varicose veins treatment

Varicose veins are a disease accompanied by thinning of the venous wall, an increase in the diameter of the lumen of the veins and the formation of nodular dilatations similar to aneurysms. Any vein can be involved, but it is most commonly diagnosed in the lower extremities. The 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 mention only the provoking factors that increase the risk of developing pathology:

• genetic predisposition. If one of the parents had a disease, it can develop in children.
• long static loads. Working standing up causes blood to stagnate in the veins, which leads to their expansion and causes the development of varicose veins.
• Lack of movement.
• Excessive loads, including professional sports.
• Excess weight, which leads to increased pressure in the vessels of the lower extremities.
• Pregnancy, in which the pressure in the vessels of the small pelvis and lower extremities increases and the elasticity of the vascular wall also changes.
• Wearing shoes with high heels, which interrupt the contractility of the calf muscle involved in the movement of blood through the veins (the so-called "muscle pump").
• Inadequate nutrition (in particular, lack of fiber) leading to constipation, which causes increased pressure in the vessels of the small pelvis and lower extremities.
• Bad habits.
• Hormonal imbalances.

These are common causes of enlarged veins. If in women the first signs of venous insufficiency appear during pregnancy or immediately after childbirth, in men, as a rule, the disease makes itself felt after 40 years. Vessels in the legs are most often involved. The treatment of varicose veins of the lower extremities in both sexes is practically the same.

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 the classes:

• C0There are no signs of vascular damage, but the patient complains of varicose veins.
• C1. Expansion of small superficial veins is noted.
• C2. Expanded veins are revealed during visual examination.
• C3. The patient complains of tissue swelling, pain, excessive fatigue after a day's work.
• C4. The first symptoms of trophic disorders are determined visually.
• C5. Trophic changes appear, but ulcers heal. There may be scars.
• C6. Trophic changes are pronounced, there are active ulcers.

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

The first symptoms can be called:

• Increased fatigue in the legs.
• Tissue swelling, especially pronounced at night, passing after a short rest.
• Pain sensations.
• Characteristic heaviness in the legs.
• Nocturnal cramps in the calf muscles.
• Burning sensation along the course of the vein.

Pain is especially significant. It never radiates to the thigh or heel, but is always observed at the site of the affected vein and has a painful character. Often the sensations are exhausting, preventing sleep. After sleep, the pain subsides.

In the initial phase, there are no signs of saphenous vein injury, but changes are already taking place. The process can take several years, so treatment of varicose veins usually starts when a 3-4 pathology class already exists. Over time, the clinic increases and the severity of symptoms of venous insufficiency increases:

• Increasing tissue swelling. It is mainly located in the calf muscles. Like the pain, the swelling occurs in the afternoon and goes away after a night's rest. It is important to distinguish edema in the calf muscles from swelling in the tissues of the foot. The latter indicates violations of lymph flow.
• Itchy skin. It is noticed along the ships.
• Visual changes in the skin in the form of tortuous veins, presence of extensions.
• 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, and so on. Violation of venous valves can cause the following complications:

• Thrombophlebitis. It is characterized by the formation of blood clots. Without help, the condition is fatal.
• Venous thrombosis. Occurs with vessel blockage. It is manifested by intense pain, aggravated during physical activity.
• Pulmonary embolism. It occurs as a result of the separation of a blood clot. With its small size, it is possible to develop pneumonia, or chronic heart failure.
• Trophic ulcers. The first signs are tissue thickening over the affected vein. In addition, the tissues become thinner, an ulcer appears. Focus does not heal for long and does not respond to therapy.

Disease diagnosis

Despite the characteristic symptoms, it is impossible to make a diagnosis and start taking drugs based solely 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 blood cells.

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

In the event that the listed methods do not provide an exhaustive answer, CT is prescribed. If thrombosis, angiodysplasia, and damage to the veins of the small pelvis are suspected, radiopaque phlebography is prescribed.

Treatment of varicose veins in the legs

A phlebologist is involved in the diagnosis and treatment of pathology. It is this specialist that you should contact at the first signs of illness. In advanced cases, when conservative therapy does not produce the desired effect, radical methods are used. In this case, the vascular surgeon is involved in the elimination of varicose veins.

Treatment methods are determined based on the test results. In the early stages, it is possible to use general and local medications. When medications don't work, surgery is prescribed.

Conservative treatment

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

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

The use of antiplatelet agents and anticoagulants is allowed. They are indicated with a high risk of blood clots, as well as in the presence of them. Thanks to them, it is possible to destroy blood clots and reduce viscosity. Funds are used for a pronounced violation of blood viscosity, but with a risk of bleeding, they cannot be used.

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

• Linen puts pressure on affected varicose veins and deep vessels.
• In the lower part of the legs, the vessels suffer the most pronounced pressure from the meshes, which eliminates congestion.
• Vessels are constantly in a compressed state, so valve operation becomes more efficient.
• When wearing underwear, the severity of swelling and pain decreases.

Methods of surgical treatment of varicose veins

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

• Conservative treatment failure
• The first signs of thrombophlebitis.
• Pronounced expansion of the vascular 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 clotting, during which the affected areas are affected by a laser.
• Varadi technique with complete removal of the affected vessel.
• The Venaseal technique, thanks to which the valves of the veins are united.
• Sclerotherapy, which allows 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 let the patient go home. The choice of technique is determined by the physician based on the results of the examination.

pathology prevention

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

• Refusal to drag things.
• Wear medium-heeled shoes.
• Complete nutrition.
• Weight control.
• Normalization of the consumption regime.
• Active recreation, swimming, cycling.
• Rejection of bad habits.

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