Treatment of varicose veins

Varicose veins are a disease accompanied by thinning of the venous wall, an increase in the diameter of the lumen of the veins and the formation of nodular dilations similar to aneurysms. Any vein can be involved, but it is most commonly 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 underlying cause of the disease is not fully understood. We can name only provoking factors that increase the risk of developing pathologies:

• genetic predisposition. If one of the parents has a disease, it can develop in children.
• long static loads. Working in a standing 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 leads to increased pressure in the vessels of the lower extremities.
• Pregnancy, in which the pressure in the vessels of the small pelvis and lower limbs increases, and the elasticity of the vascular wall also changes.
• Wear high-heeled shoes, which disrupt the contractility of the calf muscle involved in the movement of blood through the veins (the so-called "muscle pump").
• Improper nutrition (in particular, lack of fiber) leads to constipation, which causes an increase in pressure in the vessels of the small pelvis and lower limbs.
• Bad habits.
• Hormonal imbalances.

These are common causes of dilated 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 vessels of the legs are most 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. Undercompensation.
3. Decompensation.

In addition, there is an international classification that distinguishes the classes:

• C0. There are no signs of vascular damage, but the patient complains of varicose veins.
• C1. Expansion of small superficial veins is noted.
• C2. Expanded veins are revealed during visual examination.
• C3. The patient complains of tissue swelling, pain, excessive fatigue after a working day.
• C4. The first symptoms 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.

The degree of pathology is determined on the basis of the results of a visual examination, instrumental diagnostic methods and existing signs of a chronic disease.

The first symptoms can be called:

• Increased leg fatigue.
• Swelling of the tissues, especially pronounced in the evening, which passes after a short rest.
• Pain sensations.
• Characteristic heaviness in the legs.
• Night cramps in the calf muscles.
• Burning sensation along the course of the vein.

Pain is particularly significant. It never radiates to the thigh or heel, but is always noted in the location of the affected vein and has a painful character. Often the sensations are exhausting, preventing sleep. After sleep, the pain disappears.

In the initial phase there are no signs of damage to the saphenous vein, but changes are already underway. The process can take several years, so the treatment of varicose veins often begins when there is already a 3-4 class of pathology. Over time, the clinic increases, and the severity of symptoms of venous insufficiency increases:

• Increased tissue swelling. It is mainly located in the calf muscles. Like pain, swelling occurs in the afternoon and subsides after a restful night. It is important to distinguish edema in the calf muscles from swelling of the foot tissues. The latter indicates violations of the outflow of lymph.
• Itchy skin. It can be seen along the ships.
• Visual changes on the skin in the form of tortuous veins, the presence of extensions.
• Skin changes due to circulatory disorders. There is cyanosis, thickening of tissues, darkening is possible.

In the absence of therapy, the clinic is supplemented by signs of tissue malnutrition, the appearance of trophic ulcers, eczema, and so on. Violation of the venous valves can cause the following complications:

• Thrombophlebitis. It is characterized by the formation of blood clots. Without help, the condition is life-threatening.
• Venous thrombosis. Occurs with the blockade of the ship. It is manifested by severe pain, aggravated during physical activity.
• Pulmonary embolism. It occurs as a result of the separation of a blood clot. With its small size, pneumonia or chronic heart failure can develop.
• Trophic ulcers. The first signs are the thickening of the tissues above the affected vein. In addition, the tissues thin, an ulcer appears. 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 medications based only on the results of a visual examination.

Dopplerography is mandatory. This is one of the simplest ways to evaluate the vascular bed. It is based on the determination of the degree of variation in the frequency of the sound signal reflected by the blood cells.

When performing ultrasound, angioscanning is performed, which allows you to assess the condition of the vessel wall and the direction of blood flow. The result will be a two-dimensional image of the veins with reflection of the valves, possible blood clots.

In the event that the listed methods do not give a complete answer, CT is prescribed. If thrombosis, angiodysplasia and damage to the veins of the small pelvis are suspected, radiopaque venography is prescribed.

Treatment of varicose veins in the legs

A phlebologist is engaged in the diagnosis and treatment of pathology. It is to this specialist that you should contact at the first signs of diseases. In advanced cases, when conservative therapy does not give the desired effect, radical methods are used. In this case, the vascular surgeon is engaged in the elimination of varicose veins.

Methods of treatment are determined based on the results of the examination. In the initial stages, general and local drugs can be used. When drugs don't work, surgery is prescribed.

Conservative treatment

The main drugs are venotonic (phlebotonic). Available in the form of tablets and capsules, which have a systemic effect. Thanks to them, it is possible to normalize blood circulation and improve the condition of the whole organism. In addition to compresses, you can use local remedies with a similar effect. These are creams and gels. They have a pronounced effect, but the effect lasts a short time.

The action of the phlebotonic is based on improving the elasticity of blood vessels, reducing the permeability of the wall and eliminating congestion. Patients have a decrease in edema and normalization of hematopoiesis.

The use of antiplatelet and anticoagulant agents is allowed. They are indicated at high risk of blood clots, as well as in their presence. Thanks to them, it is possible to destroy blood clots and reduce viscosity. Funds are used for a pronounced violation of blood viscosity, but with the risk of bleeding it is not allowed to use.

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

• Linen puts pressure on the affected varicose veins and deep vessels.
• In the lower legs, the vessels undergo the most pronounced pressure of knitting, which eliminates congestion.
• The vessels are constantly in a compressed state, so the operation of the valves becomes more efficient.
• When using underwear, the severity of edema and pain decreases.

Methods of surgical treatment of varicose veins

In the absence of the effect of drug therapy, an operation is prescribed. The indications for its implementation are the following conditions:

• Failure of conservative treatment
• The first signs of thrombophlebitis.
• Pronounced expansion of the vascular wall.
• Significant swelling of the tissues.

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

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

Modern methods of treating varicose veins allow you to carry out all the necessary procedures without hospitalization and let the patient go home. The choice of technique is determined by the doctor based on the results of the examination.

Pathology prevention

Varicose veins are difficult to treat and even after surgery it is necessary to take preventive measures to prevent recurrence. Some patients use drug therapy throughout their lives and wear compression stockings. Pathology can be prevented as follows:

• Refusal to drag things along.
• Wear shoes with medium heels.
• Complete nutrition.
• Weight control.
• Normalization of the consumption regime.
• Active recreation, swimming, cycling.
• Refusal of bad habits.

Compliance with preventive measures and a careful attitude to the body will help prevent the disease and will notice deviations over time. Timely treatment of varicose veins eliminates the progression of the pathology and the formation of complications.