Treatment of varicose veins

Varicose veins are a disease accompanied by thinning of the vein wall, an increase in the diameter of the vein lumen and the formation of nodular enlargements similar to aneurysms. 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 root cause of the disease is not fully understood. We can only list provoking factors that increase the risk of developing pathology:

• genetic predisposition. If one of the parents had the disease, then it can develop in the 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 pelvis and lower extremities increases, and the elasticity of the vascular wall changes.
• Wearing shoes with high heels, which disturb the contractility of calf muscles involved in the movement of blood through the veins (the so-called "muscle pump").
• Improper nutrition (especially lack of fiber) leads to constipation, which causes an increase in 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, then in men, as a rule, the disease is felt after 40 years. The blood vessels of the legs are more often affected. 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 veins is observed.
• C2. Varicose veins are revealed during a visual inspection.
• 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. Scarring may occur.
• C6. Trophic changes are pronounced, there are active ulcers.

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

The first symptoms can be called:

• Increased leg fatigue.
• Tissue swelling, especially pronounced in the evening, passes after a short rest.
• Feelings of pain.
• Characteristic weight in the legs.
• Nocturnal cramps in the calf muscles.
• A burning sensation along the course of the vein.

Pain is especially significant. It never radiates to the thigh or heel, but is always observed at the site of the affected vein and has a painful character. Often the feelings are exhausting, preventing sleep. After sleeping, the pain subsides.

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 are already 3-4 classes of pathology. Over time, the clinic increases, and the severity of the symptoms of venous insufficiency increases:

• Increase in tissue swelling. It is localized mainly in the calf muscles. Like the pain, the 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 foot tissue. The latter indicates a violation of lymph outflow.
• Itchy skin. It is noted along the vessels.
• Visual changes on the skin in the form of tortuous veins, the presence of enlargement.
• Skin changes as a result of circulatory disorders. There is cyanosis, tissue thickening, darkening is possible.

In the absence of therapy, the clinic is complemented by signs of tissue malnutrition, the appearance of trophic ulcers, eczema, and so on. Violation of 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 when a vessel is blocked. It is manifested by severe pain, which intensifies during physical activity.
• Pulmonary embolism. It occurs as a result of the separation of a blood clot. Due to its small size, it is possible to develop pneumonia, or chronic heart failure.
• Trophic ulcers. The first signs are thickening of the tissue above the affected vein. Furthermore, the tissues become thinner, an ulcer appears. The focus does not heal for a long time and does not respond to therapy.

Disease diagnosis

Despite the characteristic symptoms, it is impossible to make a diagnosis and start taking medication based only on the results of a visual examination.

Doppler imaging 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 by the blood cells.

During the ultrasound, angioscanning is performed, which enables the assessment of the condition of the blood vessel wall, as well as the direction of blood flow. The result will be a two-dimensional image of the veins with a reflection of the valves, possible blood clots.

In the case when the mentioned methods do not give an exhaustive answer, CT is prescribed. If thrombosis, angiodysplasia and damage to the veins of the small pelvis are suspected, radiopaque phlebography is prescribed.

Treatment of varicose veins on the legs

A phlebologist deals with the diagnosis and treatment of pathology. You should contact this specialist at the first signs of illness. 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. When medicines do not work, surgery is prescribed.

Conservative treatment

The main drugs are venotonics (phlebotonics). 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 tablets, you can also use local drugs with a similar effect. These are creams and gels. They have a pronounced effect, but the effect lasts a short time.

The action of phlebotonics is based on improving the elasticity of blood vessels, reducing wall permeability and removing congestion. Patients have reduction of edema and normalization of hematopoiesis.

The use of antiplatelet agents and anticoagulants is allowed. They are indicated for high risk of blood clots, as well as in their presence. Thanks to them, it is possible to destroy blood clots and reduce viscosity. Means are used for marked violation of blood viscosity, but with the risk of bleeding, they are not allowed to be used.

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

• The cloth puts pressure on the affected varicose veins and on the deep vessels.
• In the lower part of the legs, the vessels experience the most pronounced pressure of the knitwear, which eliminates congestion.
• The vessels are constantly in a compressed state, so the operation of the valve becomes more efficient.
• When you use underwear, the intensity of edema and pain decreases.

Methods of surgical treatment of varicose veins

In the absence of drug therapy effect, surgery is prescribed. Indications for its application are the following conditions:

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

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

• Radiofrequency 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.
• Venaseal technique, thanks to which the valves of the veins are connected.
• Sclerotherapy, which allows you to "glue" the veins from the inside.

Modern methods of treating varicose veins allow you to perform 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.

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 their entire lives. Pathology can be prevented as follows:

• Refusal to drag things.
• Wear shoes with a medium heel.
• 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 towards the body will help prevent the disease and detect deviations in time. Timely treatment of varicose veins eliminates the progression of the pathology and the creation of complications.