According to statistics, up to 20% of the population suffers from varicose veins of the lower extremities, and this disease occurs twice as often in women. It has been proven that there are additional predisposing factors (pregnancy, taking estrogen-progestogen contraceptives, imbalance of sex hormones) that contribute to a decrease in vascular tone in women.The types of treatment of leg veins do not differ between men and women, but due to the additional effect of hormones (estrogen and progesterone effects), the frequency of postoperative recurrence is higher in women.
What causes varicose veins in women's legs?
Venous diseases of the legs should be treated by a phlebologist who specializes in this pathology. Various methods of treating varicose veins are not radical, because they are not aimed at eliminating the main pathogenetic cause - the failure of the valve apparatus of the vessel. Surgical and conservative treatment slows down the course of the disease for a long time. The recurrence rate is high and reaches 10-50% 5 years after surgery.
Treatment of varicose veins should be comprehensive. There are three groups of methods to eliminate varicose veins:
- phlebosclerosis,
- surgical,
- conservative.
Each type of treatment has its advantages and disadvantages and a certain recurrence rate. The choice of method is conditional, because the phlebologist often needs to combine all three methods to achieve the most favorable result.
Characteristic signs of varicose veins in women
Symptoms of varicose veins begin with the appearance of functional disorders such as a feeling of heaviness in the legs, swelling of the ankle joints at the end of the working day. Spider veins first form on the skin of the legs.
Spider veins are one of the first signs of the development of varicose veins of the legs. The main symptoms of the disease - the union of varicose veins - appear several years after the onset of the disease. If left untreated at this stage, symptoms such as cramps in the calf muscles and itchy skin on the feet appear.
Signs of trophic disorders: skin pigmentation in the lower third of the leg, cyanosis, sclerotic changes in the subcutaneous tissue, eczema with the formation of a trophic ulcer.
Characteristic signs of varicose veins in women
- Painful symptoms appear cyclically and intensify before menstruation, which is associated with changes in the level of sex hormones;
- Symptoms of varicose veins during pregnancy may disappear after childbirth;
- in the second half of the menstrual cycle, due to the effect of progesterone, the diameter of varicose veins increases, so the signs of swelling and heaviness in the legs are more obvious;
- symptoms of varicose veins worsen during hormone therapy.
Now let's talk about therapy methods.
Radiofrequency ablation and endovenous laser coagulation
Radiofrequency ablation of veins
The method is based on the introduction of a special disposable catheter into the lumen of the dilated vessel under ultrasound guidance. The catheter is equipped with a special electrode, the working part of which is heated up to 120 degrees under the influence of radiofrequency radiation. Advancing the catheter through the vein causes the vessel wall to adhere or "weld". Obliterated veins are removed from the circulatory system of the legs.
Endovenous laser coagulation
The surgical method consists of puncturing the affected vessel and inserting a laser light guide into its lumen under ultrasound control. Under the influence of laser radiation, the proteins of the vessel wall coagulate, as a result, the vessel collapses and after a while grows with connective tissue. Radiofrequency ablation (RFA) and endovenous laser obliteration (EVLO) are relatively new methods for treating varicose veins in the legs. Despite the differences in implementation techniques, they have common features.
Advantages and disadvantages of RFA and EVLA
| Hospitalization is not required | High price |
| Execution speed (from 30 minutes to 1 hour) | Relapse rate up to 10% |
| Painless | Impossibility of performing the procedure due to certain anatomical features of the vessels (sharp bending of the blood vessels) |
| Bloodless | |
| It is performed under local anesthesia | |
| Absence of postoperative scars (desirable cosmetic effect for women) | |
| Short rehabilitation periods |
RFA or EVLO is chosen by women who want to treat varicose veins on an outpatient basis, with minimal restriction of physical activity in the postoperative period and preserving the aesthetic appearance of their legs.
Phlebosclerotherapy
A special drug is injected into the lumen of the affected segment of the vessel, which has a sclerosing ("gluing") effect on the vessel wall. The sclerosing agent can be used in liquid or foam form. Due to the greater contact area of the substance with the vessel wall, foam sclerotherapy should be preferred.
Advantages and disadvantages of phlebosclerotherapy:
| There is no postoperative scar | Possible long-term pigmentation of the skin at the puncture site (up to 2 years) |
| It is performed on an outpatient basis | Rarely, postoperative inflammation of a vein (phlebitis) |
| The operation is performed without anesthesia | Swelling and redness of tissues for 2 days after the procedure |
| Manipulation is practically painless (slight burning at the puncture site) | Allergic reaction due to individual intolerance to the drug |
| 20% of cases show spider veins on the legs (telangiectasia) | |
| Relapse rate up to 50% |
The recurrence of varicose veins after sclerotherapy depends on the lumen of the affected vessel - the wider the lumen, the higher the risk of recanalization. In the treatment of recurrent varicose veins after surgical phlebectomy, sclerosing therapy is chosen.
