According to statistics, up to 20% of the population suffers from varicose veins of the lower extremities, while in women the disease occurs 2 times more often. It has been shown that women have additional predisposing factors that contribute to the decrease in vascular tone (pregnancy, taking estrogen-progestin contraceptives, imbalance of sexual hormones).The types of treatment for leg veins do not differ between men and women, however, the frequency of postoperative recurrences in women is higher due to the additional influence of hormones (estrogenic and progesterone influence).
What are the causes of varicose veins on women's legs?
Venous diseases of the legs must be treated by a phlebologist who specifically deals with this pathology. Various methods of treating varicose veins are not radical, since they are not aimed at eliminating the main pathogenetic cause - the failure of the valve apparatus of the vein. Surgical and conservative treatment delay the progression of the disease for long periods. The recurrence rate is high and reaches 10 to 50% 5 years after surgery.
Treatment of varicose veins should be comprehensive. There are three groups of methods for eliminating varicose veins:
- phlebosclerosing,
- surgical,
- conservative.
Each type of treatment has its advantages and disadvantages and a certain recurrence rate. The choice of method is conditional, since the phlebologist often has to combine all three methods to achieve the most favorable result.
Characteristic symptoms of varicose veins in women
Symptoms of varicose veins begin with the appearance of functional disorders such as feeling of heaviness in the legs, swelling of the ankle joints at the end of the working day. Spider veins initially form on the skin of the legs.
Varicose veins are one of the first symptoms of the development of varicose veins in the legs. The main signs of the disease - associations of saphenous varicose veins - appear several years after the onset of the disease. If left untreated at this stage, symptoms such as cramps in the calf muscles and itchy skin on the legs occur.
Signs of trophic disorders: skin pigmentation in the lower third of the leg, cyanosis, sclerotic changes in the subcutaneous tissue, eczema, against which a trophic ulcer is formed.
Characteristic symptoms of varicose veins in women
- Painful symptoms appear cyclically and intensify before menstruation, which are associated with changes in the level of sex hormones;
- During pregnancy, signs of varicose veins may disappear after giving birth;
- in the second half of the menstrual cycle, due to the action of progesterone, the diameter of the varicose veins increases, so the symptoms of swelling and heaviness in the legs are more accentuated;
- Signs of varicose veins worsen during hormone therapy.
Now let's talk about therapeutic methods.
Radiofrequency ablation and endovenous laser coagulation
Radiofrequency vein ablation
The method is based on the introduction, under ultrasound guidance, of a special disposable catheter into the lumen of the dilated vein. The catheter is equipped with a special electrode, the working part of which is heated to 120 degrees under the influence of radio frequency radiation. Advancing the catheter along the vein leads to gluing or "welding" of the vascular wall. Obliterated veins are excluded from the circulatory system of the legs.
Endovenous laser coagulation
The surgical technique consists of puncturing the affected vein and inserting a laser light guide into its lumen under ultrasound control. Under the influence of laser radiation, the proteins of the vascular wall coagulate, as a result of which the vein collapses and after a while is covered with connective tissue. Radiofrequency ablation (RFA) and endovenous laser obliteration (EVLO) are relatively new methods for treating varicose veins on the legs. Despite the differences in execution techniques, they have common features.
Advantages and disadvantages of RFA and EVLA
| It does not require hospitalization | High price |
| Execution speed (30 minutes to 1 hour) | Recurrence rate up to 10% |
| Painless | Inability to perform the procedure due to some anatomical characteristics of the veins (severe tortuosity of the blood vessels) |
| Without blood | |
| Performed under local anesthesia | |
| Absence of postoperative scar (cosmetic effect desirable for women) | |
| Short periods of rehabilitation |
RFA or EVLO are chosen by women who wish to treat varicose veins on an outpatient basis with minimal limitation of physical activity in the postoperative period and maintaining the aesthetic appearance of the legs.
Phlebosclerotherapy
A special drug is injected into the lumen of the affected segment of the vein, which has a sclerosing ("gluing") effect on the vascular wall. The sclerosing agent can be used in liquid or foam form. Preference should be given to foam sclerotherapy due to the increased contact area of the substance with the vein wall.
Advantages and disadvantages of phlebosclerotherapy:
| No postoperative scars | Possible long-term pigmentation of the skin at the puncture site (up to 2 years) |
| Performed on an outpatient basis | In rare cases, postoperative inflammation of the vein (phlebitis) |
| The operation is performed without anesthesia | Swelling and redness of the tissues for 2 days after the procedure |
| The manipulation is practically painless (slight burning at the puncture site) | Allergic reaction due to individual intolerance to the drug |
| In 20% of cases, varicose veins appear on the legs (telangiectasis) | |
| Recurrence rate up to 50% |
The recurrence of varicose veins after sclerotherapy depends on the lumen of the affected vessel: the wider the lumen, the greater the risk of recanalization within it. Sclerosing therapy is chosen in the treatment of recurrent varicose veins after surgical phlebectomy.
