Varicose veins of the lower extremities is a chronic pathology that is characterized by thinning of the venous wall, increased vascular lumen and the formation of knobby extensions.
The disease, which is diagnosed in about 15-17% of the adult population. In adulthood, the disease is more frequently diagnosed in women, which is the result of hormonal changes in the body (menopause, pregnancy, menstruation).
Varicose veins in the legs, manifested an extensive clinic. Patients complain of heaviness and pain in the limbs, fatigue, ankle swelling, cramps at night, protruding blue veins. Pathology on the background of the lack of appropriate treatment leads to a variety of complications.
Causes and risk factors of varicose veins of the lower extremities
Varicose veins of the lower extremities in most of the image, which is the result of a genetic predisposition. Proximate cause: the functional immaturity in the valves of the veins and immaturity in the connective tissue element of the blood vessels. This leads to increased load on the inside of the blood vessels and the appearance of varicose veins.
The etiology is due to innate factors, which are associated with hypercoagulability – increased blood clotting. On the background of the infringement was of blood clots, which violates the full flow in the legs, leads to the pathological expansion of the venous lumen.
A common cause of disease in women is a hormonal imbalance. Based on the changes in the concentration of sex hormones in the blood. Associated with the onset of menopause and pregnancy.
Causes of varicose veins on the legs:
- Weight. Obesity has mechanical effects on the venous wall, are particularly pronounced itself on the background of the abdominal type. As a result, the patient increased pressure venous;
- Diabetes. Due to the complex disorder of the metabolic processes associated with chronic high blood sugar at a relatively insufficient insulin, reducing the elasticity of the venous walls with their further extension;
- Alcohol, dependency. Alcoholism the body lacks fluids, the blood becomes thicker, which leads to disruption of blood circulation;
- Professional factors (continuous search in a vertical position, excessive physical activity, lack of physical exercise);
- Wearing uncomfortable footwear such as high heels;
- Severe pathology of the cardiovascular system, which is manifested by circulatory failure.
Cause varicose veins on the legs can be chronic diseases of the sexual organs. In particular, inflammation of the prostate in men and adnexa in women.
The mechanism of the disease is based on the involvement in the inflammatory process, the smallest blood vessels, which causes swelling and obstruction of the blood flow.
Signs and symptoms of varicose veins
Varicose veins on the legs is expressed in a variety of symptoms. Let's start with the external changes. So, the most obvious sign that indicates the occurrence of diseases, with this change, the outline and the form of subcutaneous veins on the legs. Shows, flatulence, nodular thickening of the. The veins become dark colors, revealing the veins and vessels.
Venous leg ulcers are considered from two sides. Part of the doctors attribute to the wound with the symptoms and other complications of the disease, a witness, that is the last, most advanced stage of the pathological process.
Classification of varicose veins on the legs
Varicose veins on the legs is diagnosed more often in older women than in men of this age. At a young age, illness, boys and girls, which is reflected with the same frequency. In accordance with the classification, the disease can be primary and secondary in nature. In the first case, the pathological changes relate to surface vessels. Violation of the structure and the structure of the deep vessels, which do not exist.
Secondary varicose veins is a complication of abnormalities of the deep veins, which in the observed negative changes in the surface veins of the legs. This image is displayed on the background of congenital disorders of the venous system, and also as a consequence of phlebothrombosis.
Also the disease is classified on clinical forms. These include varices of the lateral vessels of the lower legs and thighs form the reticular and varicose telangiectasia. Consider these forms more:
- Varicose veins lateral veins sometimes as an independent disease, and in combination with other diseases. Reverse reflux venous fluid, which occurs in the deep vein via the saphenous and surrounding blood vessels.
- Mesh (reticular form) is manifested as an independent disease. Does not lead to venous insufficiency, represents only a cosmetic error.
- Telangiectasia varicose veins are also a cosmetic error.
In recent years, surgeons distinguish venous insufficiency idiopathic forms. It is characterized by increased venous tone, with a clear reason such violation cannot be detected. Clinical manifestations the pathology does not differ from the classical clinic.
Rate and extent of varicose veins
Varicose veins on the leg varies depending on the stage and extent. For the establishment of this account of the clinic for the patient. Chronic disease, which is in several phases, which are some of the differences:
| Phase | Feature |
| Compensation | Pain syndrome weakly expressed or not. Patients complain of an uncomfortable feeling in the legs due to years of. It should be noted, the presence of spider veins on the skin, sometimes manifested by swelling of the ankle, it comes quickly after the holidays. |
| Subcompensation | Visual examination of the lower extremities of the patient visible blood vessels with abnormal clearance. Patients have a lot of complaints. In particular, they complain of persistent pain expander nature, fatigue, weight in feet. Often at night they twitch muscle, the "run the goose bumps" on the skin. Swelling, after a night's sleep in 90% of cases leveled independently. |
| Decompensation | The most difficult stage of varicose veins. Obvious changes on the skin. He becomes too dry, the hair falls out on your feet. In addition, it is showed hyperpigmentation, which leads to abnormal thickening of the subcutaneous tissue. Cracks and scratches on my legs to heal, for a long time, it may be to transform into sores. Swollen feet constantly, rest and sleep do not help. Swelling usually rise higher on the leg. |
When a girl or a boy come to the doctor with complaints of the described symptoms, the doctor performs a visual inspection, prescribes laboratory and instrumental methods of diagnostics. On the basis of the received results speak about the form, level and extent of the disease.