Surgical phlebectomy
Surgery is a more radical way to remove varicose veins. The principles of surgical treatment are to eliminate pathological blood flow from deep into the superficial veins of the legs and to remove the dilated veins themselves. Stages of combined phlebectomy:
- Cutting and closing the mouth of the great inguinal vein (incision in the groin) or the small saphenous vein (incision in the popliteal fossa);
- Removal of varicose veins. This is done using a special metal probe that pulls the vein into the skin incision.
| Radicalism | Hospitalization from 5 to 7 days |
| The possibility of surgery at any stage of the disease | Scar on legs |
| Spinal or general anesthesia | |
| Damage to the surrounding tissues when the vein is pulled | |
| Possible complications: bleeding, wound infection | |
| Relapse rate up to 20% |
When varicose deformation of the great or small saphenous veins occurs significantly, surgical treatment is preferred for trunk-type lesions. And when there are signs of trophic disorders of soft tissues and signs of decompensation of venous insufficiency.
Miniphlebectomy
Miniphlebectomy is a separate surgical option that can treat varicose veins of the legs at the initial stage. It is mostly used in the case of single varicose veins in the legs. A puncture is made in the skin over the pathological formation and the vein is removed and crossed with a fork. The operation does not require general anesthesia or skin sutures.
Conservative therapy
It is necessary to start the treatment of varicose veins in the legs with the use of medication and compression therapy.Prescribing blood circulation-improving drugs and wearing medical compression stockings are the main conditions that determine the outcome of any surgical intervention on the veins of the legs.
Compression therapy
Elastic leg compression is the leading treatment method in cases where surgery is contraindicated. Elastic bandages and special medical knitwear can be used as compression products: socks, knee socks, tights. Medical products are highly durable, maintain the original level of compression for a long time and are comfortable to wear, which is important for women.
Depending on the degree of compression, there are 4 classes of elastic knitwear. Varicose veins are recommended to be treated using Class 2 products when the disease has not progressed for up to 6 months and further use during physical activity or prolonged standing. If there are signs of damage to the valves of deep veins or severe symptoms of impaired lymphatic drainage, the 3rd class form is prescribed until the development of varicose veins stops.
The therapeutic effect of compression stockings is related to:
- a decrease in the volume of the vein, which causes less blood flow to the varicose veins;
- increased absorption of tissue fluid into the bloodstream, as a result of which symptoms of swelling and heaviness in the legs disappear;
- improving blood flow, which prevents blood clotting.
Varicose veins are one of the oldest diseases known to mankind. It is mentioned in the works of Ibn Sina, Hippocrates, Paracelsus and other legendary healers, and the Italian scientist Marcello Malpighi devoted many years to its study. It can affect any organs with pathological large vessels (stomach, esophagus, male testicles), but varicose veins of the lower extremities are the most common. Let's talk about the causes, diagnosis and elimination methods of varicose veins in the legs.
About varicose veins of the lower limbs
Varicose veins are irreversible expansion of the veins as a result of a violation of the valves involved in the blood circulation mechanism of the veins of the lower extremities. With normal muscle contraction and relaxation, it moves strongly upward from valve to valve, but when the vessel dilatesthe valves stop closing and blood flow slowscausing a number of clinical symptoms.
According to statistics, today people suffer from the symptoms of varicose veins in the legs:Every tenth man and every third woman aged 30-40. Among the leading countries in terms of the prevalence of pathology are the developed countries of Europe, where 30-40% of the population is diagnosed; Varicose veins are the least common in Africa and Asia (about 0. 1%).
Why it appears, risk factors
The exact causes of the disease are not known, but most expertstends to the hereditary theory: people with a family history of varicose veins are at risk. Factors that lead to the development of pathology include:
- gender. Women are more susceptible to varicose veins than men - this is due to increased venous load during pregnancy and childbirth, as well as taking hormonal drugs;
- bad habits and excess weight. Smoking, abuse of fatty foods and alcohol have a negative effect on the blood circulation in the body, increase the load on the vessels and can cause relevant disorders;
- working conditions. Due to the nature of their profession, people who have to stand or sit still for a long time (hairdressers, salesmen, waiters, office workers) suffer from this disease more than others;
- excessive physical activity. Another category of people who are at risk of developing varicose veins are those who engage in heavy physical labor or certain strength sports (for example, weightlifting);
- uncomfortable clothes or shoes. Tight, restrictive clothing and high-heeled shoes also contribute to poor venous blood flow.
