Treatment of varicose veins

Varicose veins are a disease characterized by thinning of the vein wall, an increase in the diameter of the venous lumen, and the formation of aneurysm-like nodular extensions. Any vein can be affected but is more commonly diagnosed in the lower extremities. Treatment of varicose veins includes drug therapy and surgical methods. Lack of therapy increases the risk of dangerous complications.

Causes of varicose veins

The underlying cause of the disease is not fully understood. We can only name provoking factors that increase the risk of pathology:

• genetic predisposition. If one of the parents had a disease, then it can develop in children.
• long static loads. Standing work leads to stagnation of blood in the veins, which leads to their expansion and causes the development of varicose veins.
• lack of exercise.
• Excessive loads, including professional sports.
• Obesity, which leads to increased pressure in the vessels of the lower extremities.
• Pregnancy, during which the pressure in the vessels of the small pelvis and lower extremities increases, and the elasticity of the vascular wall also changes.
• Wearing high-heeled shoes that disrupt the contractility of the calf muscle involved in moving blood through the veins (the so-called "muscle pump").
• Improper nutrition (especially lack of fiber) leads to constipation, which leads to an increase in pressure in the vessels of the small pelvis and lower extremities.
• Bad habits.
• Hormonal imbalances.

These are common causes of enlarged veins. If the first signs of venous insufficiency appear in women during pregnancy or immediately after childbirth, in men the disease usually becomes noticeable after 40 years. The vessels of the legs are more often affected. The treatment of varicose veins of the lower extremities is practically the same for both sexes.

Symptoms of varicose veins of the lower extremities

Officially, the disease is divided into three stages:

1. Compensation.
2. undercompensation.
3. decompensation.

In addition, there is an international classification that distinguishes classes:

• C0. There are no signs of vascular damage, but the patient complains of varicose veins.
• C1. Expansion of small superficial veins is noted.
• C2. Dilated veins are revealed during visual examination.
• C3. The patient complains of tissue swelling, pain and excessive fatigue after a day's work.
• C4. The first symptoms of trophic disorders are determined visually.
• C5. Trophic changes occur, but ulcers heal. Scarring may occur.
• C6. Trophic changes are pronounced, there are active ulcers.

The degree of pathology is determined based on the results of a visual examination, instrumental methods of diagnosis and existing signs of a chronic disease.

The first symptoms can be called:

• Increased leg fatigue.
• Swelling of the tissues, especially pronounced in the evening, which goes away after a short rest.
• pain sensations.
• Characteristic heaviness in the legs.
• Nocturnal cramps in the calf muscles.
• Burning along the course of the veins.

Pain is particularly important. It never radiates to the thigh or heel, but is always noticeable at the site of the affected vein and is painful in character. Often the sensations are exhausting and prevent sleep. After sleep, the pain subsides.

At the initial stage there are no signs of damage to the saphenous vein, but changes are already taking place. The process can take several years, so treatment of varicose veins often begins when there is already a 3-4 class of pathology. Over time, the clinic increases, and the severity of the symptoms of venous insufficiency increases:

• Increasing tissue swelling. It is mainly localized in the calf muscles. Like pain, swelling appears in the afternoon and disappears after a night's rest. It is important to distinguish edema in the calf muscles from swelling of the foot tissues. The latter indicates violations of the outflow of lymph.
• itching of the skin. It is noted along the vessels.
• Visual changes on the skin in the form of tortuous veins, the presence of dilatations.
• Skin changes as a result of circulatory disorders. There is cyanosis, tissue thickening, darkening is possible.

In the absence of therapy, the clinic is supplemented by signs of tissue malnutrition, the appearance of trophic ulcers, eczema, etc. Injury to the venous valves can cause the following complications:

• thrombophlebitis. It is characterized by the formation of blood clots. Without help, the condition is life-threatening.
• Venous thrombosis. Occurs when the vessel becomes clogged. It is manifested by severe pain, which is aggravated by physical activity.
• pulmonary embolism. Occurs as a result of the separation of a blood clot. Due to its small size, it is possible to develop pneumonia or chronic heart failure.
• Trophic Ulcers. The first signs are thickening of the tissue over the affected vein. In addition, the tissues become thinner, an ulcer appears. The focus does not heal for a long time and does not respond to therapy.

diagnosis of the disease

Despite the characteristic symptoms, it is impossible to diagnose and start taking medication based only on the results of a visual examination.

