Varicose veins on the legs

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

The term “varicose veins” comes from the Latin word varicose, which means “twisted, intertwined.”

Humanity has known about varicose veins since Antiquity.During archaeological research during the excavations of the Mastaba burial in Egypt from 1595 to 1580. In British Columbia, a mummy was found with signs of varicose veins and treatment for a trophic venous ulcer of the leg.

This disease is rightly considered the price humanity pays for being able to walk upright.On average, about 15% of men and up to 25% of women (including pregnant women) in economically developed countries suffer from varicose veins on their legs.The high-risk group includes women, overweight people, people in occupations that involve long-term stress on the lower extremities and whose job requires them to stand or sit for long periods of time.

Ranking

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

1. Primarydevelops with varicose veins.In the case of varicose veins, it is mainly the superficial veins that change, while the deep veins have a normal structure and function.For a long time, varicose veins of superficial veins manifest themselves only as a cosmetic defect, but later, as the disease progresses, venous outflow disorders occur, leading to painful sensations in the lower extremities, swelling of the feet and legs, darkening of the skin in the lower third of the leg, inflammatory changes and trophic ulcers.Varicose veins are a constantly evolving disease.
2. Secondaryis a complication of deep vein disease, in particular, it develops either as a result of congenital malformations of the venous system (fistulas, congenital dysplasia, etc.), or after phlebothrombosis.Phlebothrombosis is a complex process of thrombus formation in the deep main veins of the lower extremities, which leads to disruption of blood flow in the deep veins.Over time, the forming blood clot becomes fixed in the vein, holes appear through which limited blood flow is possible, but the venous valves at the location of the blood clot heal and no longer prevent reverse blood flow.Due to dysfunction of the valves of the deep veins, blood begins to flow up and down through them, returns to the superficial veins and secondary varicose veins develop.As a result, favorable conditions are created for venous stagnation, especially in the lowest parts of the limb - the foot and lower leg.

Symptoms of varicose veins

In most people, varicose veins appear as a cosmetic defect, most often appearing on the inner surface of the legs.Sometimes varicose veins can only appear in the form of a venous network, which is formed when small diameter veins change, most often on the legs and less often on the face or upper extremities.Varicose veins turn blue or dark purple and have a tortuous course.

Symptoms of varicose veins: fatigue, heavy feeling, shooting pain, burning and tingling sensation, throbbing, itching, cramps and anxiety.Also, one of the symptoms may be the appearance of swelling in the legs.Due to a pronounced expansion of varicose veins, a violation of the blood supply to the tissues of the lower extremities may develop, skin defects may occur in the form of darkening or redness and inflammation.In extremely advanced cases of varicose veins, trophic ulcers develop.

Diagnosis of varicose veins

To make a diagnosis, the doctor first examines the patient, paying particular attention to the appearance and swelling of the lower extremities.You may also be asked a number of questions about your sensations to clarify the nature of the pain.Another important step is to perform a series of tests to assess the functional state of the superficial and deep veins.And finally, perform a Doppler ultrasound examination of the main veins of the lower limbs.The ultrasound examination method allows the doctor to see the structure and assess the function of the veins of the lower extremities, as well as identify venous blood clots.

As soon as the first symptoms of the disease appear, you should contact doctors who deal with diseases of blood vessels and veins in particular (general surgeon, vascular surgeon and phlebologist), and if the skin is damaged, you should also consult a dermatologist.Only after consulting with specialist doctors on their recommendation can you visit a cosmetology clinic.

