation;
  • Poor nutrition and consumption of foods with plant fibers contribute to impaired vascular permeability. Increasing plant fiber in the diet can reduce the flow of toxins into the intestines. A sedentary lifestyle is an important factor leading to obesity and impaired venous blood supply;
  • Most people are at risk for complications when sitting or standing. Damage to the vein valves has a negative impact. Corsets and tight underwear contribute to compression of the veins in the groin area. An increase in intra-abdominal pressure with external compression of the venous vessels for a long time causes stagnant changes in the lower extremities;
  • Wearing high-heeled shoes is not physiological. The procedure promotes stretching of the muscular-ligamentous apparatus, which leads to stagnant changes in the veins;
  • The valves are capable of completely blocking the vessel, leading to stagnant changes in the lower extremities. Against the background of pathology, the walls of the venous system become overstrained, forming venous nodes;
  • Genetic predisposition is formed due to mutation of the gene apparatus responsible for the structure of the vein wall. With protein defects, vascular permeability increases, constant inflammatory changes and swelling are formed due to fluid sweating through the damaged membrane. Vessel weakness leads to increased venous pressure. The result is varicose veins;
  • Hormonal disturbances during pregnancy lead to increased levels of estrogen and progesterone, which affect the formation of vascular clotting factors. A decrease in the tone of the venous wall against the background of pathology leads to deformation and blockage of blood vessels;
  • Diabetes mellitus is a pathology that leads to a decrease in blood glucose levels, which creates a favorable environment for the development of blood clots;
  • Alcohol abuse leads to blood thickening, increasing the risk of blood clots in the vessels;
  • Long walking, forced sitting position are provoking factors for varicose veins;
  • Inadequate nutrition, heavy lifting, slow blood flow to the heart, and the development of stagnation are provoking factors of pathology;
  • Chronic constipation is accompanied by an increase in intra-abdominal pressure, difficulty in the outflow of blood from the lower extremities;
  • Dehydration of the body under the influence of intense sunlight leads to thickening of the blood, accelerating the formation of blood clots;
  • Venous insufficiency and congenital defects contribute to the pathology of cardiovascular activity;
  • An overdose of drugs increases blood clotting, leading to blockage of blood vessels with blood clots;
  • Surgical interventions increase blood volume and increase the likelihood of thromboembolism.
  • Varicose veins of the legs are a polyetiological disease. In patients, there are usually several reasons that led to the development of nosology.

    Signs of varicose veins are specific for diagnosis. There are 2 forms of the disease depending on the characteristics of the etiological factors - primary, secondary.

    The primary form is associated with weakness of the venous wall, which occurs under the influence of congenital or acquired factors. Secondary nosology develops under the influence of other causes.

    Causes of varicose veins in the legs:

    • Swelling of the skin;
    • Pigmentation disorder (darkening);
    • Pain in the evenings and afternoons;
    • Trophic skin damage (eczema, dermatitis).
    • Primary varicose veins are associated with weakness of the vein wall, the development of obesity, and the proliferation of connective tissue fibers. Secondary pathology is formed due to disruption of venous outflow due to injuries and tumors. The degree of increased stretching of the venous wall is unpredictable. With pathology, the risk of thromboembolism increases, which can be fatal. Typically, blood clots are localized in the legs, but there are cases of embolism in the venous system of the arms or abdomen.

      A secondary complication of the disease is trophic ulcers. Even a minor scratch with impaired trophism can contribute to the formation of ulcerative defects on the legs. The pathology is difficult to cope with when visiting a doctor. Treatment lasts for decades, so you should contact a phlebologist in a timely manner.

      Every day doctors have to deal with bleeding. If the disease is advanced, the veins protrude above the surface of the skin. Pathology leads to thrombophlebitis with irreversible consequences. Constantly monitor the condition of the venous system. To prevent pathological changes, thrombophlebitis should be associated with irreparable consequences.

      The uniqueness of the dilation of the vein wall is that pain occurs only at the initial stage. Gradually, the receptors get used to pain, so the wider the vein, the less pronounced the pain.

