From this article you will learn about the risk factors, symptoms and principles of treating reticular varicose veins. This disease is included in the group of chronic diseases of veins. Its main feature is the defeat of small intradermal and subcutaneous venous vessels, leading to a noticeable cosmetic defect.
The reasons for the development of reticular varicose
Reticular varicose veins located in the reticular layer of the skin, manifested by their expansion and deformation. Often, the smaller vessels of the upper papillary layer of the skin are simultaneously affected, while forming telangiectasias - "vascular asterisks".In addition to an aesthetic defect, the disease can manifest itself with other symptoms that make it necessary to carry out active treatment.
Click on the picture to enlarge In varicose veins, in contrast to reticular varicose, larger subcutaneous vessels are affected. Reticular varicose proceeds more easily than varicose veins and has a more favorable prognosis. But with extensive damage, the disease creates serious aesthetic problems. In some cases, it can be complicated by intradermal hemorrhage and external bleeding.
The pathology is treated by a surgeon, a vascular surgeon or phlebologist. Conservative treatment may be prescribed. If necessary, minimally invasive interventions are used to resolve local manifestations of varicose veins. Completely cure the disease is not possible, because the changes are systemic. But it is possible to eliminate local cosmetic defects and stabilize the course of the disease, suspending its further progression.
Causes of development of reticular varicose
In the development of the disease, a significant role is played by heredity. In relatives, in most cases there is a lesion of small veins, "vascular sprouts", and sometimes the symptoms of varicose veins.
Thus, patients with reticular varicose have genetically predetermined features of venous vessels that promote the development of the disease under the action of triggers. What it is? Triggers are trigger factors triggering a pathological process. The following factors can provoke the disease or aggravate its course:
- long standing in a standing or sitting position during the day, related to the peculiarities of the work;
- intensive physical activity;
- rapid increase in body weight;
- pregnancy, childbirth;
- intensive sports;
- oral contraceptives, hormone replacement therapy.
The relationship between reticular varicose veins and varicose veins is still being discussed. Some experts consider changes in the reticular veins as the initial stage of the disease, after which the main subcutaneous vessels are involved in the process and the classical picture of varicose veins develops. But most studies have shown that there is no direct link between diseases. There are many cases of reticular varicosity with pronounced manifestations and a prolonged course of the process, which did not lead to the defeat of large subcutaneous venous vessels.
The ultrasound study found the anatomical features of the location of the large saphenous vein, in the presence of which the probability of developing varicose disease increases. Similar changes are not characteristic for reticular varicose veins and telangiectasias. As for the feedback: varicose veins - reticular varicose, this is quite possible. The prolonged existence of stagnation and reflux( blood flow in the opposite direction) in the main vessels can lead to the expansion of small subcutaneous and intradermal veins.
Symptoms of varicose veins of the reticular veins
Pathology is manifested by the widening, thinning of the walls, the tortuosity of the venous vessels. The diameter of the veins undergoing transformation is from 1 to 3 mm. Smaller veins are usually found in the upper papillate layer of the skin. Their expansion leads to the formation of telangiectasias. Because the causes of varicose transformation of the vessels of both layers of skin are similar, often reticular varicose and telangiectasia develop simultaneously.
Types of telangiectasias - vascular asterisks The most frequent variant of the disease is reticular varicose veins of the lower extremities. On clinical manifestations, it has a number of differences from varicose veins. For it, symptoms of venous congestion associated with prolonged vertical position are more typical. With the progression of varicose veins of the lower extremities, trophic disorders appear, the risk of thrombosis and thrombophlebitis increases. For reticular varicose, such manifestations of venous insufficiency are not characteristic.
Patients may not make any other complaints, except for aesthetic defects. The fine veins located close to the skin are clearly visible when viewed with the naked eye. Changes can be found on any part of the body, but most often they are observed in the lower extremities. Blue meandering small veins and even more delicate plexus of veins with telangiectasias are most often seen in the region of popliteal pits, on the back of the thigh and lower leg( almost in 100% of cases).
Somewhat less often the process is observed on the outer and inner surfaces of the thighs and lower legs, even less often the small venous vessels of the gluteal region, ankles and feet are affected. In approximately 30% of patients, veins are transformed on the shoulders, chest, face.
Many patients have symptoms of phlebopathy( lesions of venous vessels).In reticular varicose, as in varicose veins, the relationship of symptoms with prolonged stays on the legs or in the sitting position is traced. The degree of expression of phlebopathy is determined by evaluating the functionality of the venous system under the existing loads:
- The first degree is characterized by an episodic increase in severity after increased loads.
- If the severity at the end of the day is a constant concern, but does not require rest with raised legs, this lesion of the veins corresponds to the second severity level.
- At the third degree there is a need for rest with raised lower limbs.
There is still a zero degree in the absence of heaviness in the legs.
Symptoms of blood stagnation in the veins of the lower limbs are combined into a so-called "heavy foot syndrome".Complaints arise or intensify usually at the end of the day, as well as after a long walk or forced standing. This syndrome can have the following manifestations:
- feeling of heaviness in the lower limbs;
- increased fatigue;
- feeling of bursting and burning sensation in the legs at the end of the day;
- swelling of the feet, lower part of the shins in the evening;
- convulsions at night in the calf muscles;
- is a symptom of a "tight boot" when it becomes more difficult to fasten the boot top in the evening compared to the morning time.
In addition to the symptoms of phlebopathy, resulting from prolonged vertical position of the body, some patients show local symptoms in the zone of localization of the dilated veins. Complaints about burning sensation, impaired sensation, unpleasant sensations, itching affect about one in four patients with reticular varicose veins and telangiectasias.
Symptoms of phlebopathy Methods for treating
disease Patients with reticular varicosity are treated with conservative treatment and minimally invasive procedures. The need for conservative treatment in the presence of only a cosmetic defect and the absence of complaints of a different nature remains controversial.
In these cases, microsclerotherapy can be performed. In the course of this procedure, special substance - sclerosant - is introduced into the lumen of the enlarged veins by hypertensive needles. As a result, the veins subside, sclerose and disappear. Sclerosants can be used in the form of micro-foams, which ensure high effectiveness of the intervention in the shortest possible time( foam-form sclerotherapy).With the expansion of small veins, low-concentration sclerosing drugs are usually used.
Microsclerotherapy The basis for the appointment of microsclerotherapy:
- Bleeding from the enlarged veins is an absolute indication for the intervention.
- Local discomfort is a relative indication.
- Aesthetic defect - at the insistence of the patient.
Conducting conservative therapy is necessary if there is a "heavy foot syndrome", an increase in the shin circumference by the end of the day, with the development of reticular varicose after taking hormonal drugs. Conservative treatment includes a number of activities, the main of which are:
- Lifestyle correction aimed at minimizing daytime orthostatic load. In some situations, there is a need for a change in work activity if it is associated with prolonged sitting or standing.
- Use of compression knitwear. Special elastic stockings or knee-highs improve the outflow of lymph, reduce the diameter of the superficial veins, positively influence the work of the muscular foot pump.
- Course of phlebotrophic drugs. These include drugs that increase venous tone, improve lymphatic drainage and blood circulation in small vessels.
Prognosis for pathology
The prognosis for reticular varicose is favorable in most cases. In those situations when the disease is not combined with varicose veins, the risk of trophic disorders, ulcers and thrombophlebitis is minimal. Aesthetic defects and local manifestations can be, if necessary, eliminated by the procedure of microsclerosis. The appointment of phlebotrophic drugs, lifestyle correction helps to reduce the symptoms of venous congestion, which develops with prolonged lying on the legs.