Varicose vein prevention

Currently, there is no method to completely prevent the development of varicose veins.Through prevention, it is possible to improve muscle tone, which helps to improve microcirculation in the tissues, as well as improve the condition and function of the veins of the lower extremities and reduce the risk of complications.The traditional and most widespread prevention methods are as follows:

1. Physical activity.Move more.Your legs should be constantly moving.During a walk, more favorable conditions are created for blood circulation in the lower extremities.Consult your doctor.It will help you choose the most optimal type and level of physical activity.
2. Control your weight.Being overweight increases the load on the circulatory system and particularly on the veins.In addition, with excessive salt consumption, edema increases more pronounced due to water retention in the body.
3. Be careful what you wear.Avoid high heels.Your shoes should always be comfortable.When you wear low-heeled shoes, the muscles in your lower extremities work much better, which helps improve venous outflow.You should also avoid wearing uncomfortable and tight pants and skirts.
4. Raise your feet.When you raise your legs, the venous outflow of blood from the lower extremities improves.Try to take a few breaks throughout the day and get up.For example, lie on your back with your feet on a pillow.
5. Avoid prolonged periods of standing or walking.To improve blood circulation, try to change your body position as often as possible.Try to get up and walk around every 30 minutes.
6. Don't sit cross-legged.Sitting cross-legged creates unfavorable conditions for blood circulation in both lower limbs.

To prevent varicose veins, a good remedy is to wear stockings, high socks and socks with a compression effect.It can also be a good complement to the main treatment (drug or surgical).Currently, pharmacies offer a wide range of compression garments.

Treatment of varicose veins

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

1. conservative (medications and compression therapy).
2. surgical.

Conservative treatment

Doctors consider elastic compression to be the most effective conservative way to treat and prevent varicose veins - the use of special compression stockings (stockings, golf, tights).When wearing this knit, uniform pressure is ensured on the lower limbs, which promotes normal blood circulation and improves its flow, while forming a sort of external framework that supports the weakened vascular walls.As a result, the load on the veins is reduced, the outflow of venous blood is improved, the rate of disease progression is reduced, and the risk of developing thrombosis is reduced.

Modern compression stockings are divided into two types: therapeutic and preventive.Each medical product is marked in mmHg, according to which it is divided into classes from I to IV.At different stages of the disease, compression of a certain force is used and it is necessary to consult a doctor, because only a doctor can prescribe and select appropriate compression stockings, taking into account the nature of the pathology and according to certain individual standards.

If you have a sedentary lifestyle, as well as during prolonged physical activity, during pregnancy or with a hereditary predisposition, it is recommended to wear preventive compression stockings and tights.If even minor signs of varicose veins appear, you should immediately contact a specialized clinic.

Drug therapy can reduce the clinical manifestations of the disease - pain, swelling, discomfort, cramps, etc., but cannot completely stop the progression of the disease and is used today only as part of complex therapy during the main surgical treatment.Unfortunately, most of the drugs offered today on the pharmaceutical market for the treatment of varicose veins have a rather low effectiveness, despite the theoretical feasibility of their use.One of the reasons for this is the poor absorption by the body of the medicinal substances underlying these drugs.It is possible that in this situation increasing the dose of the drug taken will be useful, but this is associated with an increased risk of complications and side effects.Another reason for the low effectiveness of these drugs is that their spectrum of action is relatively narrow and targets a particular link involved in the development and progression of the disease.And to achieve the optimal effect, a complex effect on the disease and the use of several drugs is necessary.An ideal drug for the treatment of venous insufficiency and varicose veins should affect as many of the pathogenetic links of chronic venous insufficiency as possible, while having a minimum of side effects and being well absorbed by the body.

Surgical treatment

Today, surgical treatment of varicose veins of the legs does not require a long hospitalization.Thanks to the use of modern invasive treatment methods, the removal of varicose veins can be carried out not only under anesthesia with the patient completely turned off, but also under local anesthesia, when the patient is in full consciousness, only the pain sensitivity of the lower extremities is disabled.Varicose veins disappear on their own within 3 months of giving birth, without any treatment.

The following surgical treatment methods are available:

