Treatment of varicose veins

Varicose veins are a disease accompanied by a thinning of the vein wall, an increase in the diameter of the lumen of the veins and the formation of nodular dilations resembling aneurysms. Any vein can be involved, but it is most often diagnosed in the lower extremities. The treatment of varicose veins includes drug therapy and surgical methods. Lack of treatment increases the risk of dangerous complications.

Causes of varicose veins

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

• genetic predisposition. If one of the parents had 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 dilation 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, and the elasticity of the vascular wall also changes.
• Wearing high-heeled shoes, which disrupts the contractility of the calf muscle involved in moving blood through the veins (the so-called "muscle pump").
• Poor nutrition (in particular, a lack of fiber) leads to constipation, which causes increased pressure in the vessels of the small pelvis and lower extremities.
• 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, then in men, as a rule, the disease makes itself felt after 40 years. The vessels of the legs are more often affected. The treatment of varicose veins of the lower extremities in both sexes is practically the same.

Symptoms of varicose veins of the lower limbs

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. Dilated veins are revealed on 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 scars.
• 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 tissues, especially pronounced in the evening, passing after a short rest.
• Feeling of pain.
• Characteristic heaviness in the legs.
• Night cramps in the calf muscles.
• Burning sensation along the path of the vein.

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

At 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 3-4 class of pathology. Over time, the clinic increases and the severity of symptoms of venous insufficiency increases:

• Increased tissue swelling. It is localized mainly in the calf muscles. Like the pain, the swelling occurs in the afternoon and subsides after a night's rest. It is important to distinguish edema of the calf muscles from swelling of the tissues of the foot. The latter indicates violations of the outflow of lymph.
• Itchy skin. It is noted along the vessels.
• Visual changes on the skin in the form of tortuous veins, the presence of extensions.
• Changes in the skin as a result of circulatory disorders. There is cyanosis, thickening of tissues, possible darkening.

In the absence of therapy, the clinic is supplemented by signs of tissue malnutrition, the appearance of trophic ulcers, eczema, etc. Violation of the venous valves can lead to the following complications:

• Thrombophlebitis. It is characterized by the formation of blood clots. Without help, the condition is life-threatening.
• Venous thrombosis. Occurs with blockage of the ship. It is manifested by intense pain, aggravated during physical activity.
• Pulmonary embolism. Occurs as a result of the separation of a blood clot. With its small size, it is possible to develop pneumonia, or chronic heart failure.
• Trophic ulcers. The first signs are thickening of the tissues 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 treatment.

Diagnosis of the disease

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

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

During ultrasound, angioscanning is performed, which makes it possible to assess the condition of the 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 event that the listed 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 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 turn 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 removal of varicose veins.

Treatment methods are determined based on the results of the examination. At the initial stages, it is possible to use both general and local drugs. When drugs 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 for 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 a normalization of hematopoiesis.

The use of antiplatelet agents and anticoagulants 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 they are not allowed to be used.

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:

• Flax 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 from the knits, 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:

• Radiofrequency obliteration, which allows you to restore the structure of blood vessels.
• Laser coagulation, during which the affected areas are affected with a laser.
• Varadi technique with complete ablation of the affected vessel.
• The Venaseal technique, thanks to which the valves of the veins stick together.
• Sclerotherapy, which allows you to "glue" the 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 avoid recurrences. Some patients use drug therapy all their life and wear compression stockings. Pathology can be prevented as follows:

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

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