Phlebeurismis a pathological condition characterized by a change in the structure of the venous system, which leads to an increase in the diameter of the lumen of superficial veins and disruption of the valve system, manifested by valve insufficiency, i. e. in their incomplete closure of the vein.
Normally, blood flows through the veins against the force of gravity, from bottom to top, which is possible exclusively thanks to the work of venous valves. Under the influence of a number of reasons, primary (due to changes in the valve itself) or secondary (due to dilation of the vein) valve insufficiency occurs; this condition is characterized by incomplete closure of the venous valve and reversed blood flow. Reverse blood flow aggravates changes in the venous wall and also contributes to blood stagnation in the lower extremities, causing swelling of the lower extremities and a feeling of heaviness in the legs.
In addition to blood stagnation in the lower extremities, the above processes lead to disruption of the linear flow of blood through the veins from top to bottom, the appearance of reflux (reverse blood flow) and turbulent blood flows in the area of lower limbs. expansion. Changes in blood flow characteristics are the main cause of thrombosis.
Possible causes of the development of varicose veins of the lower extremities
- Physical inactivity- the main cause of varicose veins. A sedentary lifestyle and prolonged sitting contribute to a high and prolonged load on the venous valves. During physical activity - walking, running, swimming - the constantly working muscles of the thigh and lower leg help to "expel" blood from the venous system of the lower extremities. Sitting statically in a sitting position for a long time leads to an increased load on the venous valves, and over time, the venous valves, unable to withstand the load, may stop fully performing their function.
- Obesitythe second most important reason should be considered. High weight also increases the load on the valvular system of the veins of the lower extremities, contributing to the disruption of their proper functioning.
- Pregnancyit is the third most common cause. Hormonal changes, increased body weight, compression of the pelvic veins by the fetus are sufficient reasons for dysfunction of the venous valves. However, up to 50% of changes in the venous wall detected during pregnancy are functional in nature and disappear on their own within the first year after birth.
- To smoke– the fourth most common cause of varicose veins. Changes in the venous wall may be associated with the unfavorable effect of the composition of smoking mixtures on the tone of the venous wall.
- Inheritance– another possible reason for the development of varicose veins. It is generally accepted that heredity plays a major role in the development of varicose veins, however, the genes responsible for the development of varicose veins have not yet been discovered; it is generally accepted that genes responsible for changes in the structure of connective tissue structures are the main cause of varicose veins. However, the influence of heredity can be greatly exaggerated, and lifestyle changes, normalization of body weight and smoking cessation will help to avoid varicose veins even in patients with an unfavorable hereditary history.
Signs of varicose veins
- Presence of dilated saphenous veins, the non-linear course of the vein is the most objective, but not the only, manifestation of varicose veins. Often even several times dilated veins may not be visible, especially with a pronounced subcutaneous layer.
- Edema of the lower limbsat the end of the working day, especially in the case of asymmetrical swelling, they are the first and most common sign of varicose veins.
- You should also think about the presence of varicose veins whenpresence of heaviness in the legsin the evening and at night, leg cramps at night.
- Spider veins and venous patternintradermal veins, although representing more of an aesthetic problem, can also indicate the presence of alterations in the saphenous veins.
- Persistent redness, thickening of the skin, lipodermatosclerosis, trophic ulcers on the foot and leg indicate a decompensated course of varicose veins.
Diagnosis of varicose veins
The diagnosis of varicose veins of the lower extremities can be made only on the basis of ultrasound diagnostic data.
During ultrasound of the veins of the lower extremities, the doctor examines in detail the characteristics of the deep and superficial veins from the groin to the ankle, measures the diameter of the veins, analyzes the characteristics of blood flow in the veins and detects the presence of reflux. Based on the data obtained, the doctor formulates a conclusion.
Prevention of varicose veins
Prevention of varicose veins is a rational motor regimen, normalization of body weight and cessation of smoking.
If there are early signs of varicose veins, venotonics and the use of compression stockings will help reduce the rate of progression of the disease.
Compression hosiery should be selected by a doctor based on the severity of varicose veins and the patient's anthropometric data.
Treatment of varicose veins
The treatment of varicose veins is exclusively surgical.
At the moment, many different methods of surgical treatment have been developed - from open techniques - combined phlebectomy to minimally invasive methods - coagulation of veins with laser or radiofrequency, mechanochemical methods.
- Varicose veins can be removed using a miniphlebectomy, a technique in which varicose veins are removed from the tissue under the skin by separate, bandaged punctures.
- Small varicose veins can be removed by sclerotherapy - the introduction of a special glue-like substance - sclerosant - into the venous lumens.
- Varicose veins and intradermal veins can be removed using sclerotherapy.
However, even after complete treatment, the risk of recurrence of varicose veins of the lower extremities is 10-15%. Adequate physical activity, practicing sports (running, walking, stationary bike, swimming), normalizing body weight and abandoning bad habits will help reduce the likelihood of recurrence after surgical treatment. Periodic use of phlebotonics and the use of properly selected compression stockings will help reduce the rate of spread.
The main thing is not to delay the visit to the doctor!