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Phlebeurism

symptoms of varicose veins

The team of qualified cardiovascular surgeons/phlebologists at the clinic diagnoses and treats all types of varicose veins at any stage of the disease, as well as accompanying pathologies. Our advantage, which we are proud of, is treatment according to Israeli protocols, which show maximum efficiency in clinical practice.

Varicose veins - the trigger for the appearance of varicose veins is considered to be the disruption of the normal functioning of the venous valves with the appearance of reverse flow (reflux) of blood.

As a rule, valves that are subject to maximum mechanical stress are the first to be hit. In this case, there is a pathological discharge of blood through the mouth of the great and small saphenous veins, sometimes through large perforating veins. The excessive volume of blood that occurs in the superficial veins gradually leads to overstrain of the vein wall. The total volume of blood in the superficial venous bed of the lower extremities increases. This increased volume of blood continues to flow into the deep system through the perforating veins, overstretching them. As a result, dilatation and valvular insufficiency occur in the perforating veins.

Symptoms and signs of the disease

Signs of illness are not necessarily associated with pain. On the contrary, most patients claim that at the beginning of the disease they are more concerned about aesthetic problems than pain.

The clinical picture depends on the localization of the pathological process, as well as on the stage of the disease.

Varicose veins of the lower extremities manifest as follows:

  • Heaviness in the legs, feeling of fullness in the legs.
  • Occurrence of leg cramps, foot and toe cramps.
  • Feeling tired after a long walk.
  • Ankle swelling in the evening.
  • Venous relief pattern on the skin, spider veins, spider veins.
  • The signs accompanying the disease are cellulite, itching of the legs, dry ankles and calves, thinning and loose skin, long-lasting ulcers, uneven pigmentation - from dark spots to colorless areas, pronounced nodular formations with a color from bluish to dark purple or burgundy. , trophic ulcers.

Progressive venous disease is accompanied by deterioration of general health:

  • Unstable blood pressure, hypertension, hypotension.
  • A feeling of chronic fatigue, apathy develops.
  • Arrhythmia, tachycardia.
  • Shortness of breath, frequent diseases of the respiratory system.

Obvious symptoms of varicose veins of the lower extremities in women may appear more strongly before menstruation and decrease after it.

Symptoms of venous pathology in the upper extremities are characterized by numbness of the hands, spastic conditions of the fingers, a feeling of suffocation, tingling and coldness.

Dilated esophageal veins are manifested by belching, burning, pain behind the sternum, inflammation in the esophagus and stomach, difficulty swallowing and signs of reflux esophagitis, anemia.

Disease diagnosis

Effective treatment of varicose veins cannot be carried out without a preliminary comprehensive diagnosis. The diagnosis is clarified by the clinical picture and data analysis after hardware studies.
The following methods are most often used for diagnosis:

  • duplex or triplex ultrasound angioscanning;
  • phlebography with contrast;
  • MRI with venography;
  • contrast angiography.

In order to determine the presence of reflux in the affected veins and evaluate blood flow, several test manipulations are performed:

  • Examination of veins with compression on different segments.
  • Valsalva maneuver or stress test.
  • Parana test with imbalance for the assessment of veins in the calf regions.
  • Walking test of different intensity.

Additional methods to clarify the diagnosis:

  • Plethysmography to determine venous reflux, obstruction.
  • CT, MRI for visualization of tissues and structures in the affected area.
  • Infrared thermography to assess the temperature balance in the affected area of the body.
  • Intravascular ultrasound uses a catheter to visualize the vascular walls from the inside.

The results of all performed diagnostic studies are evaluated comprehensively. Each diagnosis is very helpful in determining the tactics of further treatment.
Clinical laboratory tests of blood and urine complement the picture of the disease and may indicate accompanying pathologies.

How are varicose veins treated?

If alarming symptoms of varicose veins appear, it is necessary to consult a doctor in order to make a diagnosis and start treatment in time. In regional medical institutions, general surgeons deal with this issue, in clinics - phlebologists and angiosurgeons.

The multidisciplinary medical clinic has a well-equipped phlebology department, staffed by a team of surgeons with extensive practical experience. The center offers a high level of service and quality of treatment, which is reflected in the excellent clinical results that we are proud of.

Varicose veins of the lower extremities and other types of pathology can be treated in the first stages of development. As the process progresses, it turns out to be increasingly ineffective, partially retaining only symptomatic significance.

Therapeutic effects cannot completely eliminate the disease, but as long as it is possible to delay the destruction of blood vessels and the development of complications, this must be done by all available means.

Conservative treatment

  • At the beginning of the treatment of varicose veins, drugs are limited to venotonics.
  • To reduce the risk of thrombosis and occlusion, injections of anticoagulants and low molecular weight heparin-fragmin are used.
  • New oral anticoagulants.
  • For inflammatory phenomena in blood vessels and surrounding tissues, the use of non-steroidal anti-inflammatory external drugs with diclofenac and indomethacin is indicated.

How to additionally treat varicose veins?