Surgical phlebectomy
Surgery is a more radical way to eliminate varicose veins. The principles of surgical treatment are to eliminate the pathological discharge of blood from the deep to superficial veins of the legs and remove the dilated vessels themselves. Phases of combined phlebectomy:
- Crossing and ligation of the entrance of the great saphenous vein (incision in the inguinal area) or of the small saphenous vein (incision in the popliteal fossa);
- Removal of trunks of varicose veins. It is done using a special metal probe that drags the vein into the skin incision.
| Radicality | Hospitalization for 5 to 7 days |
| Possibility of performing surgery at any stage of the disease | Scar on legs |
| Spinal or general anesthesia | |
| Injury to surrounding tissues when a vein is pulled | |
| Possible complications: bleeding, wound infection | |
| Recurrence rate up to 20% |
It is preferable to treat the trunk-type lesion surgically when the varicose deformation of the large or small saphenous veins is significant. And also when signs of trophic disorders of soft tissues and symptoms of decompensation of venous insufficiency are present.
Miniphlebectomy
Miniphlebectomy is a separate surgical option that can treat varicose veins in the legs in the early stages. It is often used in the presence of single varicose veins on the legs. A puncture is made in the skin above the pathological formation, and the vein is taken out and crossed using a hook. The operation does not require general anesthesia or skin stitching.
Conservative therapy
It is necessary to begin treatment of varicose veins of the legs with the use of medications and compression therapy.The prescription of drugs that improve blood circulation and the use of medical compression stockings are the main conditions that determine the outcome of any surgery on the leg veins.
Compression therapy
Elastic compression of the legs is the main method of treatment in cases where surgical intervention is contraindicated. Elastic bandages and special medical knitwear can be used as compression products: stockings, knee-highs, tights. Medical products are highly durable, maintain the original compression level for a long time and are comfortable to wear, which is important for women.
There are 4 classes of elastic knitwear depending on the degree of compression. It is recommended to treat varicose veins using class 2 products in the absence of disease progression for up to 6 months and with further use during physical activity or prolonged standing. If there are signs of damage to the valves of the deep veins or severe symptoms of impaired lymphatic drainage, class 3 meshes are prescribed until the progression of varicose veins stops.
The therapeutic effect of compression stockings is due to:
- a decrease in the volume of the vein, which leads to less blood discharge into the varicose vessels;
- increased absorption of tissue fluid into the bloodstream, due to which signs of swelling and symptoms of heaviness in the legs disappear;
- improve blood flow, which prevents blood clots from forming.
Varicose veins are one of the oldest diseases known to mankind. Mention of him can be found in the works of Avicenna, Hippocrates, Paracelsus and other legendary healers, and the Italian scientist Marcello Malpighi devoted many years to studying him. The pathology can affect any organ in which large veins are present (stomach, esophagus, male testicles), but varicose veins of the lower limbs are the most common. Let's talk about the causes of varicose veins in the legs, methods of diagnosing and eliminating them.
On varicose veins of the lower extremities
Varicose veins are an irreversible expansion of the veins due to the rupture of the valves involved in the circulatory mechanism of the veins of the lower extremities. With normal muscle contraction and relaxation, it moves vigorously upward from one valve to another, but when the vein dilatesthe valves stop closing and blood flow slows, leading to a variety of clinical symptoms.
According to statistics, today people suffer from symptoms of varicose veins on the legs: one in ten men and one in three women aged between 30 and 40. Among the leading countries in terms of prevalence of the pathology are the developed countries of Europe, where it is diagnosed in 30-40% of the population; Varicose veins are less common in Africa and Asia (about 0. 1%).
Why it appears, risk factors
The exact causes of the disease are not known, but most expertstends towards the hereditary theory: People who have had cases of varicose veins in the family are at risk. Factors provoking the development of pathology also include:
- type. Women are more sensitive to varicose veins than men: this is due to the increased venous load during pregnancy and childbirth, as well as taking hormonal drugs;
- bad habits and overweight. Smoking, abuse of fatty foods and alcohol negatively affect blood circulation in the body, increase the load on the veins and can cause corresponding disorders;
- working conditions. People who, due to the nature of their profession, are forced to stand or sit still for a long time (hairdressers, shop assistants, waiters, clerks) suffer from this disease more often than others;
- excessive physical activity. Another category of people at risk of developing varicose veins is those who practice heavy physical work or some strength sports (for example weight lifting);
- uncomfortable clothes or shoes. Tight, restrictive clothing and high-heeled shoes also contribute to deterioration of venous blood flow.