1. Sclerotherapy.During this procedure, a solution is injected, under the influence of which a scar forms at the site of the damaged vein.This method only applies to small and medium varicose veins.Sometimes not one, but several injections of a sclerosing solution may be necessary to completely disappear the vein.Sclerotherapy is very effective when performed correctly, is minimally traumatic, leads to good therapeutic and cosmetic effects, and a significant advantage is that sclerotherapy is carried out under local anesthesia (that is, without anesthesia), directly in the doctor's office.
2. Laser surgery.Laser radiation can be used to eliminate varicose veins of any diameter and in particular venous mesh.The essence of the method is to irradiate the inner surface of the vein with a laser beam.Through a small puncture in the skin and vein wall, a special device is inserted - a light guide through which a laser beam passes under ultrasound control.The inner surface of the vein is irradiated with a laser and then glued.When using this method, the doctor directs a laser beam at the vein that needs to be removed, resulting in slow fading and complete disappearance of the vein.An important advantage of this method is that no incisions are made in the soft tissue or skin.Thanks to the laser method, it is possible to eliminate damaged veins and cure trophic ulcers of the lower leg.
3. Surgical removal of varicose veins.During surgical removal, a series of small incisions are made in the skin and soft tissues, through which the damaged vein is removed and insufficient perforator veins in the leg are ligated.When using this technique, anesthesia is a necessary condition.This method is used to eliminate large varicose veins.
4. Ambulatory phlebectomy (removal of varicose veins).This method is suitable for removing veins of small diameter.With this method, the vein is removed through several small incisions in the skin under local anesthesia.The scars formed after removal are small and almost invisible.
5. Endoscopic removal of varicose veins.This method is particularly suitable for the formation of skin defects in the form of ulcers.During this method, a special video microcamera is inserted into the container, which allows you to see the container from the inside and observe the entire removal procedure.The vein is then removed under observation using this camera.

Thanks to the use of modern treatment methods, it is possible to achieve complete healing and a good cosmetic effect.But we must not forget that varicose veins can reappear.

Complications of varicose veins

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

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

Causes of varicose veins

The true nature of varicose veins is not clear enough.According to most scientists, varicose veins are hereditary and genetically determined.Its main cause is weakness of the vein wall and dysfunction of the venous valves.The venous valves arise from the wall of the veins and normally have 2 leaflets oriented towards the heart.With normal closure of the valves, blood from the overlying section of the vein cannot enter the underlying section.When valve function is impaired and the valves do not close completely, blood moves up and down, leading to venous stagnation and dilation of the veins below the valve whose function is impaired.Initially, a varicose vein appears in the place where there is a valve with impaired function, and blood is drained from deep veins to external veins, the overfilled vein stretches and expands, which leads to stretching and disruption of the function of the underlying valve, and so on.Disturbances in the venous outflow of blood from the lower extremities to the heart gradually develop, which leads to disruption of blood microcirculation in the tissues of the lower extremities, which is manifested by edema, increased pigmentation, thrombophlebitis and trophic ulcers.

Factors for the development of varicose veins

Factors contributing to varicose veins may include:

1. Genetic predisposition – thin and weak wall of superficial veins.
2. Increased load on the veins: sedentary work, prolonged standing, wearing uncomfortable shoes with high heels, lifting heavy objects, lack of movement of the lower leg muscles.Pregnancy and childbirth are also a trigger for the development of varicose veins.In case of sudden physical overstrain, there is a sharp increase in hydrostatic pressure in the veins of the lower extremities, which triggers the process of varicose veins.

Risk factors for developing varicose veins also include:

1. Age.With age, the wall of the veins, as well as the valves, become thinner, which leads to a natural disruption of their function.
2. Ground.Women are more likely to suffer from varicose veins.It is possible that this is due to a number of hormonal reactions.Female sex hormones influence the process of relaxation of the vein wall.Pronounced hormonal changes in the female body occur during pregnancy and childbirth, during the menstrual cycle and during menopause, which cannot but affect the functioning of the venous system.It is also impossible to exclude the influence of taking hormonal contraceptives on the process of varicose veins.
3. Obesity.With overweight and obesity, the load on the veins of the lower extremities increases.
4. Pregnancy and childbirth.In pregnant women, the volumetric load in the body increases, but at the same time the rate of blood flow from the lower extremities to the pelvic cavity to the lower vena cava system and to the heart decreases.Thus, favorable conditions are created for the development of varicose veins.Changes in the circulatory system in the female body ensure the development of the fetus, but at the same time provoke the development of varicose veins.As pregnancy progresses or during childbirth, varicose veins can progress not only in the lower extremities, but also in the hemorrhoidal veins around the anus.