Varicose veins of the lower extremities is a chronic pathology that is characterized by the thinning of the venous wall, increased vascular lumen and formation of the knobby extensions.
The disease is diagnosed in 15-17% of the adult population. In adulthood, the disease is more frequently diagnosed in women that is due to hormonal changes in the body (menopause, pregnancy, menstruation).
Varicose veins on the legs is a great clinic. Patients complain of heaviness and discomfort in the extremities, fatigue, ankle swelling, cramps at night, are the blue veins. For pathology on the background of the lack of adequate treatment leads to various complications.
Causes and risk factors of varicose veins of the lower extremities
Varicose veins of the lower limbs in most paintings is the result of a genetic predisposition. Proximate cause: the functional immaturity of the valves of the veins and of the immaturity of the connective tissue element of blood vessels. This leads to increased load on the inside of blood vessels and the occurrence of varicose veins.
The etiology is due to innate factors that are associated with a hypercoagulable state – increased blood clotting. On the background of violations of formed blood clots, which violates the full flow in the legs, leads to a pathological expansion of the venous lumen.
A frequent cause of the disease in women is a hormonal imbalance. It is based on the change in the concentration of sex hormones in the blood. Associated with the beginning of menopause and pregnancy.
Causes of varicose veins of the legs:
- Weight. Obesity has mechanical effects on the venous wall, this is especially pronounced on the background of abdominal type. As a result, the patient increased venous pressure;
- Diabetes. As a result of complex disorders of the metabolic processes associated with chronically high blood sugar at a relative insufficiency of insulin, a decrease in the elasticity of venous walls and their subsequent extension;
- Alcohol dependence. Alcoholism the body lacks fluids, the blood becomes thicker, which leads to disruption of blood circulation;
- Professional factors (a constant finding in vertical position, excessive physical activity, lack of exercise);
- Wearing uncomfortable shoes, for example high heels;
- Severe pathology of the cardiovascular system, manifested by circulatory failure.
Cause varicose veins of the legs can chronic disease of the genital organs. In particular, inflammation of the prostate gland in men and adnexa in women.
The mechanism of the disease is based on the involvement of inflammation of small veins, which causes swelling and obstruction of blood flow.
Signs and symptoms of varicose veins
Varicose veins of the legs manifests itself in different symptoms. Let's start with the external changes. So, the most obvious symptom that indicates the occurrence of the disease, this transformation the contour and shape of subcutaneous vessels of the legs. Manifested bloating, nodular thickening. Vessels become dark in color, are mesh and star.
Venous leg ulcers are considered from two sides. The part of the clinicians treated the wound before the symptoms, others to the complications of the disease, which indicates past – the most advanced stage of the pathological process.
Classification of varicose veins of the legs
Varicose veins of the legs most often diagnosed in older women than men of this age. At a young age, the disease in boys and girls manifests itself with the same frequency. In accordance with the classification, the disease can be primary and secondary nature. In the first case, the pathological changes relate to surface vessels. Violation of the structure and the structure of deep vessels do not exist.
Secondary varicose veins is a complication of abnormalities of the deep veins, resulting in the observed negative changes in the surface vessels of the legs. This picture is shown 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 tibia and femur, form the reticular and varicose telangiectasia. Let us consider these forms:
- Varicose veins lateral veins sometimes as an independent disease, and in combination with other pathologies. Reverse venous reflux of the liquid occurs in a deep vein via the saphenous and surrounding vessels.
- Mesh (reticular form) is manifested as an independent disease. Does not lead to venous insufficiency, represents only a cosmetic defect.
- Telangiectasia varicose veins are also a cosmetic defect.
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. The clinical manifestations of the pathology do not differ from the classical clinic.
Stage and extent of the varicose veins
Varicose veins on the leg varies depending on stage and extent. To establish their account of the clinic of the patient. Chronic disease is of several stages, which have some differences:
|Compensation||Pain syndrome weakly expressed or not. Patients complain of discomfort in the legs due to prolonged standing. It is noted the presence of spider veins on the skin, occasionally manifested by swelling of the ankle, passes quickly after the holidays.|
|Subcompensation||Visual inspection of the lower extremities of the patient visible veins with abnormal clearance. Patients have a lot of complaints. In particular, they complain of persistent pain expander nature, fatigue, heaviness in the legs. Often at night there are twitching of the muscles, "run 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. Identifies changes in the skin. He becomes overly dry, hair fall out on my feet. In addition, there is a hyperpigmentation, which leads to abnormal thickening of the subcutaneous tissue. Cracks and scratches on my legs heal for a long time that can turn into sores. Swollen legs constantly, rest and sleep do not help. Swelling tend to rise higher on the legs.|
When a girl or a guy come to the doctor with complaints of the described symptoms, the doctor conducts a visual examination, prescribes laboratory and instrumental diagnostics methods. On the basis of the received results speak about forms, stages and degrees of pathology.
