Treatment of varicose veins

Varicose veins are a disease accompanied by thinning of the venous wall, an increase in the diameter of the lumen of the veins and the formation of aneurysm-like nodular expansions. 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 main cause of the disease is not fully understood. We can only point to 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 an upright 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 small pelvis and lower limbs increases, and the elasticity of the vascular wall also changes.
• Wearing high-heeled shoes, which disrupts the contractility of the calf muscle involved in the movement of blood through the veins (the so-called "muscle pump").
• Improper nutrition (especially the lack of fiber), which leads to constipation, which leads to an increase in pressure in the vessels of the small pelvis and lower limbs.
• Bad habits.
• Hormonal imbalance.

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 more often affected. The treatment of varicose veins of the lower limbs 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 the small superficial veins is noted.
• C2. A visual examination reveals varicose veins.
• 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 the 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 chronic disease.

The first symptoms can be called:

• Increased leg fatigue.
• Swelling of the tissues, especially pronounced in the evening, passing after a short rest.
• Painful sensations.
• Characteristic heaviness in the legs.
• Nocturnal cramps in the calf muscles.
• Burning sensation along the course of the vein.

Pain is particularly significant. It never radiates to the thigh or heel, but is always noted at the site of the affected vein and is painful in nature. Often the sensations are exhausting, they interfere with sleep. After sleep, the pain subsides.

In the initial stage, there are no signs of damage to the saphenous vein, but changes are already occurring. The process can take several years, so the treatment of varicose veins often begins when there is already 3-4 grade pathology. Over time, the clinic increases and the severity of the symptoms of venous insufficiency increases:

• Increase in tissue swelling. It is mainly localized 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 swelling of the calf muscles from swelling of the tissues of the foot. The latter indicates disorders of the outflow of lymph.
• Itchy skin. It is noted along the length of the vessels.
• Visual changes on the skin in the form of curved veins, presence of expansions.
• Skin changes as a result of impaired blood circulation. There is cyanosis, thickening of tissues, darkening is possible.

In the absence of therapy, the clinic is supplemented by 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. It occurs when the vessel is blocked. It manifests itself with severe pain that worsens during physical activity.
• Pulmonary embolism. It occurs as a result of the release of a blood clot. Due to its small size, the development of pneumonia or chronic heart failure is possible.
• Trophic ulcers. The first signs are thickening of the tissues above the affected vein. In addition, the tissues thin out, an ulcer appears. The focus does not heal for a long time and does not respond to therapy.

Diagnosis of the disease

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 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.

When performing an ultrasound, angioscanning is performed, which allows assessing 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 a comprehensive answer, CT is prescribed. If thrombosis, angiodysplasia, and damage to the veins of the small pelvis are suspected, X-ray contrast phlebography is prescribed.

Treatment of varicose veins of the legs

The phlebologist deals with the diagnosis and treatment of pathology. It is to 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 deals with the elimination of varicose veins.

Treatment methods are determined based on the results of the study. In the initial stages, it is possible to use general and local drugs. When drugs do not work, surgery is prescribed.

Conservative treatment

The main drugs are venotonics (phlebotonics). It is 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 reduction in edema and normalization of hematopoiesis.

The use of antiaggregants and anticoagulants is permitted. They are indicated at 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. Means are used for a pronounced violation of blood viscosity, but with a risk of bleeding, they cannot be used.

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

• Underwear puts pressure on the affected varicose veins and deep vessels.
• In the lower part of the legs, the vessels experience the most pronounced pressure of knitwear, 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 swelling and pain decreases.

Methods of surgical treatment of varicose veins

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

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

Effective treatment of varicose veins is possible through 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.
• 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 recurrence. Some patients use drug therapy throughout their lives and wear compression stockings. Pathology can be prevented as follows:

• Refuse to drag things.
• Wear shoes with a medium heel.
• Complete nutrition.
• Weight control.
• Normalization of the drinking regime.
• Active recreation, swimming, cycling.
• Giving up bad habits.

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