Classification
Most often (75-80%) the disease affects the trunk and branches of the great saphenous vein, in 5-10% the small saphenous vein, and in 7-10% of patients both veins are affected. . In the clinical course of varicose veins of the lower extremities, experts distinguish two forms and four groups.
Forms:
- descending- the process starts from the mouth and spreads from top to bottom along the large femoral vein;
- increasing- the disease begins in the leg and is caused by a malfunction of the valvular apparatus of the deep veins.
Groups:
- subcutaneous or intradermal pathology not burdened by venous discharge;
- segmental with reflux through perforating and superficial vessels;
- widespread with venous reflux (through superficial and perforating veins);
- dilatation with reflux through the deep veins.
According to the degree of venous insufficiency, there are four main stages of varicose veins:
- - there may be symptoms of the disease, but they are not determined by diagnostic methods;
- I - this stage is characterized by transient swelling, "heavy legs" syndrome and the appearance of "spider veins";
- II - the appearance of persistent swelling in the evening, skin discoloration, eczema;
- III - the presence of trophic ulcers, including non-healing ones.
Danger and complications
The risk to the patient's health and life is not caused by the disease itself, but by its complications. These include skin malnutrition that causesTrophic ulcers and erysipelas may occur, as well as the most dangerous complication - thrombophlebitis. This leads to an increase in the formation of thrombus, as a result of which blood clots breaking off from the venous walls can disrupt the work of internal organs and, in the most difficult cases, cause the death of the patient.
In addition, dilated vessels with thinner walls are at risk of mechanical damage that can cause serious bleeding.
Symptoms
The first symptoms of the disease are heaviness and fatigue in the legs, which usually appear in the evening and decrease when lying down.Veins take on a blue color and appear on the surface of the skin, "spider veins".(a network of dilated capillaries visible through the skin) and a characteristic feature is the disappearance of the venous pattern when the limbs are elevated higher (for example, when placed in a chair).
Over time, varicose veins become more obvious and visiblethe appearance of small nodules or large conglomerates.
Unpleasant symptoms seem to aggravate and disturb patients even at nightsoft tissue swellingmost often in the area of the legs, feet and ankles, as well as a feeling of fullness in the legs and cramps in the calf muscles.
In the absence of adequate treatment, varicose veins progressthe skin dries up, lumps and dark spots appear on it, and later trophic ulcers. With the development of thrombophlebitis, the veins are bright red, cord-like and painfully compressed during palpation.
When should you see a doctor?
Many people ignore the first signs of varicose veins, associating them with ordinary fatigue. This makes the treatment of the disease very difficult and therefore can lead to the most serious consequencesAfter the symptoms of the disease appear, you should immediately contact a phlebologist.constant feeling of fatigue and heaviness in the legs, discoloration of veins and skin, swelling, spider veins, etc.
Diagnostics
The diagnosis of "varicose veins of the lower extremities" is made after a comprehensive examination, which includes the following:
- general blood test- by the level of red blood cells, platelets, leukocytes and hemoglobin, it is possible to judge the presence of blood coagulation disorders and inflammation;
- ultrasoundrepresents the most effective method for identifying affected vessels and sections of vessels;
- rheovasographyit is carried out to determine the lack of blood supply of tissues (the so-called rheographic index), based on which the stage of the disease can be determined;
- phlebography, during this period, a contrast agent is injected into the veins, after which the state of the venous system is evaluated with an X-ray machine;
- physiological tests(Troyanov-Trendelenburg test, Hackenbruch test) allows to assess the valve apparatus of superficial vessels.
Treatment
In the initial stages of varicose veins, you can fight with conservative methods: taking medicine, using ointments and gels, wearing compression clothes and moderate physical activity. Patients may be recommended minimally invasive surgery or laser treatment to correct cosmetic defects. In more advanced cases, varicose veins can be removed only through surgery, and its type is selected individually for each specific case.
Varicose veins of the legs is a disease that is best prevented, because it is very difficult to treat. Therefore, every woman should know the causes and symptoms of such a problem.
What is the danger of varicose veins in the legs?
With the early development of the disease, many believe that its worst manifestation is the appearance of a swollen limb. Unfortunately, this is not the case. The worst case for the development of varicose veins on the legs in women is death. In addition, the complications of the disease can be very different.