Classification
Most often (in 75-80% of cases) the disease affects the trunk and branches of the great saphenous vein, in 5-10% the small saphenous vein, and in 7-10% of patients both veins are involved in the process. In the clinical course of varicose veins of the lower extremities, experts distinguish two forms and four groups.
Shapes:
- descending– the process extends from top to bottom along the great femoral vein, starting from its mouth;
- ascending– the disease begins in the foot and is caused by a malfunction of the valvular system of the deep veins.
Groups:
- subcutaneous or intradermal pathology not burdened by venous secretion;
- segmental with reflux through perforating and superficial veins;
- diffuse with venous reflux (through superficial and perforating veins);
- dilation with reflux through the deep veins.
Depending on the degree of venous insufficiency, four main stages of varicose veins are distinguished:
- – symptoms of the disease may be present, but are not determined by diagnostic methods;
- I - this phase is characterized by transient swelling, "heavy legs" syndrome and the appearance of "varicose veins";
- II - appearance of persistent swelling that appears in the evening, discoloration of the skin, eczema;
- III - the presence of trophic ulcers, including non-healed ones.
Danger and complications
The risk to the patient's health and life is not represented by the disease itself, but by the complications it causes. These include impaired skin nutrition, which causesTrophic ulcers and erysipelas may form, as well as the most dangerous complication: thrombophlebitis. It leads to an increase in the formation of thrombus, as a result of which blood clots, detaching from the venous walls, can disrupt the functioning of internal organs and, in the most difficult cases, cause the patient's death.
Additionally, dilated vessels with thinner walls run the risk of mechanical damage that can cause severe bleeding.
Symptoms
The first symptoms of the disease are heaviness and fatigue in the legs, which usually appear in the evening and decrease when lying down.The veins acquire a bluish tint and stand out on the surface of the skin, "spider veins" appear.(a network of dilated capillaries visible through the skin), and a characteristic sign is that the vein pattern disappears if the limbs are raised higher (for example, placed on a chair).
Over time, varicose veins become more pronounced and appearappearance of small nodules or large conglomerates.
The unpleasant symptoms intensify and disturb patients even at nightsoft tissue swellingmore often in the feet, legs and ankles, as well as a feeling of fullness in the legs and cramps in the calf muscles.
In the absence of adequate treatment, varicose veins progressthe skin becomes dry, lumps and dark spots appear, and subsequently trophic ulcers. As thrombophlebitis develops, the veins become bright red, rope-like and painfully compacted upon palpation.
When should you see a doctor?
Many people ignore the first signs of varicose veins, attributing them to normal tiredness. This significantly complicates the treatment of the disease and can therefore lead to the most serious consequencesYou should contact a phlebologist immediately after the symptoms of the disease appear.constant feeling of tiredness and heaviness in the legs, changes in the color of the veins and skin, swelling, capillaries, etc.
Diagnostics
The diagnosis of "varicose veins of the lower extremities" is made after a comprehensive examination, which includes:
- general blood test– from the number of red blood cells, platelets, leukocytes and hemoglobin level one can judge blood coagulation disorders and the presence of inflammation;
- ultrasoundrepresents the most effective method for identifying the affected vessels and sections of veins;
- rheovasographycarried out in order to determine the lack of nutrition of tissues with blood (the so-called rheographic index), on the basis of which it is possible to determine the stage of the disease;
- phlebography, during which a contrast medium is injected into the veins, after which the condition of the venous system is evaluated using an X-ray machine;
- physiological tests(Troyanov-Trendelenburg test, Hackenbruch test) allow us to judge the functioning of the valvular apparatus of the superficial veins.
Treatment
In the initial stages of varicose veins you can fight with conservative methods: taking medications, using ointments and gels, using compression clothing and moderate physical activity. To correct cosmetic defects, patients may be recommended minimally invasive surgery or laser treatment. In more advanced cases, varicose veins can be eliminated exclusively by surgery, and their type is selected individually for each specific case.
Varicose veins of the legs are a disease whose onset is best prevented, because it is quite difficult to cure. Therefore, every woman needs to know the causes and signs of such a problem.
What are the dangers of varicose veins on the legs?
With the early development of the disease, many believe that its worst manifestation is the appearance of a swollen limb. Unfortunately it isn't. The worst case scenario for the development of varicose veins on the legs in women is death. In addition, the complications of the disease can be very different.