The rate of varicose veins on the legs are defined with numbers. 0 (zero) at the clinic cannot be established, the external changes do not exist; I – puffiness, fatigue of the limbs; II – constant swelling accompanied by hyperpigmentation, abnormal seal subcutaneous tissue; III – pain that does not go swelling of the legs, trophic ulcers.
Complications of venous insufficiency
Varicose veins is a chronic incurable disease, so treatment it has a specific purpose – to stop progression and prevention of complications. If the treatment assigned is incorrect or the patient turns for help to a medical professional, develop complications of the disease.
Thrombophlebitis – inflammation of the venous walls in the presence of a blood clot. In the inflammatory process may involve the surrounding blood vessels and soft tissue. There are several forms. May be acute (lasts around 30 days), subacute – duration up to six months and chronic.
Migratory thrombophlebitis is rare. It is characterized by inflammation that occurs in various parts of Vienna quickly.
Symptoms include:
- Visually it is a clear outline of the inflamed vessels.
- Acute pain, on palpation the pain is getting stronger.
- Swollen nodules, protruding above the skin.
- The local rise in temperature.
Thrombophlebitis with varicose veins of the feet, can lead to other complications. For example, the periphlebitis is an inflammation of the surrounding tissues, wet gangrene of the extremities, deep vein thrombosis. In the propagation of inflammation occur complications, which go beyond the extremity – embolism and sepsis.
Deep vein thrombosis is a common complication of varicose veins on the legs. The pathology is characterized by the formation of dense blood clot partially or fully occludes a blood vessel that disrupts the blood circulation in whole. In this complication is the risk of death due to detachment of the thrombus.
Trophic ulcers occur in severe cases. Often joins infectious process, compounding the clinical picture. The sores can affect not only tissues, but also the deeper layers of the muscles. Heal, for a long time. Requires comprehensive treatment.
Varicose eczema is characterized by the following symptoms:
- Inflammatory hyperpigmentation of the skin purple or bright red color;
- Microvesicles are formed, which are independently opened;
- Severe swelling of the legs;
- Itching, which is observed constantly;
- Moisture that after drying the crust;
- Abnormal thickening of the skin.
Varicose eczema can go into a chronic course, which apparently hardening of the skin and subcutaneous tissue.
Upon accession infection eczema complicated by trophic ulcers.
Conservative treatment of varicose veins on the legs
Conservative treatment of varicose veins includes medications and wearing compression underwear. Compression stockings of different compression class purpose is for the prevention and treatment of diseases. Panty hose, tights, stockings, socks, and socks should choose a doctor based on specific characteristics. Exactly right, the underwear gives the desired result.
Prescribed medicines. Perfect effective medications, which would affect all the pathological elements of the disease does not exist. We recommend the use of systemic medications – tablets and local media – gels, balms, creams and ointments.
In addition to the prescribed physiotherapy – magnetotherapy, electrophoresis; special exercises. You can use folk remedies – recipes with medicinal herbs can help reduce the severity of symptoms.
Sometimes recommended hirudotherapy – treatment with leeches.
Methods of surgical treatment
When conservative methods give a small result, the disease progresses, it is recommended to conduct operations. Often practiced sclerotherapy. In the vein injected a special substance, which glues the affected vessels. Over time it is replaced with connective tissue.
Radio-frequency ablation. While the surgical procedure is performed "welding" of the blood vessels (the patient) with the help of the probe, which radiates the waves. The probe heats the walls, causing stenosis. After some time will be required to wear a compression garment.
The method of the patient after surgery depends on a number of criteria. The doctor takes into account the stage of the disease, the patient's health status, presence of chronic diseases, which may be a contraindication to the use of the intervention.
Other types of surgical treatment:
- Phlebectomy the doctor removes the affected veins and arteries. Through a small puncture of the skin introduction to the tool, with the hook, whereby pull out the container. This technique is the combined use of surgical intervention and the use of a laser.
- The most effective way of treatment is considered, laser coagulation of blood vessels of the lower extremities. The technique of the operation, which is performed with minimal incisions and injuries. Through a small incision in the skin in a vessel which is injected with the best transactions, which emits waves of a desired frequency. In the area of influence of the observed warming. The walls are stepped, which allows to attack the problem.
By stripping is carried out using a small probe that is inserted through the incision and glue the affected part of the vein. Cryostripping in the pathological vessel with liquid nitrogen, is introduced, which leads to the degradation of the region, followed by the not function.
Prevention
Preventive measures are of great importance. A favorable prognosis depends on the correct doctor appointments and treatment, and the patient, who needs to change their way of life, to strictly follow the recommendations of the phlebologist.
So, it is necessary to wear compressive underwear or bandaging the limb with an elastic bandage. For reviews of patients, the first option is more convenient. Also after the surgery requires constant physical activity, but without excessive stress on the body.
During sleep, it is recommended that the leg be raised. If you want to do this, the limb placed on a pillow or folded blanket. If the work involves continuous standing or sitting, every 60-80 minutes to do some stretching to stimulate blood circulation in the body.
Women should not wear high heel shoes. Maximum heel height should be 5 cm for All patients, we must choose comfortable shoes to abandon the clothes, which puts pressure on the extremities.
Varicose veins – a serious disease that requires a multifaceted treatment approach. Only a complex impact consisting of drugs, compression garments, physiotherapy, physical activity and proper nutrition will lead to a positive outcome and sustained remission.