      Symptoms of varicose veins at an early stage:

      Blood should not flow in the opposite direction through venous valves. When they are deficient, reverse blood flow develops, resulting in stagnation. The accumulation of blood in a certain place creates the preconditions for the formation of blood clots. A similar picture can be seen when the technology for sclerotization of varicose veins is violated. Inflammation forms at the injection site, creating opportunities for the formation of a blood clot by increasing the adhesive properties of the vascular wall.

      Classification of thrombophlebitis by course:

      Acute thrombophlebitis develops quickly. At the location of the embolus, pain, redness of the skin, and dilation of the vein occur.

      The chronic course is not characterized by pronounced symptoms. Pain syndrome in pathology is periodic. The patient experiences pain after physical activity. Swelling is eliminated by elastic compression. Patients are recommended to wear special bandages.

      Drug and surgical treatment

      Drug treatment of varicose veins of the lower extremities does not completely eliminate the pathology. When the permeability of the vascular walls is impaired and congestive changes occur, new blood clots appear, which must be treated promptly to prevent pulmonary embolism and death. For these purposes, venotonics and anticoagulants are used in the form of oral tablets and local creams. Popular non-ionizing agents are Troxevasin, Detralex, Lyoton. To relieve inflammation, anti-inflammatory ointments are recommended - diclofenac, indomethacin. To prevent the disease, fraxiparin and heparin are recommended.

      In addition to medications, traditional treatment and physiotherapy (magnet, bicycle track, therapeutic exercises) are available. To get rid of skin rashes, a decoction of oak bark, chamomile, and St. John's wort is recommended.

      Surgery to remove varicose veins on the legs - types, principles of treatment

      The methods described above are currently used less frequently, since there are more popular operations.

      Sclerotherapy is the intravenous administration of an adhesive substance (sclerosant), which in the early stages of the disease eliminates varicose veins in several sessions. The procedure involves the introduction of a special substance into the varicose node, which promotes the closure of the lumen of the vein. Varieties of the method are minisclerotherapy, echosclerotherapy.

      Segmental venectomy, short stripping, is an analogue of venectomy, in which the ends of the vein are sealed with adhesive tape. Removal of affected venous nodes is carried out using endoscopic equipment. Miniphlebectomy allows blood clots to be removed through small incisions.

      Coagulation of affected veins with a laser is a modern procedure that allows you to avoid excision of tissue with a knife.

      Indications for surgical phlebectomy:

      • Significant expansion of the saphenous veins;
      • Danger of thromboembolism;
      • Trophic skin disorders;
      • Acute thrombophlebitis;
      • Swelling, severe fatigue of the patient.
      • The operation cannot be performed during pregnancy, severe infections, coronary artery disease, inflammation of the lower extremities, pyoderma, or eczema. The only way to treat the disease with deep vein varicose veins in order to correct the functioning of the valve apparatus is surgery.

        Laser therapy is indicated for patients with diseases of the cardiovascular system, genitourinary system, peritonitis and increased blood pressure, when surgical interventions are contraindicated.

        To get rid of an unpleasant vascular pattern, radiofrequency coagulation can be performed according to indications. The advantages of the operation are painlessness, absence of cosmetic skin defects, and disability.

        Indications for sclerotherapy of the disease are pathology with duplex Doppler ultrasound, varicose veins in the early stages. The disadvantage of the procedure is that the sclerosant gets into the deep veins, reducing the effectiveness of treatment in advanced cases.

        Treatment of chronic varicose veins

        For chronic varicose veins, elastic compression should be used correctly. For these purposes, a program has been developed:

      • Compression with knitwear of 1-2 classes at 0 degree;
      • Elastic compression with knitwear grades 1-2 with mono pharmacotherapy, physiotherapy for grade 1;
      • For grades 3-4, elastic compression with grade 2-3 jersey with continuous pharmacotherapy, local treatment with ointments, and physiotherapy is recommended.
      • Conservative complex treatment includes angioprotectors, phlebotonics, anti-inflammatory drugs (reopirin, diclofenac), local agents (curiosin, Lyoton 1000), anticoagulants (fraxiparin, heparin).

        Standardized treatment regimens for varicose veins with the described drugs protect against the incorrect use of certain types of therapy. Only a doctor can prescribe the frequency and dosage.

