From this article you will learn: what is varicose veins on the legs, what are the main external signs of pathology. Causes, symptoms and possible complications. Methods of treatment of the disease.
- More articles on the mechanism of the pathology
- Causes of the disease
- Symptoms
- Possible complications
- Conservative and surgical treatment
- Forecast
Varicose veins on the legs are called chronic vascular pathology, as a result of which deformations( lengthening, expansion) develop.vessels and insufficiency of intravascular valves.
Click on the photo to enlarge What happens in pathology? Normal blood supply of the limbs provides a whole system of blood vessels( deep and superficial).Blood from the heart to the extremities comes easily( from top to bottom), reverse current( from the bottom to the top) provide a contraction of the heart and a system of venous valves that "lock" the fluid between the contractions, preventing it from moving in the opposite direction.
For various reasons( hereditary predisposition, excess weight during pregnancy, hormonal failure), the venous walls are stretched, deformed, lose elasticity, the lumen of the vessel in this place increases. This entails inadequate closure of nearby valves, blood flow disorders, blood stasis. Because of stagnant phenomena, deformation with time is aggravated more and more, a varicose node, a loop, a bend of the superficial veins of the foot are formed.
At the initial stages, the pathology proceeds asymptomatically or gives itself out by the appearance of a so-called reticular pattern( in the form of a fine mesh), vascular asterisks of blue-violet color, clearly visible through the skin. With such manifestations, the disease is considered harmless, does not worsen the prognosis, does not complicate the patient's life in any way.
The late stages of varicose veins on the legs are dangerous for their complications. Because of the violation of the permeability of the vascular wall and the appearance of obstructions on the way of blood flow in the damaged veins, thrombi begin to form, which eventually cover the lumen of the vessel. Develops thrombophlebitis( inflammation of the vessel blocked by a thrombus), blood supply of adjacent tissues is disturbed, which leads to necrosis of skin areas and the formation of trophic ulcers. At this stage, the disease severely limits the motor activity of the patient and temporarily worsens the quality of life( the trophic ulcer heals about 3 months).
Varicose veins can not be cured completely. Surgical methods can achieve a long lasting effect and the disappearance of superficial deformed veins, but over time the disease may appear again( in 80% of cases this occurs).
Patients with varicose veins on their legs are treated and observed by a phlebologist, operated by angio-surgeons.
Another couple of words about the mechanism of the development of pathology
Varicosity appears not only because of the weakness of the vascular walls and the lack of venous valves. The third acting link in the system of blood flow from the bottom up( from the limbs to the heart) is the muscle contractions of the lower legs and thighs, or the muscular pump.
Normally, these contractions lightly squeeze the vessels, ensuring blood flow through the vessels from the lower leg and thigh to the small pelvis.
When the muscle is weakened or relaxed( hypodynamia, sedentary lifestyle), the muscle pump does not work efficiently, the blood supply to the small pelvis slows down, the pressure in the deep vessels increases, and under its influence the blood enters the superficial veins.
In combination with valvular insufficiency and weakness of the vascular walls, weakening of the muscular pump creates a favorable ground for the development of varicose veins.
Causes of pathology
The main causes of varicose veins on the legs:
- Hereditary predisposition.
- Weakness of the vascular walls and valve apparatus.
Possible causes of the onset of varicose veins The following diseases and conditions contribute to the weakening of the vessel wall and valvular insufficiency:
- hormonal changes( in pregnancy, menopause);
- weight lifting;
- the load on the lower limbs, caused by excess weight( with obesity);
- inactivity;
- chronic inflammatory processes( pyelonephritis, rheumatism);
- chronic liver disease( hepatitis, cirrhosis);
- metabolic disorders( hyperlipidemia);
- trauma and compression( compression) of the lower limbs;
- reception of hormonal contraceptives;
- increased intra-abdominal pressure( swelling of the abdominal cavity organs).
