Varicose veins

Varicose veins are changes in the leg veins, their shape, structure and functionality.

Varicose veins (VVs) most commonly occur in the legs. This is the "reward" for an upright posture, namely the load on the veins of the lower extremities is very high, so dilatation or expansion often occurs.

In the ICD, the disease is coded 183, it is widespread worldwide and occurs everywhere in all countries.

Enlarged veins in the legs with varicose veins

General information

The pathology is the most common, the incidence is 60% in the adult population. In most cases, varicose veins on the legs are not noticed in the initial stages because there are no clinical manifestations yet.

causes

A single specific cause of leg vein disease is unknown, but doctors identify risk factors or situations that create favorable conditions for varicose veins:

Causes of varicose veins particularities

Genetic predisposition

The disease is often inherited from close relatives. The basis is usually a mutation of genes that are responsible for the consistency of the vessel wall. Mutated genes cannot function normally and the tone of the venous wall decreases, it becomes "weak" and stretches, which in turn leads to the development of valve insufficiency and the appearance of reverse blood flow in the veins. Without treatment and prevention, varicose veins "sink" deeper andKnots and lumps gradually form.

Old

The older the person is, the higher the likelihood of developing the disease.

Female

Men get sick much less often.

obesity

A sedentary lifestyle and the accumulation of visceral fat affect the walls of blood vessels.

When there is a hormonal imbalance, there is a decrease in the tone of the venous network. Experts are sure that the etiological factor in most cases is a violation of venous outflow in the lower extremities.

How the disease develops

The most important thing in the development of this pathology is a change in the condition and functional activity of the veins. The "rupture" damages the walls of blood vessels and valves - resulting in reflux, which in turn "stretches" the veins even more and worsens their condition.

As the pathology develops, connective tissue grows in the muscular layer of the vein, after which it atrophies and the collagen framework of the vessel is destroyed. The vessels lose their elasticity, the function of the valves is disrupted and blood circulation becomes even worse. The veins continue to swell and look swollen.

Signs of varicose veins

The first symptoms can be overlooked - few of us pay attention to the doughy and heavy legs, especially in the evening after work. Since the veins are not yet visually visible, people rarely see a doctor at this stage. Although no treatment is required at this stage, all you can do is change your lifestyle and thereby slow down the development of the pathological process. Varicose veins on the legs can manifest themselves as:

  1. Color change.Occurs as the disease progresses. The skin over the veins may change characteristics, including color. Blue veins with a tortuous shape can also attract attention and cause aesthetic discomfort.
  2. Rashes.Some patients may experience itchy blisters, nodules, and redness on the legs. These symptoms may disappear on their own after a long night's sleep in a horizontal position.
  3. Chronic form.If the signs do not disappear even after a night's sleep, this may indicate chronic venous insufficiency and a serious stage of the disease. Patients may also complain of pain in the calf muscles and increased leg fatigue.

Trophic disorders are a consequence of the disease progression without treatment, which often lasts years and decades. They start with skin symptoms:

  • Hyperpigmentation – the appearance of brown spots,
  • venous eczema and lipodermatosclerosis, i. e. thickening of the skin.

It is important to note that lower extremity venous disease can worsen with decreasing physical activity, such as when a person stands or sits for long periods of time during the workday. However, with active movements, such as walking, the symptoms subside. Wearing compression stockings and lying in a horizontal position provides further relief.

Burning or tingling, cramps in the calf muscles or restless leg syndrome (unpleasant sensations in the legs at rest when the body literally asks them to move to eliminate this discomfort) - in most cases it is always the casenor about neurological symptoms and accompanying pathologies such as radicular syndrome.

Take note!The intensity of discomfort and unpleasant symptoms can be periodic: venous problems are more pronounced in the warm season or during menstruation in women.

Complications due to altered veins in the legs

As the disease progresses, microcirculation and metabolic processes are disrupted to such an extent that trophic ulcers can form or even thrombosis of damaged veins and bleeding from varicose vein nodes.

Diseases of the leg veins are associated with thrombophlebitis, which can cause pulmonary embolism. Bleeding from the affected veins leads to large blood losses and anemia.

Which doctors should I contact?