The most common are:
- trophic ulcers;
- thrombosis;
- phlebitis and thrombophlebitis.
Phlebitis is the process of damage to the internal walls of a vein. In this case, the leg swells more and the protruding vessels become hard upon palpation. As phlebitis further develops, the patient's body temperature rises and any movement of the leg causes severe pain. And then the phlebitis ceases to become thrombophlebitis. In this case, blood clots appear on the walls of the veins - small clots of stagnant blood.
Thrombosis is the formation of blood clots in the absence of phlebitis. This problem is scary because it is almost impossible to diagnose.
Attention! A thrombus detached from the vessel wall is the cause of death in most clinical cases. Furthermore, this process occurs instantly (sometimes within a matter of minutes) and it is almost impossible to recognize a detached blood clot before it interrupts blood circulation.
Now you know what the causes of varicose veins on women's legs are. To prevent varicose veins it is necessary to constantly take preventive measures. This is especially true for those women who have a hereditary predisposition to the disease. To reduce the risk of the disease it is necessary to carry out moderate physical activity, wear comfortable shoes and avoid hypotension.
Consequences and complications
There is no single course of varicose veins. Different groups of patients have individual characteristics of the course of the disease associated with the pathogenesis of varicose veins. Varicose veins can be primary, that is, associated with congenital insufficiency of the venous valve and weakness of the vascular wall, which is almost always accompanied by reverse blood flow (reflux). And secondary (acquired), when reflux develops several years after the onset of the disease.
What are the dangers of varicose veins on women's legs? Varicose veins have a tendency to progress; as they develop and in the absence of conservative treatments, the symptoms of the disease worsen. Heaviness in the legs is replaced by persistent, persistent swelling, against the background of which tissue damage develops, open trophic ulcers appear, as a result of which the person completely loses the ability to work and requires constant maintenance therapy.
Treatment at home
Many women are interested in how to treat varicose veins on women's legs at home? Therapeutic exercises, herbal medicine and some recommendations for a healthy lifestyle for patients with varicose veins will help alleviate the symptoms of the disease and prevent its further development.
Therapeutic exercises
Every day in the morning and evening you need to perform simple exercises for varicose veins:
- Lying on your back, lift your legs vertically, placing them against the wall at a 90° angle. Hold them in this position for 3 minutes, breathing slowly through your chest, not your stomach.
- While lying on your back, perform a cycling exercise for 3 – 5 minutes.
- While standing, raise your feet on toes 1 cm off the floor and lower them. Perform 30 times in two approaches.
- While standing, alternately lift one heel off the floor, then the other, at an angle no greater than 45°. Start with 15 minutes a day, extending up to 30 minutes.
You should make time for a walk every day, at least 30 minutes. It is useful to go to the pool to swim once a week.
Folk remedies
Take the herbal mixture internally: mix 1 tablespoon each of birch buds, motherwort, string, calamus roots, coltsfoot leaves, thyme.
Pour half a glass of mixture with boiling water and heat in a water bath for 40 minutes. Let it brew, filter. Drink 0. 5 cups before each meal for a month.
Prepare compresses with homemade ointments:
- Mix half a glass of curdled milk with fresh chopped wormwood leaves. Apply to diseased veins, secure them with gauze on top and cover with film. Keep for 30 minutes a day.
- Grate the beets on a fine grater, add 2 tablespoons of melted honey, mix, cool and apply to sore feet.
To eliminate evening swelling, apply fresh cabbage leaves to the ankles, first pierced with a fork until the juice appears. Secure with a bandage.
Forecasts and preventive measures
From varicose veinsit is an irreversible process, in this case it is not necessary to talk about complete recovery. But with timely diagnosis, proper treatment and prevention, patients can completely eliminate unpleasant symptoms and lead a full life.
Preventive measures for varicose veins includehealthy lifestyle, correct nutrition and abandonment of bad habits. People forced by professional activity to remain in the same position for a long time are advised to avoid crossing their limbs, perform simple exercises from time to time, bend and straighten their legs and do a light massage to improve blood circulation.
In your free time you should take walks in the fresh air as often as possible and engage in moderate physical activity.
Women who follow the dress code of fashion or work and go there constantlyhigh heels, you should change them from time to time for more comfortable shoes.
The same goes foruncomfortable clothes, because even tight underwear can cause poor circulation and the appearance of varicose veins on women's legs.
Varicose veins of the lower limbs are today considered a widespread disease, which is often not given much importance.
It is very important to remember thisInattention to foot health can cost a person not only his ability to work, but also his life, while in the initial stages varicose veins can be successfully corrected using the simplest methods.