Factors that increase the likelihood of the appearance of varicose veins are age( in 60% of the disease appears after 45 years) and sex( in men it is 2 times less likely than in women).
Characteristic symptoms
Varicose veins have several characteristic external features.
| Degrees of varicose | Symptoms |
|---|---|
| 1 degree | A thin vascular pattern( reticular) appears, blue-violet stars that are clearly visible through the skin but not protruding from the surface |
| 2 degree | Appear enlarged swollen veins, small nodules |
| 3 degree | Appearseverely deformed, convoluted veins and nodes that are clearly visible through the skin and protruding above the surface |
| 4-6 degree | These varicose degrees are characterized by an increase in the number of deformed veins,it stains pigmentation, dryness and dermatitis( inflammation of skin), the formation of extensive areas of necrosis and trophic ulcers |
Degrees varices. Click on the photo to enlarge In the early stages( reticular pattern, spider veins) the disease proceeds almost asymptomatically, any manifestations of varicose are similar to elementary fatigue after a hard day( legs "buzz", but are quickly restored).
At this time, there is no need to restrict physical activity or regular exercise. The only contraindication is weight training and weight lifting.
In case of varicose in the late stages, there are severe symptoms - there are pains in walking, swelling, fatigue, this forces the patient to limit daily motor activity, to give up excessive loads, prolonged standing on the legs, active sports.
The occurrence of complications of varicose veins( thrombophlebitis and trophic ulcers) causes temporary disability, since at this stage any physical effort can result in rupture of the vessel and profuse venous bleeding.
Symptoms characteristic of varicose veins of the lower extremities:
- heaviness in the legs by the end of the day;
- puffiness, which intensifies toward evening and falls to the morning( after a rest period);
- convulsions at night;
- raspiruyuschaya and throbbing pain;
- itching, burning, dry skin;
- fatigue.
Over time, the puffiness does not drop completely even after a long rest, which is due to violations of hemodynamics( blood flow), lymph flow( movement of lymph) and metabolism as a result of prolonged oxygen starvation of tissues.
Possible complications of
In 30% of cases, varicose is complicated by development:
- Venous bleeding. Normal connective tissue of the vascular walls gradually changes its properties, becomes fragile, inelastic, can burst from any physical effort( even from coughing or sneezing).
- Dermatitis and eczema, which develop due to disorders of blood supply, prolonged oxygen starvation. On the skin appear a small itchy rash, wet bubbles, crusts, dry scales and peeling.
- Treatment of varicose veins on the legs in 17% complicates the appearance of thrombophlebitis. Because of the bends, knots and deformities, the blood flow damages the vascular walls, provoking the formation of thrombi that cover the lumen of the vessel, increasing the disturbances in the blood supply of the adjacent tissues. This process is combined with inflammation of the vascular wall, reddening of the skin, hardening of the tissues, pain, development of local and general temperature.
- Thrombosis. The process is characterized by the formation of deep vein thrombi, oxygen starvation of tissues is manifested by the appearance of persistent edema, painful sensations. At any physical exertion, the performance of elementary household activities remains a threat of separation of thrombus and death as a result of thromboembolism( blockage of the pulmonary artery).The presence of thrombosis is a lifelong limitation of motor activity for the patient. Necrosis and trophic ulcers. The process develops against the background of thrombophlebitis, due to metabolic disturbances and prolonged oxygen starvation of tissues, for the blood supply of which the inflamed varicose vessel responds. On the surface of the skin, small areas of dying cells form. Over time, their number increases, turning into large necrotic ulcers, which are very poorly healed( from 3 months).
The development of thrombosis and thrombus rupture. Closure of thrombus in thrombosis can trigger not only pulmonary embolism, but also blockage of any vital vessels and cause circulatory and breathing disorders that are life-threatening. Conservative and surgical treatment of
It is impossible to get rid of varicose completely if it has already appeared - deformed vessels do not take the same shape under any circumstances. Surgical methods remove superficial veins, but they will not relieve deformations of deep veins( they are difficult to diagnose).After any surgery, there is a chance( high - 80%) that varicose veins will eventually reappear.