The degree of varicose veins of the legs are defined by numbers. Zero (0) – clinic not detected, external changes do not exist; I – the puffiness, the tiredness of limbs; II – constant swelling accompanied by hyperpigmentation, abnormal seal subcutaneous tissue; III – pain that is swelling of the legs, trophic ulcers.
Complications of venous insufficiency
Varicose veins – an incurable chronic disease, so treatment pursues goal is to stop the progression and prevent complications. If treatment is incorrectly assigned or the patient turns for help to a medical professional, develop complications of the disease.
Thrombophlebitis – inflammation of the vein 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. Can be acute (lasts about 30 days), subacute – duration up to six months and chronic.
Migratory thrombophlebitis is rare. It is characterized by the inflammation which occurs in different parts of Vienna quickly.
- Visually there is a clear outline of the inflamed vessel.
- Acute pain, on palpation the pain is getting stronger.
- Swollen nodules that protrude above the skin.
- The local temperature increase.
Thrombophlebitis with varicose veins of the legs can lead to other complications. For example, periphlebitis is an inflammation of the surrounding tissues, wet gangrene of the extremities, deep vein thrombosis. In the propagation of inflammation found complications that go beyond the extremity – embolism and sepsis.
Deep vein thrombosis is a common complication of varicose veins of the legs. The pathology is characterized by the formation of a dense clot which completely or partially occludes the blood vessel that disrupts the blood circulation fully. In this complication there is a risk of death due to detachment of the thrombus.
Trophic ulcers appear in severe cases. Often joins infectious process that complicates the clinical picture. Wounds can affect not only the tissue but also deeper layers of the muscles. Take time to heal. Need complex treatment.
Varicose eczema is characterized by such symptoms:
- Inflammatory hyperpigmentation of the skin purple or bright red in color;
- Microvesicles are formed, which are independently opened;
- Severe swelling of the legs;
- Itching, which is observed constantly;
- Moisture that after drying crusts;
- Abnormal thickening of the skin.
Varicose eczema may go into a chronic course, resulting in a manifest hardening of the skin and subcutaneous tissue.
Upon accession infection eczema complicated by trophic ulcers.
Conservative treatment of varicose veins of the legs
Conservative treatment of varicose veins involves both medication and wearing compression underwear. Compression stockings of different compression class and the purpose is for the prevention and treatment of diseases. Tights, stockings and socks should choose a doctor based on specific characteristics. Just the right underwear gives the desired result.
Prescribed drugs. Perfect effective of the medicines that 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.
Additionally prescribed physiotherapy – magnetotherapy, electrophoresis; special exercises. You can use folk remedies – recipes with medicinal herbs can help to 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 that glues the affected vessel. Over time it is replaced through connective tissue.
Radiofrequency ablation. While surgery is the "welding" of the blood vessel (patient) with a probe, which radiates the waves. The probe heats the walls, which leads to stenosis. After the intervention some time need to wear compression underwear.
The choice of the method of the patient by surgery depends on many criteria. The doctor takes into account the stage of the disease, the health of the patient, presence of chronic diseases which can be a contraindication to the use of the intervention.
Other types of surgical treatment:
- Phlebectomy the doctor removes the affected veins and vessels. Through a small puncture of the skin injected with a hook tool, which pulls the vessel. This technique is a combined use of surgical intervention and the use of the laser.
- The most effective way of treatment is considered laser coagulation of the veins of the lower extremities. The technique of the operation is performed with minimal incisions and injuries. Through a small incision in the skin into the vessel is injected with a fine transaction, which radiates waves of desired frequency. In the zone of influence of heating observed. The walls are fused, which allows to attack the problem.
The Stripping is performed using a small probe that is inserted through the incision and glue the affected part of the vein. Cryostripping in the pathological vessel, liquid nitrogen is introduced, which leads to the degradation region, followed by a not function.
Preventive measures are of great importance. A favorable prognosis depends on the proper prescription and treatment, and patient – that he needs to change his 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. Even after surgery need constant physical activity, but without excessive stress on the body.
During sleep it is recommended that the legs be given the raised position. To do this, the limb placed on a pillow or folded blanket. If the work involves constant 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 in All patients need to choose comfortable shoes, to abandon the clothes, which puts pressure on the limbs.
Varicose veins – a serious disease that requires multifaceted treatment approach. Only complex impact consisting of drugs, compression garments, physiotherapy, physical activity and proper nutrition will lead to a positive outcome and sustained remission.