If veins protrude on the legs and feet, this is a reason to see a specialist. Most often, patients turn to a surgeon. If concomitant illnesses are identified, a visit to a cardiologist, phlebologist, endocrinologist or therapist is necessary.

Diagnosis of the disease

Making the diagnosis usually does not cause any difficulties. The doctor initially relies on the patient's complaints and examination data. When taking an anamnesis, attention is drawn to swelling and heaviness in the legs; upon examination, the doctor will see dark, tortuous veins and, in severe cases, bumps and bumps.

To confirm the diagnosis, instrumental research methods are prescribed, the main and leading of which is ultrasound duplex scanning, or USDS for short. This allows you to quickly, accurately and effectively determine the cause of varicose veins, assess the structure and condition of the vessel, the functional characteristics of the venous valves, the presence/absence of blood clots and the extent of reverse blood flow.

During the ultrasound examination, the specialist examines both the deep and superficial venous system.

To assess valve function and the extent of reflux, the following may be performed:

  • Compression tests – pressing on various parts of the legs of the lower extremities;
  • stress test;
  • Reaction to taking Paran.

Based on the results of the study, the specialist creates a special "venous map", which he needs to consider treatment tactics.

If additional examination methods are required, the doctor may also prescribe: Doppler ultrasound, phlebography with contrast agent, CT or MRI, thermography, intravascular ultrasound (IVUS).

Sclerotherapy is a procedure to eliminate varicose veins

What to do

If the veins in your leg are swollen, you must follow a specific diet prescribed by your doctor. Physical activity should be moderate, shock loads should be avoided, massages, baths, saunas are contraindicated. To improve blood circulation and train the vein walls, contrast baths are recommended.

Treatment of varicose veins

The main goal of therapy is to eliminate any veins that are no longer functioning properly. In fact, this is possible with the help of invasive procedures: removal, sclerosis and obliteration. This helps eliminate the cause, and not just the unpleasant symptoms. Treatment methods for varicose veins are selected by doctors based on the clinical picture.

distance

Removal of varicose veins is the oldest and, for a long time, the only effective way to get rid of varicose veins. First, the doctor stops the anastomosis, i. e. the connection between the common saphenous vein and the great saphenous vein, and then removes the affected vein.

This helps to cure the disease, but this method has its disadvantages – the need for anesthesia, a long recovery time, the presence of incisions and stitches.

Endovenous laser or radiofrequency obliteration

During the procedure, the affected veins are "brewed", after which they stop functioning and gradually dissolve. This procedure allows you to quickly and safely remove varicose veins without cuts or scars. Obliteration is called "office surgery". It is assumed that a person can undergo treatment quickly and safely during their lunch break and then return to work.

Sclerotherapy

"Gluing" or mechanochemical obliteration is a procedure in which the doctor uses a thin needle to inject a special solution, a sclerosant, into the damaged vein. This substance glues the vessel walls and separates them from the bloodstream, and over time such a vein disappearscomplete.

The drug is harmless to health and remains in the place where it was administered without spreading throughout the body.

Take note!After the procedure, elastic compression is applied and the patient is recommended to actively walk and warm up for an hour. The bandages are not removed for 10-14 days, after which the use of compression stockings is recommended.

FAQ

How do veins in the legs hurt and what are the symptoms?

Clinically, varicose veins on the feet and legs are manifested by pain in the calf muscles, a feeling of heaviness, cramps, itchy skin and doughy limbs in the evening.

Why do varicose veins develop and what do they look like?

In the early stages, varicose veins are not noticeable. Then dark veins become visible, curved, sometimes "branched". In a severe stage, you can see nodes and bumps, and if complications occur, you can also see trophic ulcers on the legs.

Why are venous diseases in the legs more common?

This is due to the fact that when working for a long time while sitting or standing, blood stagnation occurs in the vessels of the legs. If this situation lasts for a day or even a week, nothing bad will happen.

Expert opinion

Very often different people suffer from veins in their legs. This is because humans are upright walking creatures. We spend a lot of time on our feet or sitting in the office. This leads to poor blood circulation in the lower extremities and fluid retention. This, in turn, affects the veins and worsens their condition and functionality.

To cure varicose veins, you must contact a competent specialist. He conducts an examination and selects the most effective therapy to eliminate not only the symptoms, but also the root cause of the pathology.