Treatment of varicose veins

Varicose veins are a disease associated with thinning of the venous wall, increase in the diameter of the lumen of the veins and the formation of nodular expansions similar to aneurysms. Any vein can be involved, but it is most 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 underlying cause of the disease is not fully understood. We can only mention provocative factors that increase the risk of developing the pathology:

• genetic predisposition. If one of the parents had a disease, then it can develop in the children.
• long static loads. Working on your feet 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 extremities increases, as well as the elasticity of the vascular wall changes.
• Wearing high-heeled shoes, which disrupts the contractility of the calf muscles involved in the movement of blood through the veins (the so-called "muscle pump").
• Improper nutrition (in particular lack of fiber) leading 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 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 classes:

• C0. There are no signs of damage to blood vessels, but the patient complains of varicose veins.
• C1. Dilation of small superficial veins is noted.
• C2. Varicose veins are detected during visual examination.
• C3. The patient complains of tissue swelling, pain, excessive fatigue after a day's work.
• C4. The first symptoms of trophic disorders are determined visually.
• C5. Trophic changes appear, but ulcers heal. There may be scarring.
• 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 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 importance in walking.
• Nocturnal cramps in calf muscles.
• Burning sensation along the course of the vein.

Pain is especially important. It never radiates to the thigh or heel, but is always noticed in the location of the affected vein and has a painful character. Often the sensations are exhausting, preventing sleep. After sleep, 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 is already a grade 3-4 pathology. Over time, the clinic grows and the severity of the symptoms of venous insufficiency increases:

• Increased tissue swelling. It is mainly located in the calf muscles. Like the pain, the swelling appears 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 tissues. The latter indicates a violation of lymph flow.
• Itchy skin. It is observed along the vessels.
• Visual changes in the skin in the form of twisted veins, the presence of protrusions.
• Skin changes as a result of blood circulation disorders. There is cyanosis, tissue thickening, darkening is possible.

In the absence of therapy, the clinic is filled with signs of tissue malnutrition, the appearance of trophic ulcers, eczema, etc. 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 with clogging of the container. Appears with strong pain, aggravated during physical activity.
• Pulmonary embolism. It occurs as a result of the breakdown of a blood clot. With its small size, it is possible to develop pneumonia, or chronic heart failure.
• Trophic ulcer. The first signs are thickening of the tissue over the affected vein. Further, the tissues become thinner, an ulcer appears. The focus does not heal for a long time and does not respond to therapy.

Diagnosis of the disease

Regardless of 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 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, the angioscan is performed, which allows the assessment of the condition of the blood vessel wall, as well as the direction of the 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 listed methods do not give an exhaustive answer, CT is prescribed. If thrombosis, angiodysplasia and damage to the veins of the small pelvis is suspected, radiopaque phlebography is prescribed.

Treatment of varicose veins in the legs

A phlebologist is engaged in the diagnosis and treatment of pathology. It is precisely this specialist that you should contact 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 is engaged in 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 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 phlebotonics 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 agents and anticoagulants is allowed. They are indicated in a 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 marked violation of blood viscosity, but with the risk of bleeding, they are not allowed to be used.

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

• Linen puts pressure on affected varicose veins and deep vessels.
• In the lower part of the legs, vessels experience the most pronounced pressure of knitted clothing, which eliminates overload.
• 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, surgery is prescribed. Indications for its implementation are the following conditions:

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

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

• Radiofrequency ablation, 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 are glued together.
• Sclerotherapy, which allows you to "glue" vessels 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 throughout their lives and wear compression stockings. Pathology can be prevented as follows:

• Refuse to drag things out.
• Wearing shoes with medium heels.
• Complete nutrition.
• Weight control.
• Normalization of the drinking regime.
• Active recreation, swimming, cycling.
• Rejection of bad habits.

Compliance with preventive measures and an attentive attitude to 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 formation of complications.