Varicose veins: treatment and symptoms

The disease is named afterVaricose veins of lower limbs, is the Latin word "varicis". It is translated as "swelling" and fully reflects the main symptom of this pathology, which is characterized by abnormal dilation of veins. It is also accompanied by other equally unpleasant manifestations, such as impaired blood flow and valve dysfunction.
The medical statistics are relentless: this disease already affects the majority of the world's population! Therefore, almost 90% of women and more than 65% of men have varying degrees of clinical manifestations of varicose veins. Unfortunately, this disease is affecting younger people more and more - today there are reports that it has been found even in school-age children!If you have more than 80% of the symptoms listed, we strongly recommend that you seek medical advice.Varicose veinsIt is a venous disease with clinical manifestations of venous dilation, pathological tortuosity, and the formation of venous nodules, which then progress to varying degrees of chronic venous insufficiency symptoms (starting with a feeling of heaviness), leg fatigue, varying degrees of swelling, and subcutaneous fat. Compaction of tissues and skin, appearance of dermatitis, eczema and ultimately the formation of venotrophic ulcers).Doctors classify this pathological condition as multietiological because it occurs due to the influence of multiple factors. mainly include:

• innate tendencies;
• female pregnancy;
• hormonal imbalance;
• excess weight;
• Passive lifestyle.

A team of dedicated vein specialists from the Doctors Nearby family clinic network are ready to help those who want a cure for this disease. The choice of treatment is made on an individual basis and takes all factors into account. Coupled with the use of modern and effective techniques, this allows you to achieve the desired results.

Causes and signs of varicose veins

The main pathogenesis of varicose veins is:

• increased venous pressure, determined primarily by venous hydrostatic pressure due to gravity, measured by the height of the fluid column, i. e. the distance from the heart to the measuring point on the leg. The pressure within the body cavity - the abdomen or pleura, which when increased (pregnancy, overweight, lifting and carrying heavy objects, etc. ), worsens the return of venous blood to the heart.
• Vein walls are relatively weak, which is genetically determined, but sometimes changes under the influence of venous inflammatory processes.

The interaction of these factors results in progressive stretching of the veins, venous valve insufficiency, reverse flow, and venous bed stagnation.With long-term exposure to irritants, an inflammatory process occurs, and as inflammation occurs, it affects and weakens the vein valves and the strength of the vein walls.The result of all these processes is a pathological reverse flow of blood along the veins, called regurgitation, and venous stasis, leading to the development of subcutaneous fat and inflammation of the skin, which with further development leads to the appearance of trophic ulcersSymptoms of varicose veins:

• In advanced cases, the saphenous vein becomes visually markedly dilated and tortuous - the formation of venous knots;
• There is a feeling of heaviness, fatigue, and fullness in the lower limbs and calves;
• The formation of telangiectasia (vascular "stars", "webs");
• Calf muscle cramps at night;
• swelling of feet and legs;
• Itchy, dry, hyperpigmented and bluish skin
• Nutritional, exudative, poorly healing ulcers occur.

Risk of varicose veins

Varicose veins in the legs themselves are more of a cosmetic problem, but can lead to unpleasant complications: chronic venous insufficiency and inflammation of the veins, called acute varicosephlebitis. Acute varicose phlebitis is a pathological condition that occurs due to inflammation of the vein wall and the occurrence of blood clots within the lumen. A dangerous complication of venous thrombophlebitis is that the blood clot continues to grow and spread into the deep veins. Therefore, this condition requires mandatory medical supervision and treatment, and sometimes even emergency surgery. Modern medicine offers many effective techniques that can help eliminate the risk of such diseases, but treatment must be started promptly.

Classification of varicose veins

There are different classifications of varicose veins, as shown in the table below.

Varicose vein type/stage/category according to CEAP	logo
The form and extent of the pathology and its resulting complications
C1	Intradermal vascular damage: telangiectasia (commonly known as "spider", "web", "asterisk") and dilated reticular veins.
C2	Dilation, pathological tortuosity, and damage to the great saphenous vein.
C3	Damage to the saphenous vein with edema
C4aС4b	The appearance of hyperpigmentation (dark brown) or eczema (skin inflammation, dermatitis) in the lower legs The appearance of lipodermatosclerosis (inflammation and thickening of subcutaneous fatty tissue).
C5	Nutritional ulcer healing
C6	"Open" trophic ulcer
According to Savelyev, the stages of development of pathological conditions
compensation	There are no symptoms or complaints; examination reveals dilated veins in one or both lower limbs.
Compensation	Patients experience discomfort with swelling and "tingling" in the legs, as well as nighttime calf muscle spasms. This condition is accompanied by swelling in the evening, which disappears in the morning. Varicose veins in the lower extremities were found during examination.
decompensation	The discomfort described above is complemented by inflammatory skin lesions and eczema. The skin looks dry, shiny, and hyperpigmented.

