Varicose veins

Varicose veins of the lower extremities

Phlebeurismit is a pathological condition characterized by a change in the structure of the venous system, which leads to an increase in the diameter of the lumen of superficial vessels and a violation of the valvular system, which manifests itself in valvular insufficiency, i. e. in their incomplete closure of the vessel.

Normally, blood flows through the veins against the force of gravity - from the bottom to the top, which is possible only thanks to the work of the venous valves. Under the influence of a number of reasons, primary (due to changes in the valve itself) or secondary (due to expansion of the vessel) valvular insufficiency occurs; this condition is characterized by incomplete closure of the venous valve and reverse blood flow. The reverse flow of blood aggravates the changes in the venous wall, and also contributes to the stagnation of blood in the lower extremities, causing swelling of the lower extremities and a feeling of heaviness in the legs.

In addition to the stagnation of blood in the lower extremities, the above-mentioned processes cause a violation of the linear blood flow from top to bottom through the vessels, reflux (reverse blood flow) and the appearance of turbulent blood flow in the area. Enlargement. Changes in blood flow characteristics are the main cause of thrombosis.

Possible causes of the development of varicose veins of the lower extremities

  1. Physical inactivity- the main cause of varicose veins. Sedentary lifestyle and long sitting position contribute to long-term high load on vascular valves. During physical activity - walking, running, swimming - the constantly working muscles of the thigh and lower leg help to "drive" blood from the venous system of the lower extremities. Static sitting for long periods of time causes an increase in the load on the venous valves, and over time, the venous valves, which cannot withstand the load, can stop performing their functions fully.
  2. Obesityshould be considered the second most important reason. Heavy weight also increases the load on the valve system of the veins of the lower extremities, causing their proper functioning.
  3. Pregnancyis the third most common reason. Hormonal changes, increased body weight, compression of the pelvic vessels by the fetus are sufficient reasons for the dysfunction of the venous valves. However, up to 50% of venous wall changes detected during pregnancy are functional in nature and resolve spontaneously within the first year after delivery.
  4. To smoke– The fourth most common cause of varicose veins. Changes in the venous wall can be associated with the negative effect of the composition of smoking mixtures on the tone of the venous wall.
  5. Heredity– Another possible reason for the development of varicose veins. It is generally accepted that heredity plays a leading role in the development of varicose veins, but the genes responsible for the development of varicose veins have not yet been discovered; It is generally accepted that genes responsible for changes in the structure of connective tissue structures are the main cause of varicose veins. However, the influence of heredity can be greatly exaggerated, and lifestyle changes, normalization of body weight and smoking cessation will help prevent varicose veins even in patients with an unfavorable hereditary history.

Symptoms of varicose veins

  • The presence of enlarged saphenous veins, the nonlinear course of the vein is the most objective, but not the only manifestation of varicose veins. Often, even multiple dilated veins may not be visible, especially with an open subcutaneous layer.
  • Edema of the lower extremitiesat the end of the working day, especially with asymmetric swelling, is the earliest and most common symptom of varicose veins.
  • You should also think about the presence of varicose veins from time to timeheaviness in the legsevening and night, leg cramps at night.
  • Spider veins and venous patternintradermal veins, although more of an aesthetic problem, may also indicate the presence of changes in the saphenous veins.
  • Persistent redness, thickening of the skin, lipodermatosclerosis, trophic ulcers on the legs and feet indicate the decompensated course of varicose veins.

Diagnosis of varicose veins

The diagnosis of varicose veins of the lower extremities can be made only on the basis of ultrasound diagnostic data.

During the ultrasound examination of the veins of the lower extremities, the doctor examines in detail the characteristics of the deep and superficial veins from the groin to the ankle, measures the diameter of the veins, analyzes and reveals the characteristics of the blood flow in the veins. the presence of reflux. Based on the received information, the doctor draws a conclusion.

Prevention of varicose veins

Prevention of varicose veins is a rational motor regime, normalization of body weight and smoking cessation.

If there are initial signs of varicose veins, wearing venotonics and compression stockings will help reduce the rate of progression of the disease.

Compression stockings should be selected by the doctor depending on the severity of varicose veins and the anthropometric data of the patient.

Treatment of varicose veins

Varicose veins are treated only surgically.

Currently, many different methods of surgical treatment have been developed - from open methods - combined phlebectomy to minimally invasive methods - laser or radiofrequency coagulation of vessels, to mechanochemical methods.

  • Varicose veins can be removed by miniphlebectomy, a technique in which the varicose veins are removed from the subcutaneous tissue through separate punctures and closed with a bandage.
  • Small varicose veins can be removed using sclerotherapy - the introduction of a special glue-like substance - sclerosant - into the venous lumens.
  • Spider veins and intradermal veins can be removed with sclerotherapy.

However, even after complete treatment, the risk of recurrence of varicose veins of the lower extremities is 10-15%. Adequate physical activity, playing sports (jogging, walking, exercise bike, swimming), normalizing body weight and giving up bad habits will help reduce the likelihood of relapse after surgical treatment. Periodic use of phlebotonics and wearing properly selected compression stockings will help reduce the rate of spread.

The main thing is not to delay seeing a doctor!