In parallel with the therapeutic treatment, the patient is recommended to perform certain exercises that strengthen the muscular corset of the lower extremities and have a general effect. For example, the best exercises in the lying position are the "bicycle", alternately pulling the toes towards you and stretching, as in ballet.

  • You should be careful with water and thermal procedures, because hot baths and showers, rest in the sun with tanning can worsen the situation. The vessels need to be strengthened, this is facilitated by hardening with a contrast shower, when warm and cold water is poured alternately on the legs.
  • For pain, inflammation and heaviness in the legs, daily cold foot baths with decoctions of oak bark, chamomile, calendula, birch leaves, St. John's wort, white acacia flower and horse chestnut are recommended.
  • It is useful to rub freshly squeezed juice from aloe leaves into the skin, it softens the skin and prevents inflammation.
  • It is worth changing your habits and stop smoking. The diet should be dominated by food rich in vitamins with a lot of fiber, fresh vegetables, citrus fruits and seafood.
  • You need to adjust your drinking regime by drinking enough water per day (1. 5 to 2 liters). At the same time, the consumption of coffee, strong tea, chocolate and alcohol should be reduced.

If the veins in the legs are enlarged, the doctor may recommend periodic or permanent wearing of compression stockings.

Attention! In any case, you should listen to your doctor's recommendations and strictly follow them. Self-medication is unacceptable!

Causes of disease

The family history of occurrence allows us to conclude that varicose veins are genetically determined and can be inherited.

In many clinical cases, it is impossible to determine the exact cause of the disease. The researchers concluded that the culprit is a combination of several internal and external factors.

Causes of varicose veins:

  • congenital defect of the valve system;
  • physical inactivity, lack of activity;
  • pregnancy;
  • working conditions with prolonged stress on the legs, long standing, in a static position;
  • treatment with certain hormonal drugs;
  • uncomfortable shoes, high heels;
  • obesity;
  • tight underwear, clothing that constricts the hips, knees (for example, very tight jeans, shapewear);
  • regular weight lifting;
  • systemic pathology of the kidneys, heart and blood vessels;
  • diabetes;
  • regular bowel problems, frequent diarrhea or constipation.

Varicose veins of the lower extremities (varicose veins)- expansion of the superficial veins of the lower extremities, accompanied by incompetence of the valves and disturbed blood flow. The term "varicose veins" comes from Latin. varix - "swell".

As a result, the veins stop working properly, the entire circulatory system is disturbed, complicated by congestion, disruption of tissue trophism, and clogging of blood vessels with blood clots.

Many complications are life-threatening, therefore, if varicose veins are suspected, diagnosis and treatment must be carried out immediately and professionally.

Types of diseases

The blood flow in the vessels changes, slows down, and blood clots can form in the uneven walls. Changes in the functionality of blood vessels cause blood stagnation, venous insufficiency and permanent disturbances of capillary circulation in the periphery.

According to WHO, varicose veins occur in 45% of women and 20% of men.

According to the generally accepted international CEAP classification, varicose veins are divided into six classes-stages of the disease, based on the fact that C0 is the complete absence of subjective, visual and clinical signs.

  • C1 – the initial stage, which is manifested by a capillary network and spider veins on the skin.
  • C2 – visible thickening of veins under the skin, venous pattern in the lower extremities in the form of blue threads.
  • C3 – swelling of the legs occurs as a result of prolonged standing on the feet or a state of rest (night sleep).
  • C4 – the surface of the skin changes, unevenly pigmented areas appear, venous eczema, accompanied by itching and ulcers, lipodermatosclerosis.
  • C5 – venous ulcers on the surface of the skin that heal after some time.
  • C6 – non-healing venous trophic ulcers.

The classification of varicose veins of the lower extremities distinguishes between pathology on superficial and/or deep veins, perforating communicating veins.

By origin, venous deformations can be:

  • congenital, manifested in infants;
  • acquired;
  • secondary, which arise against the background of other pathologies, injuries;
  • idiopathic, with an unknown cause.

The complete classification of varicose veins of the lower extremities and organs also includes complications - reverse blood flow, reflux and/or occlusion, blockage of the lumen.
Varicose veins of the lower extremities are not the only manifestation of varicose veins, although it is the most common. There are also varicose veins of the esophagus, sublingual veins, retina, scrotum (varicose veins in men), stomach, cavernous bodies of the rectum (hemorrhoids), pelvic veins, female genitals - vulva, labia, uterus.

Surgical treatment of varicose veins

RFO (radiofrequency saphenous vein obliteration)is a modern method of treating varicose veins. Treatment involves the application of radiofrequency radiation to the inner wall of the vein. Due to the thermal effect, the vein is "welded", disconnected from the general blood flow and after a few months it is replaced by connective tissue.

Advantages

  • The procedure is performed without general anesthesia, local anesthesia is sufficient;
  • Maximum security for the health of patients
  • RFA does not require special preparation;
  • During the manipulation, the patient does not feel pain or discomfort;
  • Radiofrequency ablation of the veins of the lower extremities is very effective;
  • Low probability of complications, almost all patients tolerate this procedure well;
  • Radiofrequency ablation can be combined with tributary mini-phlebectomy or sclerotherapy;
  • After radiofrequency ablation, no scars or marks remain;
  • Literally a few days after the procedure, the patient will be able to return to his usual way of life.