        Even a magnet for varicose veins of the lower extremities is used strictly according to indications. After the procedure, the nature of local changes should be assessed.

        Symptoms of varicose veins of the lower extremities and treatment of veins at an early stage

        A person is susceptible to various diseases, the development of which, by the way, is to a certain extent his own fault. This is our stubborn reluctance to lead a healthy and active lifestyle, the implementation of which is postponed every time until next Monday. What about this fashion? Fashionistas and fashionistas will go to great lengths to try to match style icons, after which in adulthood they reproach themselves for rash actions.

        The consequence of such behavior (not in all cases) can be an ailment such as varicose veins of the lower extremities, the symptoms and treatment of which will be discussed in more detail later.

        Varicose veins are a pathological condition in which there is an abnormal expansion of venous vessels. This is due to poor circulation, as well as insufficiency of the venous valves.

        The name of the disease translated from Latin means “bloating” . Actually, it is the swelling of the veins that can be seen with the naked eye on the affected area of ​​the body. However, this indicates the dynamic development of the disease and is not a symptom of early varicose veins.

        The veins of the legs are most susceptible to varicose changes, but pathology can also be observed in the vessels of the walls of the large and small pelvis. Very rare cases of this disease occurring in the vessels of the upper extremities.

        Reference . Varicose veins are a very common disease, the average incidence of which affects the population is 10-18%.

        It is worth noting that the appearance of the first signs of varicose veins on the legs, as well as their further development (in the absence of treatment), is observed several times more often in women than in men . Moreover, the age indicator does not matter.

        Damage to the venous walls can be bacterial, physical, traumatic, or chemical in origin.

        Based on this, the following provoking factors for the occurrence of such a disease of the legs can be identified:

      • heredity;
      • professional activities associated with heavy physical exertion or prolonged stay in one position (sitting or standing);
      • everyday wearing of tight underwear and high-heeled shoes;
      • significant increase in body weight;
      • pregnancy period, especially the second and subsequent ones.

      If at least one of these reasons is present in life, then it is worth eliminating it immediately, or at least paying more attention to the condition of the veins in the legs.

      Symptoms of varicose veins in the legs (photo attached) are directly dependent on the stage of the disease.

      Reference . The most obvious symptom of varicose veins in the legs, which cannot be confused with anything else, is the expansion of the superficial veins, with the vessels protruding most noticeably in the lower part of the legs.

      There are 4 stages of varicose veins in the lower extremities, each characterized by certain signs of manifestation:

    • initial – heaviness in the legs, fatigue after walking, swelling;
    • the first is the appearance of spider veins, a burning sensation in the calves and feet, regular cramps (especially at night);
    • the second – to all the above symptoms is added itching, numbness, and pigmentation of the skin in the affected area. In addition, the appearance of severe swelling and pronounced pain is noted. Blue nodules become more noticeable.
    • the third is a severe stage of pathology, in which the skin of the legs suffers greatly. There is dryness, cracking, and darkening of the skin in the ankle area. The vein nodules protrude more and more, which is dangerous, since they can burst even with minor injury. If this happens, then trophic ulcers appear in place of the nodules, which is dangerous not only for health, but also for human life.
    • Under no circumstances should such a disease be allowed to develop . At the slightest suspicion, you should contact a specialist for highly qualified help, because if the initial stage is quite successfully treated with conservative methods, then at the third or final stage an operation is required.

      Reference. In advanced forms of varicose veins, the development of thrombophlebitis is often observed - the formation of venous blood clots, which threatens the patient’s life.

      Separately, it is worth noting the development of this pathology in females. Due to the structural features of the body, additional symptoms of varicose veins on the legs in women may be observed.

      These include an increase in all signs of the disease during menstruation and menopause. This is a consequence of hormonal changes in the female body.

      How varicose veins begin on the legs

      We should also talk about the initial stage of varicose veins on the legs, a photo of which is presented below.

      This point is very important, since the quality of his future life will depend on the timely determination and correct actions of the patient.

      This pathological condition begins almost imperceptibly, since the signs appear in the form of ordinary fatigue .

      It is for this reason that varicose veins often go unnoticed until serious manifestations occur.

