Treatment of varicose veins

Varicose veins is a disease accompanied by thinning of the venous wall, an increase in the diameter of the lumen of the veins, and the formation of aneurysm-like nodular expansions. Any vein can be affected, but it is more often 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 main cause of the disease is not fully understood. We can name only the provoking factors that increase the risk of development of pathology:

• genetic predisposition. If one of the parents has the disease, then it can develop in the children.
• long static loads. Working in a constant position causes stagnation of blood 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 causes increased pressure in the veins of the lower extremities.
• Pregnancy, which increases the pressure in the vessels of the pelvis and lower limbs, changes the elasticity of the vessel wall.
• Wearing high heels, which impairs the contractility of the calf muscle involved in the movement of blood through the veins (called a "muscle pump").
• Improper nutrition (especially lack of fiber) that causes constipation, which causes increased pressure in the vessels of the small pelvis and lower extremities.
• Bad habits.
• Hormonal imbalances.

These are common causes of varicose 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. The veins of the legs are more 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. Subcompensation.
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. Dilation of small superficial vessels is noted.
• C2. During visual examination, dilated veins are revealed.
• C3. The patient complains of tissue swelling, pain, and extreme fatigue after a working day.
• C4. The first signs 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.

Pathological degree is determined based on the results of visual examination, instrumental diagnostic methods and existing symptoms of chronic disease.

The first symptoms can be called:

• Increased leg fatigue.
• Swelling of the tissues, which passes after a short rest, especially expressed in the evening.
• Feelings of pain.
• Characteristic heaviness in the legs.
• Nocturnal cramps in calf muscles.
• Burning sensation along the vein.

Pain is especially important. It never spreads to the thigh or heel, but is always noted at the site of the affected vein and is painful in nature. Often the feelings are exhausting and interfere with sleep. Pain decreases after sleep.

In 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 the treatment of varicose veins often begins when there is already 3-4 class pathology. Over time, the clinic increases and the severity of the symptoms of venous insufficiency increases:

• Increased tissue swelling. It is mainly localized in calf muscles. Like pain, swelling occurs in the afternoon and disappears after a night's rest. It is important to distinguish edema in the calf muscles from swelling of the tissues of the leg. The latter indicates a violation of lymph flow.
• Itching of the skin. Marked along the ships.
• Visual changes in the form of curved veins on the skin, the presence of extensions.
• Skin changes due to blood circulation disorders. There is cyanosis, thickening and darkening of tissues is possible.

In the absence of therapy, the clinic shows signs of tissue nutrition, the appearance of trophic ulcers, eczema, etc. Violation of venous valves can cause the following complications:

• Thrombophlebitis. It is characterized by the formation of blood clots. Without help, the situation is life-threatening.
• Venous thrombosis. Occurs due to vessel blockage. It is manifested by severe pain that worsens during physical activity.
• Pulmonary embolism. It is caused by 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 thickening of tissues over the affected vein. In addition, tissues become thinner, ulcers appear. 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 make a diagnosis 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 from the blood cells.

When conducting an ultrasound, angioscanning is performed, which allows assessing the condition of the vessel wall, as well as the direction of blood flow. The result will be a reflection of the valves, a two-dimensional image of the vessels with possible blood clots.

If the listed methods do not respond comprehensively, CT is prescribed. If there is a suspicion of thrombosis, angiodysplasia and damage to small pelvic vessels, radiopaque phlebography is prescribed.

Treatment of varicose veins in the legs

A phlebologist deals with the diagnosis and treatment of pathology. You should contact this specialist at the first signs of the disease. In advanced cases, when conservative therapy does not give 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. In the initial stages, it is possible to use general and local drugs. If drugs do not work, surgery is prescribed.

Conservative treatment

The main drugs are venotonics (phlebotonics). It is available in the form of tablets and capsules with a systemic effect. Thanks to them, it is possible to normalize blood circulation and improve the condition of the whole body. In addition to tablets, you can use local remedies with a similar effect. These are creams and gels. They have an obvious effect, but the effect lasts 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 reduced edema and normalization of hematopoiesis.

The use of antiplatelet agents and anticoagulants is allowed. They are indicated by their presence in addition to the high risk of blood clots. Thanks to them, it is possible to destroy blood clots and reduce viscosity. Means are used for obvious violation of blood viscosity, but their use is not allowed due to the risk of bleeding.

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

• The cloth puts pressure on the affected varicose veins and deep veins.
• In the lower part of the legs, the vessels experience the most obvious pressure of knitting, which eliminates congestion.
• The vessels are constantly compressed, so the operation of the valves becomes more efficient.
• When using underwear, the intensity of edema and pain decreases.

Methods of surgical treatment of varicose veins

If there is no effect of drug treatment, surgery is prescribed. Instructions for its implementation are the following conditions:

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

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

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

Modern methods of treatment of varicose veins allow to carry out all necessary procedures without hospitalization and to discharge the patient at home. The choice of the 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 and wear compression stockings throughout their lives. Pathology can be prevented as follows:

• Refuse to drag things.
• Wearing shoes with medium heels.
• Complete nutrition.
• Weight control.
• Normalization of the drinking regime.
• Active recreation, swimming, cycling.
• Rejection of bad habits.

Observance of preventive measures and a careful attitude to the body will help prevent disease and pay attention to deviations in time. Timely treatment of varicose veins eliminates the development of pathology and the occurrence of complications.