Varicose veins of the lower extremities

Vessels that supplying blood to the heart are called veins. In their structure they have some differences from the arteries that deliver blood from the heart to internal organs.

varicose veins of the legs

Loss of elasticity of the vessel wall of the venous type, with the expansion of its lumen, with the development of vascular insufficiency of the valves, leading to disruption of normal blood flow - has received a separate nosological unit in the form of the disease called varicose veins or varices.

Varicose veins of the lower extremities: the symptoms

1. External changes of the saphenous veins.

The most striking manifestation of varicose veins is to change the shape and contour of intradermal and subcutaneous vessels of the lower extremities.

Veins take focal saccular or uniform thickening of the diameter, with the formation of a kind of knots and tangles of vessels. Changed vessels become dark purple or blue flowers. Small veins show through the contours in the form of intradermal venous "veins".

Often such changes are veins of feet and lower leg. As the progression of the process, a similar pattern is detected in the venous vessels of the thighs.

2. Pain.

Patients report early fatigue, heaviness in the legs. Appears dull pain expander nature in the calf muscles. Over time, the pain becomes more intense, with the possible occurrence of muscle cramps of the calf. It is noted that after finding some time, legs in a horizontal position, the described symptoms for a time subsides, which would then, in the vertical condition, again to resume. The pain increases on palpation of the tibia. In the absence of changes in the superficial veins, in this situation, you should suspect the presence of varicose changes in the deep veins of the leg.

3. Swelling of the subcutaneous tissue.

There is swelling of the feet (pasty) proliferation in the lower third of the tibia, accompanied by itching of the skin in the projection of defeat. If the night pasty with subcutaneous tissue at the level of the ankle the ankle joint is not coming, then you should think about what the symptoms of venous insufficiency has passed the stage of decompensation. In these situations, it should also exclude the accession of secondary infection and the debut of the sores.

4. Itching of the skin.

May appear before the onset of clear clinical symptoms of varicose veins, but most often occurs at the phenomena of the expressed violations of the outflow of venous blood.

5. Hyperpigmentation.

Occurs when the expanded clinical picture of the disease. The skin becomes darker in the course of the diseased vein and in places of mechanical damage due to injuries. In the future, all the skin in the distal limb becomes bluish color (indurate). The surface epithelium becomes thinner and underlying structures atrophy.

6. Hypothermia end sections of the leg.

On palpation the skin of the extremities cold. Patients also feel a constant "freezing" of the limbs.

7. Trophic ulcers.

Part clinicians regard this symptom as a complication of varicose veins. The other part feels the appearance of defects in the skin in the form of open ulcers on the background of modified sections is the last stage of the disease.

Classification of varicose veins

1. Primary.

The changes relate primarily to the superficial veins. Violation of the structure of the deep veins and the change in the execution of their functions originally available.

2. Secondary.

Develops as a complication of primary diseases deep vein, after which changes occur in the superficial veins of the lower extremities. It occurs in the presence of birth defects in the venous system (cardiovascular dysplasia, fistula), as well as the outcome of migrated phlebothrombosis of the deep veins. The reasons for the formation of blood clots in the veins was discussed above.

In addition, there is a separation of varicose disease according to clinical forms.

  1. Varicose side (lateral) veins of the femur and tibia.
  2. Reticular varices.
  3. Varicose telangiectasia.
the symptoms of varicose veins

The compensation stage.

The pain is minimal or non-existent. Is defined discomfort in the legs during long sitting or upright position. In parts of the surface of the skin revealed small spider veins. Occasionally there is minor swelling of feet and ankles. They speed after the adoption of the limb horizontal position.

The stage subcompensation.

Already a superficial glance at the limb, the presence of a vein with expanded lumen noteworthy.

Complaints of patients at the same time more specific: on foot pain expander nature, fatigue. Night cramps calf muscles suddenly, or against a sense of "pins and needles" (paresthesia). Swelling in the lower third of the leg and feet are more pronounced, however, after a night's sleep they disappear.

Stage of decompensation.

The clinical picture is compounded by local changes in the skin: it takes the form of a dry and smooth surface, there is a loss of hair, hyperpigmentation of the skin with subsequent seal to be fiber.

Swelling becoming a permanent rise above.

Frequent small intradermal hemorrhage make the pigmentation more intense due to the deposition of hemosiderin (a blood pigment). Small wounds and abrasions heal very long, passing gradually into ulcers.

The degree of chronic venous insufficiency

0 – the manifestation is not revealed.

I – swelling that appears when the symptoms of fatigue of the legs.

II – permanent swelling with the phenomena of pigmentation disorders of the skin, sealing the consistency of subcutaneous tissue, the appearance of eczema.

III – education in the skin ulcers of venous origin.

Varicose veins of the lower extremities: a treatment

Conservative treatment

Includes medication and compression correction.

1. Wearing compression hosiery (socks, tights, stockings).

Distinguish between therapeutic and prophylactic compression stockings. Linen medical appointments are marked into four classes, where each division represents a certain level of uniform compression of the legs in mm. RT. art and depends on the clinical stage of the disease:

Linen preventive type is strongly recommended for people experiencing prolonged exercise, and is in a sitting position most of the working day. For these purposes use compression tights and stockings.

Uniform compression of the lower limbs compression underwear, promotes blood circulation at the level of physiological indicators, helping the outflow. The basic principle is the creation of an external frame to maintain the tonus of the weakened walls of the blood vessels of the venous type.