      One of the first symptoms of varicose veins on the legs is the appearance of vascular networks on the skin, which form small blue or red capillaries.

      Reference . Spider veins, or spider veins as they are also called, do not appear in all cases at this stage of the disease.

      The following signs are more typical for the onset of the disease:

      1. Periodic swelling of the legs.
      2. Fatigue, heaviness and pain in the legs.
      3. Feeling of fullness in the calves.
      4. The above symptoms may intensify under heavy loads, at the end of the working day, or during the hot season.

        At first, they disappear after resting in a supine position and slightly elevated legs .

        If nothing is done, over time the manifestations of the disease will begin to intensify, acquiring the next stage of progression.

        Therapy and prevention of early varicose veins

        Before we begin to consider methods of treatment and prevention of the initial stage of the disease, let us touch upon the issue of diagnosing varicose veins of the lower extremities.

        To identify and subsequently treat pathology, you need to visit a doctor who will prescribe a list of necessary tests and studies:

      5. coagulogram - study of blood clotting;
      6. general blood analysis;
      7. Ultrasound to identify affected areas of blood vessels;
      8. rheovasography - checking the lack of blood supply to tissues by calculating the rheographic index;
      9. surgical studies (very rare), for example, phlebography , in which intravenous administration of a contrast agent is performed in order to determine the condition of the circulatory system.
      10. Before identifying varicose veins in the legs using these methods, the doctor, of course, carefully listens and records all the patient’s complaints, and also conducts a thorough examination.

        Based on all the examination and determination of the nature of the pathology, the doctor prescribes appropriate therapy.

        Preventive actions

        Prevention plays an important role in the presence of risk factors for the occurrence of such a pathological condition. Therefore, you should not ignore their compliance even with beginner varicose veins (photo presented in this material).

        This can protect against further development of the disease and the need for surgical intervention.

        To this end, the following rules should be observed:

      11. Moderate physical activity, especially swimming.
      12. Proper nutrition.
      13. Taking vitamin complexes.
      14. Strengthening the walls of blood vessels using a contrast shower.
      15. Wearing compression garments.
      16. Performing exercises to improve blood circulation.

      Such exercises are known to everyone since school : “bicycle”, “scissors”, walking on toes and heels, flexion - extension of the feet at the ankle joints, as well as performing circular movements.

      Important! Such exercises should be performed daily, as this is the only way they can be beneficial.

      Treatment of symptoms of varicose veins in the legs at an early stage is quite effective. Typically, a specialist phlebologist prescribes complex therapy, which includes several different treatment methods.

      The most effective of them are the following methods:

      1. Physical therapy and walking for normal blood circulation.
      2. Therapeutic massage – eliminates fatigue and improves blood circulation.
      3. Compression garments create uniform pressure distribution.
      4. Phlebotonics to relieve pain and swelling in the legs, improve muscle tone.
      5. Creams to increase skin elasticity.
      6. Ointments and gels (preferably based on vetonics and heparin) - eliminate heaviness in the legs, eliminate blood flow.
      7. There is another extraordinary but effective method - a patch for varicose veins , based on medicinal herbs and roots.

        If at the early stage of the disease you conscientiously follow all the doctor’s instructions, then there is every chance of stopping the progression of the disease, and therefore avoiding surgery.

        You should know how varicose veins manifest themselves on the legs, because any disease is better and easier to prevent than to undergo long-term treatment later.

        Such knowledge will help you monitor the condition of your feet and, if alarming signs appear, immediately contact a specialist.

        Varicose veins

        Often a person is faced with the problem of varicose veins of the lower extremities; such a disease occurs immediately after the superficial veins expand; the whole process is accompanied by the fact that the valves do not work fully, and the blood flow is disrupted because of this. What causes the appearance of varicose veins? Due to weakness and functional impairment of the venous wall. The disease can develop due to pregnancy, obesity, congenital weak connective tissue, or wearing tights with tight elastic bands.

        Such reasons are typical for the first appearance of varicose veins. In subsequent times, varicose veins may occur due to problems with venous outflow, most often after postthrombophlebitis syndrome, due to the fact that the valves in the deep veins are not fully developed, due to a tumor, or injury.