The combination of methods of treatment and prevention helps to stop the development of the process and prevent the emergence of complications, however it will be necessary to examine and consult a phlebologist for a lifetime.
Drug therapy
Drug therapy is prescribed starting from the 2nd degree of the disease. Its goal:
- to reduce blood viscosity and vascular wall permeability;
- improve elasticity and vascular regeneration;
- strengthen the metabolism and nutrition of underlying tissues;
- prevent blood clots and inflammation;
- to remove unpleasant symptoms( pain, heaviness, itching).
Than to treat varicose veins:
| Group preparations | name | drug action that they have |
|---|---|---|
| Anticoagulants | Aspirin | blood thinning |
| Antiagreganty | Kurantil | prevents formation of blood clots, improve blood circulation and tissue repair |
| venotoniki | Detraleks, flebodia | improves the elasticity of the vascularwalls, have anti-inflammatory and lymphatic drainage action( provide lymph drainage, relieve edema) |
| Non-steroidal anti-ospalitelnye preparations | Diclofenac | relieves inflammation |
| Correctors metabolism | Preductal | improves metabolism and tissue repair |
In combination with medicinal tablets, external ointments and gels are used, which include moisturizing, anti-inflammatory, vascular toning substances: lyoton-gel, troxerutin, heparin ointment, aescin, ointments based on plant extracts( chestnut).
Minimally invasive and surgical methods of treatment
Surgical treatment of varicose veins is indicated in stages when the disease:
- worsens the quality of life of the patient and threatens the development of complications( with severe symptoms, extensive lesions);
- when a cosmetic correction of a deficiency( reticular mesh in the early stages) is needed.
| The name of the procedure | When the | is used How |
|---|---|---|
| is performed How to perform | ||
| Laser coagulation | For the treatment of leg varicose in the initial stages( asterisks, capillary and vascular reticulum) | The affected vessels are laser treated, sealed from the inside, excluding them from the circulatory system |
| Sclerotherapy | To eliminate nodes and varicose veinsveins of medium size( the perimeter of the vein should not exceed 2 cm). | A special sclerosing drug is introduced into the vein channel, which stimulates gluing and gradual withering away painoh veins. Preliminary vessel is excluded from the blood supply system( it is cut off and bandaged at the cut-off location) |
| Phlebectomy | Assigned to eliminate extensive foci of varicose veins | Varicose veins completely removed through small incisions or punctures( usually in the groin) |
Methods for treating varicose disease After surgery or minimally invasive methodstreatment of varicose patients need:
- Take a set of drugs recommended by a phlebologist.
- Adhere to a healthy lifestyle( normalize weight).
- To regulate the diet, introducing in the diet products that improve the condition of the vessels( vegetables and fruits rich in vitamin C, low-cholesterol diet).
- If possible, eliminate hypodynamia( for this purpose with varicose legs suitable for swimming).
After phlebectomy, the patient until the end of life is registered with a phlebologist.
Forecast
Varicose veins on the legs are a disease that can be treated for years, even after surgical removal in 80% it appears again.
The prognosis depends on the stage at which the treatment is started. The complex of preventive measures in the early stages( treatment of varicose veins with a course 2 times a year and a healthy lifestyle) allows to suspend the further development of the disease. Adhere to strict limits of prevention will have a lifetime.
In the late stages( with the appearance of severe deformity, knots, edema and signs of oxygen starvation of tissues), the prognosis determines the presence of concomitant diseases( diabetes, obesity) and the patient's readiness to follow the doctor's recommendations( to be examined, to take medicine, to lose weight).
In diabetes mellitus, complications of varicose veins( thrombophlebitis, trophic ulcers) develop in 89%.
Varicosis is considered a life-threatening disease, but its complications can greatly impair the quality of life and prognosis. When deep vein thrombosis from thromboembolism, about 50% of patients die within 3 months.