Preventive compression hosiery delays, and even completely neutralizes the risk of varicose veins. In cases, when it began to disturb the first clinical manifestations of varicose veins, it is recommended to urgently see a doctor in a clinic or a specialized medical centre.

When you already developed the disease, medical linen lowers the risk of developing thrombosis and embolism, reduces the symptoms of venous insufficiency, thereby stabilizing the patient's condition.

2. Drugs.

Currently, the perfect drug, influencing all pathogenetic links of the development process of varicose veins – no. You need a combination of both. The partial suspension of the process in the initial stages of using drugs is possible, but reverse the development of existing isolated nodes when medicinal treatment is not observed.

The forms of application of various preparations: tablets, solutions for injection, ointments.

treatment of varicose veins

3. Folk remedies in the treatment of varicose veins.

It is important to understand that their use, for the most part, is aimed at relieving symptoms of complications, especially thrombophlebitis and not on treatment of the underlying disease. Application of these methods at the present stage should not replace the drug therapy in the initial stages of developing varicose veins and, especially, surgical treatment when the expanded clinical.

Consider and list some of the most adequate folk remedies.

Hirudotherapy - treatment by applying medicinal leeches to a vein. Applies only when thrombophlebitis. Method dangerous risk of secondary infections and the development of bleeding from sites. A great alternative may be the use of medical analogue of a heparin ointment in the initial stages of the disease. To prevent thrombosis it is possible to apply it in later stages, avoiding sores.

Apple cider vinegar.

Used in the form of friction or wrap the feet with moistened with cloth or gauze.

Tincture of horse chestnut.

Use purified from the green skins of the fruit. They need to pre-crush, fill in with vodka at the rate of 10 gr. (two teaspoons) of chestnut 100ml. vodka. Infused for two weeks in a dark place and applied about a month 3 times a day 30 drops.

Tincture of Kalanchoe.

Crushed leaves Kalanchoe is filled half-liter of the Bank to the middle, then in a separate container filled with vodka in the amount of half a liter. After 3-4 weeks, the resulting solution produces grinding at night affected areas.

Surgical treatment.

1. Classic operating manual.

Indications:

  • when formed and released the superficial veins varicose veins involving the great and small saphenous veins;
  • with the defeat of varicose veins communicative and detection of valvular insufficiency of the deep veins of the femur and tibia with persistent manifestations of venous insufficiency, or when the complications of varicose veins (bleeding, thrombophlebitis).

If the symptoms of venous insufficiency is minimal, then the classical surgery is performed for prophylactic purposes, and should know the patient.

The operation quantity is determined based on the results of the ultrasound examination. In addition to mechanical removal of varicose veins modified, the aim is to normalize the circulation of the limb by eliminating the increased venous discharge of blood from superficial vessels into the deep. Otherwise, you will need repeated surgical procedures.

treatment of varicose veins of the legs

2. The combination of sclerosing therapy with minimal surgical manipulation.

Applied with varicose veins superficial veins of the lower limbs to the formation of vascular nodes: at the stage of spider veins, segmental veins of the lower leg changes, with reticular varicose veins, in addition to surgical treatment remaining modified vessel after removal of the veins with obvious changes.

The technique: the removal of veins from the circulation by the complete closure of the lumen with the subsequent substitution on the connective tissue when exposed to chemical substances.

3. Insulated phlebosclerosis treatment.

In the changed vessels with various technical approaches using venous catheters material is introduced. Then the limb is tightened tight elastic bandages. After some time, the vessel is "off" from the circulation.

4. Radiofrequency ablation.

In this technique, there is a thermal "welding" of the vessel using a special intravascular probe emitting RF waves. Under their action takes place insulated heating of the walls of blood vessels and their compression. After surgery some time continues wearing compression hosiery.

5. Endo venous laser treatment.

On the wall of the vessel is affected in a special venous catheter, emitting the energy pulses, causing sealing of the lumen of the vessel.

6. Transluminal phlebectomy.

Removal of the modified vessel using a special suction device under visual control through the special incision in the skin.

You need to know and remember that any surgery has a clear testimony. Because, along with recovery, every surgical procedure carries certain risks common (complications of anesthesia, secondary infection, etc.) and specific nature, related to a specific transaction.

In this regard, particular importance is taken by the prevention of varicose veins.

Prevention of varicose veins

prevention of varicose veins
  1. Wearing compression underwear.
  2. Optimal physical activity on any possible occasion, without extraordinary fatigue.
  3. The use of compression underwear.
  4. To maintaining venous tone and is helpful the use of a contrast shower when hygiene of the feet.
  5. Prevention of constipation by normalizing the diet with high content of foods rich in fiber.
  6. Prolonged static loads with a vertical or sitting position is recommended every half hour to make a simple exercise: in a standing position to move the load from the heels on toes up 15-20 times. Thereby, the course runs in a kind of "muscle pump" hard drives stagnant blood towards the heart. In these situations, it is useful several times a day to take a horizontal position. If it is impossible, at least 15-20 minutes to hold your legs in a sitting position on a nearby chair. In addition to this several times to sit down.
  7. Less likely to use shoes with high heels. Heels should not exceed 5 cm.
  8. Clothing should be loose and not restrict movement.
  9. Recommended during sleep to give the feet elevated position by putting a cushion or uplift the edge of the bed.
  10. Useful after sleep not immediately be undermined with the bed and do a few leg exercises: circular movements to stop, imitation Cycling movements.
  11. During long journeys on planes or buses need to "stretch" legs periodically to get up, make circular movements with the feet. In these situations you need to avoid alcohol and to drink more drinking water. Useful in the way to put on compression stockings.
23.07.2019