The development of varicose veins

Clinical manifestations of the diseaseDepends on which stage of progression the disease is at. At the same time, doctors identified the main clinical symptom that gave the disease its name - dilation of the saphenous veins of the lower limbs.

Beginning of disease development

Initially, the patient experiences heaviness, fatigue, and pain in the legs. During this period, visual signs of pathology are not visible. Often none of the above symptoms occur, so the patient does not seek professional medical help. During examination by a phlebologist, he discovered dilated soft veins over which the skin had not yet undergone pathological changes.

subcompensatory stage

As the disease progresses, patients will experience pain and swelling when standing or sitting for long periods of time, but this will disappear by night. During the examination, the phlebologist noticed slight swelling in the ankle area.

decompensation stage

Pathological progression is manifested by persistent heaviness in the lower limbs, rapid fatigue, and nocturnal calf muscle spasms. In addition, severe itching occurs at night.During the examination, the doctor found that the veins in the lower limbs were significantly dilated and the blood flow was impaired. Venous tone, adhesion of the vein walls to the skin, hyperpigmentation, cyanosis, roughness and dryness of the skin are noted.Skin changes occur on the lower third of the legs. First, they represent the appearance of brown color in the skin, the development of inflammation - dermatitis or eczema, the appearance of compaction of subcutaneous fatty tissue, against which background trophic ulcers subsequently begin to form and progress.

Diagnosis of varicose veins

Treatment of varicose veinsIt is prescribed to the patient after a comprehensive diagnostic study, which allows to accurately determine the stage of development of the disease and the resulting pathological changes. Depending on the circumstances, studies of the following inferior veins may be included:

• examine;
• Duplex/triple scan.
• Research on some coagulation indicators and thrombophilia markers

main methodDiagnosis of varicose veinsIt's an ultrasonic examination, but in addition to that they do a full range of tests and perform functional tests.

Treatment of varicose veins

Modern phlebology offers many effective methodsHow to treat varicose veins. Their selection is individualized based on the clinical case and patient indications.Conservative techniques should not be opposed to surgical techniques as they are used in conjunction. Sometimes conservative treatment can be carried out independently, but it is important to understand that although it slows the progression of the pathology and has a positive impact on the patient's condition, it does not lead to a cure.

Conservative treatment
When do you use it yourself?	Preparing patients with advanced disease for surgery; There are contraindications to surgery or surgery needs to be postponed; For the patient's recovery after surgery.
Problems that can be solved	Eliminate clinical manifestations; Improve patient well-being and quality of life;
Technology used	Compression therapy reduces venous diameter and eliminates reflux, and stimulates venous blood return to the heart and lymphatic drainage. During this procedure, elastic bandages and therapeutic compression stockings are used, which the patient wears every day for the rest of their life or until the surgical correction is complete. The use of therapeutic compression stockings can adequately and quickly correct hemodynamic disturbances in the legs, even duringtreatVaricose veinsat the advanced stage.
	Medical treatment involves prescribing pharmacological medications aimed at eliminating discomfort in the legs or improving blood microcirculation and lymphatic drainage. The most commonly used drugs are: Ointments and gels containing essential oils: troxevasin, antistax, etc. Flavonoid-based formulations.
surgical technique
phlebectomy
What's this?	Surgery to remove varicose veins.
What problem does it solve?	Normalization of blood flow through the great saphenous vein
Indications	Pathological dilatation of the great saphenous vein; Reflux is present; Ascending thrombophlebitis.
Features	The surgery involves removing the affected vein under the skin.
period	60 to 120 minutes.
traumatic	There are small scars of 5-10 cm in the groin area and 0. 5-4 cm on the legs. Patients are hospitalized for 1-7 days. Sick leave maximum 24 days
Endovenous laser coagulation/varicose vein occlusion (EVLK/EVLO)
What's this?	A technology designed to eliminate veins using a medical laser beam.
Indications	Pathological dilatation of veins; Nutritional ulcers are present.
traumatic	Minimally, the surgery is performed via venipuncture. Conducted on an outpatient basis.
Characteristics of the recovery period	Immediately after surgery, patients need to walk for 30-40 minutes. Compression stockings need to be worn for at least 2 weeks. Pain is usually absent or minimal
Sclerotherapy
What's this?	The procedure involves the introduction of a special substance (sclerosant) into the lumen of the blood vessel, causing the formation of a proteinaceous red blood cell plug and subsequent disappearance of the vein.
Indications	venous aneurysm.
Features	This technique is effective for the treatment of intradermal veins, and in other cases - in addition to the removal of small residual branches of the main trunk.
complication	Complications are relatively rare.

Prevent varicose veins

Prevention includes:

• Wear compression stockings;
• Maintain weight within normal range;
• Maintain an active lifestyle;
• Avoid standing for long periods of time;
• If there is a family history or symptoms of the disease are present, see a phlebologist promptly.

If you still notice the first signs of varicose veins, seek professional medical help quickly!