Treatment of varicose veins

Varicose veins is a disease accompanied by thinning of the vein wall, an increase in the diameter of the vein lumen and the formation of nodular dilatations such as aneurysms. Any vein can be involved, but is more often diagnosed in the lower leg. Treatment of varicose veins includes drug therapy and surgical methods. Lack of therapy increases the risk of dangerous complications.

Causes of varicose veins

The main cause of this disease is not fully understood. We can only name the provoking factors that increase the risk of developing pathology:

• genetic predisposition. If one of the parents has the disease, then it can develop in the child.
• long static load. 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 body weight, which leads to increased pressure in the vessels at the bottom of the leg.
• Pregnancy, in which the pressure in the vessels of the small pelvis and the lower part of the leg increases, and the elasticity of the vascular walls also changes.
• Wearing shoes with high heels, which interfere with the contraction of the calf muscles involved in moving blood through the veins (the so-called "muscle pump").
• Improper nutrition (in particular, lack of fiber) leads to constipation, which causes increased pressure in the small pelvic canal and the lower part of the legs.
• Bad habits.
• Hormonal imbalance.

This is a common cause 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 makes itself felt after 40 years. Leg vessels are more often involved. The treatment of varicose veins on the lower part of both sexes can be said to be the same.

Symptoms of varicose veins on the lower legs

Officially, the disease is divided into three stages:

1. Reparation.
2. Small compensation.
3. Decompensation.

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

• C0. There were no signs of vascular damage, but the patient complained of varicose veins.
• C1. Dilation of small superficial veins is observed.
• C2. Dilated veins are revealed during visual inspection.
• C3. Patients complain of tissue swelling, pain, excessive fatigue after a working day.
• C4. The first symptoms of trophic disorders are determined visually.
• C5. Trophic changes appeared, but the ulcer healed. There may be scars.
• C6. Trophic changes are pronounced, there are active ulcers.

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

The first symptoms can be called:

• Increased leg fatigue.
• Tissue swelling, especially pronounced in the evening, passes after a short rest.
• Sensation of pain.
• Characteristics of weight in the legs.
• Cramps at night in the calf muscles.
• Burning sensation along the vein.

The pain is very noticeable. It never radiates to the thigh or heel, but is always observed in the location of the affected vein and has a painful character. Often the sensation is exhausting, preventing sleep. After sleeping, the pain subsides.

In the early stages, there are no signs of damage to the saphenous vein, but changes have already occurred. This 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 improves and the severity of the symptoms of venous insufficiency increases:

• Increase 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 leg tissue. The latter indicates a violation of lymph outflow.
• Itchy skin. It is observed along the ship.
• Visual changes in the skin in the form of tortuous veins, the presence of connections.
• Skin changes due to circulatory disorders. There is cyanosis, tissue thickening, darkness is possible.

In the absence of therapy, the clinic is supplemented with signs of malnutrition, the appearance of trophic ulcers, eczema, etc. Violation of the venous valve can cause the following complications:

• Thrombophlebitis. It is characterized by the formation of blood clots. Without help, this condition is life-threatening.
• Venous thrombosis. Occurs with vessel blockage. It is manifested by severe pain, aggravated during physical activity.
• Pulmonary embolism. Occurs due to the separation of blood clots. With its small size, it is possible to develop pneumonia, or chronic heart failure.
• Trophic ulcer. The first signs are thickening of the tissue above the affected vein. Further, the tissue becomes thinner, ulcers appear. 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.

Dopplerography 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 sound signals reflected from blood cells.

When performing an ultrasound, angioscanning is performed, which allows assessing the condition of the vessel walls, as well as the direction of blood flow. The result will be a two-dimensional image of the vein with the reflection of the valve, a possible blood clot.

In cases where the listed methods do not provide a complete answer, CT is prescribed. If thrombosis, angiodysplasia and damage to small pelvic veins are suspected, radiopaque phlebography is prescribed.

Treatment of varicose veins in the legs

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

The treatment method is determined based on the results of the examination. In the early stages, it is possible to use general and local drugs. When medication is ineffective, surgery is prescribed.

Conservative treatment

The main drug is 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 use local drugs with the same effect. These are creams and gels. They have a noticeable effect, but the effect lasts a short time.

The action of phlebotonics is based on increasing the elasticity of blood vessels, reducing the permeability of the walls and eliminating congestion. The patient experienced a decrease in edema and normalization of hematopoiesis.

The use of antiplatelet agents and anticoagulants is allowed. They are shown 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. The funds are used for obvious violations of blood viscosity, but with the risk of bleeding, they are not allowed to be used.

In addition to the preparation, experts prescribe compression stockings. It can be an elastic bandage, socks, stockings, tights. The positive effects of its use are explained as follows:

• Linen puts pressure on the affected varicose veins and on the inner vessels.
• At the bottom of the leg, the ship experiences the most noticeable pressure of the knitwear, which eliminates congestion.
• The vessel is always in a compressed state, so valve operation becomes more efficient.
• When using underwear, the severity of edema and pain is reduced.

Methods of surgical treatment of varicose veins

If there is no effect of drug therapy, surgery is prescribed. Indications for its implementation are the following conditions:

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

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

• Radio frequency destruction, which allows you to restore the structure of blood vessels.
• Laser freezing, where the affected area is affected by the laser.
• Varadi technique with complete removal of the affected vessel.
• Venaseal technique, thanks to which the vein valves stick together.
• Sclerotherapy, which allows you to "glue" the vessel from the inside.

Modern methods of varicose vein treatment 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.

Prevention of pathology

Varicose veins are difficult to treat, and even after surgery, preventive measures must be taken to avoid recurrence. Some patients use drug therapy for the rest of their lives and wear compression stockings. Pathology can be prevented as follows:

• Reluctance to drag things.
• Wear shoes with moderate heels.
• Complete nutrition.
• Weight control.
• Normalization of drinking regime.
• Active recreation, swimming, cycling.
• Rejection of bad habits.

Compliance with preventive measures and a caring attitude towards the body will help prevent diseases and detect irregularities in time. Timely treatment of varicose veins eliminates the development of pathology and the formation of complications.