The most common are:
- trophic ulcers;
- thrombosis;
- phlebitis and thrombophlebitis.
Phlebitis is a process of damage to the inner walls of the vein. In this case, the leg swells more and the veins that come out during palpation become hard. With the further development of phlebitis, the patient's body temperature rises, and every movement of the leg brings severe pain. And then phlebitis ceases to be thrombophlebitis. In this case, blood clots appear on the walls of the vessels - small clots of stagnant blood.
Thrombosis is the formation of blood clots in the absence of phlebitis. This problem is scary because it is almost impossible to diagnose.
Attention! A thrombus detached from the vessel wall is the cause of death in most clinical cases. Moreover, this process occurs immediately (sometimes within a few minutes), and it is almost impossible to recognize a detached blood clot without stopping blood circulation.
Now you know the causes of varicose veins in women's legs. In order to prevent varicose veins, it is necessary to take preventive measures. This is especially true for women with a genetic predisposition to the disease. To reduce the risk of disease, it is necessary to do moderate physical activity, wear comfortable shoes, and avoid hypotension.
Consequences and complications
Varicose veins do not have a single course. Different groups of patients have individual characteristics of the course of the disease associated with the pathogenesis of varicose veins. Varicose veins can be primary - that is, they are associated with congenital insufficiency of the venous valve and weakness of the vessel wall, which is almost always accompanied by reverse blood flow (reflux). And secondary (acquired), when reflux develops several years after the onset of the disease.
What are the dangers of varicose veins in women's legs? Varicose veins tend to progress, as they develop and in the absence of conservative treatment, the symptoms of the disease worsen. Heaviness in the legs is replaced by persistent, continuous swelling, against the background of which tissue damage develops, open trophic ulcers appear, as a result of which the person completely loses his ability to work and requires constant care therapy.
Treatment at home
Many women are wondering how to treat varicose veins on women's legs at home? For patients with varicose veins, therapeutic exercises, herbal medicines and some recommendations for a healthy lifestyle will help alleviate the symptoms of the disease and prevent its further development.
Therapeutic exercises
Every morning and evening you should do simple exercises for varicose veins:
- Lying on your back, raise your legs vertically, lean against the wall at an angle of 90 °. Hold them in this position for 3 minutes, breathing slowly from your chest, not your stomach.
- Do cycling exercises for 3-5 minutes while lying on your back.
- While standing, lift both feet 1 cm above the floor on your toes and lower them. Perform 30 times in two approaches.
- While standing, alternately lift one heel off the floor, then the other at an angle not higher than 45o. Start with 15 minutes daily, increase to 30 minutes.
You should spend at least 30 minutes walking every day. It is useful to swim in the pool once a week.
Folk treatment
Take the herbal mixture internally: mix 1 tablespoon each of birch buds, motherwort, string, calamus roots, coltsfoot leaves, thyme.
Pour boiling water over half a cup of the mixture and heat it in a water bath for 40 minutes. Let it brew, strain. Drink 0. 5 cups before each meal for a month.
Prepare compresses from homemade ointments:
- Mix half a cup of condensed milk with freshly chopped wormwood leaves. Apply to the diseased veins, close with gauze and cover with a film. Hold for 30 minutes daily.
- Grate the beets on a fine grater, add 2 tablespoons of melted honey, mix, cool and apply to sore feet.
To relieve swelling in the evening, apply fresh cabbage leaves to your ankles, first pierce them with a fork until the juice appears. Secure with a bandage.
Prognoses and preventive measures
Since varicose veinsis an irreversible process, in this case there is no need to talk about complete recovery. However, with timely diagnosis, adequate treatment and prevention, patients can completely get rid of unpleasant symptoms and lead a full life.
Includes preventive measures for varicose veinshealthy lifestyle, proper nutrition and rejection of bad habits. People who are forced to stay in the same position for a long time due to their professional activities are advised to avoid crossing their limbs, do simple exercises from time to time, bend and straighten their legs, and do a light massage to improve blood circulation.
In your free time, you should go for a walk in the fresh air as often as possible and do moderate physical activity.
Ladies who follow fashion or work the dress code and go on and onHigh heels, you should change them periodically for more comfortable shoes.
It goes for the sameuncomfortable clothes, because such tight underwear can lead to the deterioration of blood circulation in the legs of women and the appearance of varicose veins.
Varicose veins of the lower extremities are today considered a widespread disease, which is often not given much attention.
This is very important to rememberneglecting the health of your feet can cost a person not only his ability to work, but also his life, while in the initial stages, varicose veins can be quite successfully corrected with the simplest methods.