        How do varicose veins of the lower extremities occur?

        When venous blood enters the heart, the muscles of the thigh and leg begin to contract and the arteries begin to pulsate strongly. When the muscles contract, the deep veins in the limbs begin to be compressed. Blood begins to flow into the limbs and pelvic veins.

        Valves that are weak do not allow blood to enter the venous system. If a person has varicose veins in the legs, the pressure in the veins begins to increase, when the muscles begin to contract, blood with high pressure begins to flow into the deep venous system. This is the main cause of local venous hypertension, it is expressed in the third leg, it is there that the communicating veins differ in their power. When the pressure in the veins increases, dilation begins.

        Also, high pressure in the macrocirculatory venous section provokes the appearance of swelling, induration, skin pigmentation and arteriovenous shunts, which reduce blood flow in the capillaries, hypoxia in the tissues and the appearance of ulcers.

        Symptoms of varicose veins

        The main symptom is a noticeable enlargement of the veins in the lower extremities, then fatigue appears, heaviness in the legs, cramps occur, most often in the calves, the legs burst, especially in the evening, the process may worsen at night. Swelling usually appears after a person has been on his feet for a long time; after the person has rested at night, the swelling completely disappears in the morning. Often, when varicose veins begin to progress, changes occur that form inside the lower leg - the appearance of dermatitis, trophic ulcers, induration, which are very difficult to treat.

        Diagnosing varicose veins

        This problem is diagnosed based on your medical history and complaints; after the doctor examines your limbs, it may be necessary to conduct functional tests. The purpose of this study is to exclude further development of the disease, to determine how healthy the valve in the saphenous vein is, also what is the condition of the communicative vein and how passable the deep venous system is.

        Often clinical and functional studies can be erroneous, which is why it is so important to conduct phlebography at the slightest doubt about the patency of your deep vein or whether you have trophic disorders.

        What are the complications of varicose veins?

        1. May develop into a chronic form of the disease.

        2. Trophic ulcers begin to develop.

        3. Varicose veins may rupture and bleeding begins.

        What are the stages of varicose veins?

        The first stage, there are no complaints, only cosmetic disorders appear.

        The second stage is a feeling of heaviness and convulsions. Especially at night, paresthesia occurs.

        The third stage is the appearance of edema, distension of the lower extremities, skin pigmentation, subcutaneous tissue appears and skin induration.

        Stage four – ulcers form.

        Treatment of varicose veins

        1. Wearing elastic bandages and stockings. This method especially helps pregnant women; after childbirth, varicose veins decrease.

        2. Prescribing special medications that improve microcirculation, increase the level of vitamin C in the blood, diuretics, drugs based on salicylic acid.

        3. Sclerotherapy is performed very rarely; it can cause recurrence of the disease. But this procedure must be carried out in cases where it is necessary to block the lateral branches in the saphenous vein and in cases of reticular varicose veins. A complication of sclerotherapy is thrombophlebitis, which affects the deep veins of the extremities, which causes necrosis of the subcutaneous tissue and skin after drugs are administered paravenously.

        4. The operation is based on ligating the large saphenous veins at the place where they flow into the deep ones, excising varicose veins and ligating the communicating veins. After the operation, the limbs are bandaged with an elastic bandage for up to 6 weeks.

        5. If a person has segmental varicose veins, the veins are partially removed.

        So, varicose veins are a serious disease that brings discomfort, severe pain, problems with movement, and legs that look unattractive. If it is not treated in time, it develops into a rather serious disease, which is why it is so important to consult a doctor in time, and also not to forget about preventive methods. Most often, special exercises for the legs help cope with varicose veins; they should be performed even if you notice the first vascular changes. Remember that if you have varicose veins, you should never exercise vigorously. What exercises are suitable? Everyone knows scissors, bicycle, foot rotation, half-press. An excellent method is a contrast shower, with its help you can massage your feet gradually - first with cold, then with warm water. This shower can be taken for up to 20 minutes.

        The main rule in the treatment of varicose veins is to begin treatment only with the first manifestation of its symptoms, which is why it is so important not to forget about physical exercise and careful attention to your limbs.

        Categories : Diagnostics

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