Dopplerography is mandatory. This is one of the easiest ways to assess the vascular bed. It is based on determining the degree of change in the frequency of the sound signal reflected by the blood cells.

When performing ultrasound, angioscanning is performed, which allows to assess the condition of the vascular wall, as well as the direction of blood flow. The result is a two-dimensional image of the veins with a reflection of the valves, possible blood clots.

In the event that the methods listed do not give an exhaustive answer, CT is prescribed. If there is a suspicion of thrombosis, angiodysplasia and damage to the veins of the small pelvis, radiopaque venography is prescribed.

Treatment of varicose veins in the legs

A phlebologist is engaged in the diagnosis and treatment of pathologies. You should contact this specialist at the first signs of illness. In advanced cases, when conservative therapy does not bring the desired effect, radical methods are used. In this case, the vascular surgeon deals with the elimination of varicose veins.

Treatment methods are determined based on the results of the examination. At the initial stage, it is possible to use general and local drugs. If the drugs don't work, surgery is prescribed.

Conservative treatment

The main drugs are venotonics (phlebotonics). Available in the form of tablets and capsules that have a systemic effect. Thanks to them, it is possible to normalize blood circulation and improve the condition of the whole organism. In addition to tablets, you can use local remedies with a similar effect. These are creams and gels. They have a pronounced effect, but the effect lasts only for a short time.

The action of phlebotonics is based on improving the elasticity of blood vessels, reducing the permeability of the wall and eliminating congestion. Patients have a decrease in edema and normalization of hematopoiesis.

The use of antiplatelet and anticoagulant drugs is allowed. They are indicated at high risk of blood clots and in their presence. Thanks to them, it is possible to destroy blood clots and reduce viscosity. The funds are used for a pronounced violation of blood viscosity, but they should not be used if there is a risk of bleeding.

In addition to the preparations, specialists prescribe compression stockings. It can be elastic bandages, socks, stockings, tights. The positive effect of their use can be explained as follows:

• Linen puts pressure on the affected varicose veins and deep vessels.
• In the lower part of the legs, the vessels experience the strongest pressure from knitwear, which eliminates congestion.
• The containers are constantly in a compressed state, so the operation of the valves becomes more efficient.
• When using underwear, the severity of edema and pain decreases.

Methods of surgical treatment of varicose veins

In the absence of the effect of drug therapy, surgery is prescribed. The indications for its implementation are the following conditions:

• Failure of conservative treatment
• The first signs of thrombophlebitis.
• Pronounced expansion of the vessel wall.
• Significant tissue swelling.

Effective treatment of varicose veins is possible using the following methods:

• Radiofrequency obliteration, which allows you to restore the structure of blood vessels.
• Laser coagulation, in which the affected areas are irradiated with a laser.
• Varadi technique with complete removal of the affected vessel.
• The Venaseal technique, thanks to which the vein valves stick together.
• Sclerotherapy, which allows you to "glue" the vessels from the inside.

Modern methods of treating varicose veins allow you to carry out all the necessary procedures without hospitalization and allow the patient to go home. The choice of technique is determined by the doctor based on the results of the examination.

Prevention of pathology

Varicose veins are difficult to treat, and even after surgery, preventive measures must be taken to prevent recurrence. Some patients use drug therapy throughout their lives and wear compression stockings. Pathology can be prevented as follows:

• Refusal to drag things.
• Wear medium-heeled shoes.
• Complete Nutrition.
• weight control.
• Normalization of the drinking regime.
• Active rest, swimming, cycling.
• rejection of bad habits.

Compliance with preventive measures and an attentive attitude to the body will help prevent the disease and timely notice any deviations. Timely treatment of varicose veins eliminates the progression of pathology and the formation of complications.