How is it going

The intervention is performed under ultrasound control. Before the start of the procedure, local anesthesia is applied so that the patient does not feel pain or discomfort during the treatment.
Let's see how RFA is performed step by step:

  • Before the operation, the lower limbs are thoroughly treated with antiseptics. The doctor then marks the vein that is prone to varicose veins with a marker. Then the doctor inserts a radiofrequency catheter into the vein and treats the desired area with radiofrequency waves.
  • At the end of the procedure, the catheter is removed, the doctor applies a bandage and helps the patient to put on a compression garment.
  • The procedure lasts from 30 to 50 minutes. To stop blood flow through a weakened vessel, it must be destroyed. Then the body will just redirect the blood through the healthy veins. As a result, after ablation, the walls of the veins merge and form scar tissue from the inside (it is safe and not noticeable), and the varicose veins disappear.

Rehabilitation

Immediately after the operation, the patient must walk (about 30 minutes) to avoid stagnation of blood and lymph. After radiofrequency ablation of the veins of the lower extremities, it is necessary to carefully follow the doctor's recommendations:

  • During the week, increased physical activity and heavy lifting are prohibited;
  • It is necessary to walk more, to be in the same position as little as possible (with the exception of sleeping);
  • In 3-4 weeks you must stop taking a warm bath, you can only take a shower;
  • You must stop visiting the spa for at least a month;
  • It is necessary to drink as much plain water as possible, on average about 2. 5 liters, while it is necessary to reduce the amount of salt consumed;
  • A week after the operation, you need to start physical therapy, which the doctor will tell you about;
  • It is possible that after radiofrequency ablation of the veins of the lower extremities, the doctor will prescribe some medications.

Following these rules will help you avoid complications and prevent the further development of varicose veins.

A week after the operation, a re-examination (ultrasound examination of the veins of the lower extremities) is necessary. You can find out more detailed information about radiofrequency ablation of the veins of the lower extremities at a personal consultation with a specialist.

Laser coagulation of veins

Endovasal (endovenous) laser coagulation (obliteration) of varicose veins (EVLK, EVLO) is a modern method designed to eliminate blood reflux in superficial and perforating veins using thermal energy of laser radiation. EVLO allows you to do without incisions and does not require hospitalization of the patient in a hospital. The international name is EVLA (endovenous laser ablation).

Main stages

  • Venipuncture. It is performed under the supervision of ultrasound.
  • Positioning of the light guide. A light guide is a thin optical fiber. Laser radiation is brought to its end. The light guide is inserted into the diseased vein. Its end is implanted at the place where the dilated vein flows into healthy deep veins, i. e. at the anastomosis.
  • Tumescent anesthesia. An anesthetic "cushion" is created around the vein in order to better press the vein against the light guide and avoid damage to the surrounding tissue.
  • Laser coagulation of veins. Laser radiation is fed to the working part of the optical fiber.
  • At the same time, the light guide is slowly pulled out of the vein. Thus, the vein is heated evenly by the laser to a temperature of 85 °C. Heated vein, like any protein, shrinks when heated. The lumen of the vein disappears, blood flow through it stops.

Rehabilitation

Immediately after the operation, the patient must walk (about 40 minutes) in order to avoid stagnation of blood and lymph. After EVLO veins of the lower extremities, it is necessary to follow the doctor's recommendations:

  • During the week, increased physical activity and heavy lifting are prohibited;
  • It is necessary to walk more, to be in the same position as little as possible (with the exception of sleeping);
  • In 3-4 weeks you must stop taking a warm bath, you can only take a shower;
  • You must stop visiting the spa for at least a month;
  • It is necessary to drink as much plain water as possible, on average about 2. 5 liters, while it is necessary to reduce the amount of salt consumed;
  • A week after the operation, you need to start physical therapy, which the doctor will tell you about;
  • The doctor may prescribe some medicines after the operation.

Sclerotherapyis a method of non-surgical (minimally invasive) elimination of varicose veins and spider veins of the lower extremities.

Advantages of vein sclerotherapy:

  • absolute ambulatory care that does not require additional preparation,
    execution speed,
  • no need for anesthesia,
  • absence of complications typical of surgical treatment methods such as nerve damage,
  • absence of "thermally induced phlebitis", characteristic of coagulation methods, accompanied by excruciating pain along the coagulated vein.

So, today, vein sclerotherapy for varicose veins is an effective and safe method, which in some cases can be used as an alternative to other types of surgical interventions.

The sclerotherapy method is based on the obliteration of the vein by introducing a chemical into its lumen, which "washes out" the inner layer (endothelium) with the development of endofibrosis. The degree of damage to the endothelium depends on the concentration and volume of the administered drug.

The modern medical center uses advanced technologies for the treatment of varicose veins, ensuring the maximum efficiency of all treatment measures. The use of modern equipment by experienced professionals will free you from varicose veins in the shortest possible time, without complications and the need for long-term rehabilitation.

Treatment in a modern clinic means health and a significant improvement in the quality of life.