Varicose veins are not just a cosmetic defect that appears on the thighs, legs and top of the foot in the form of a tree-like blue network, accompanied by pain and convulsive contractions in the muscles of the lower leg when walking or you do physical exercise and heaviness. in the legs. First of all, there is a high risk of thrombosis of the inferior vena cava system. This is a serious disease, the symptoms of which affect one in four people on the planet.
Thrombotic complications lead to the appearance of trophic ulcers on the legs, acute pathologies of blood flow and tissue necrosis of the lower extremities. Often, a blood clot that breaks away from the wall of a vessel that enters the blood flow system of the lower extremities ends its journey through the human circulatory system in the heart or brain. The main factor for starting treatment and preventing varicose veins is the high risk of stroke or heart attack and not the unaesthetic appearance of the legs.
Since its onset, the disease has continued to progress, affecting new areas of the internal and external venous system of the legs. It would therefore be logical to start analyzing the issue with the prevention of the disease. Competent preventive measures in most cases predetermine the rate of development of the pathology, which develops against the background of a hereditary defect in the valvular apparatus of the venous blood flow of the legs.
Prevention of varicose veins
The walls of the veins of the lower extremities are very weak, the muscular system is designed in such a way that it cannot help push blood through contractions. To control the directional flow of blood and prevent stagnation, veins are equipped with specialized valves. In some people, the valves may not function properly due to heredity. However, valve disease can develop with age due to:
heavy physical activity;
increased intra-abdominal pressure;
constipation;
frequent pregnancies.
Initially, the process develops in the external veins, but as the disease progresses it affects the deep venous network. The process of development of the disease can last decades, and the speed depends on lifestyle, the strength of the walls of blood vessels and the intensity of physical activity.
The first task of prevention– minimize the increase in intra-abdominal pressure, avoid an increase in overload and fight constipation.
Second task– promote the passive outflow of venous blood from the legs. To do this there is a technique that must be performed at the end of the day, or better yet several times throughout the day. The essence of the technique is to place your stretched legs on the surface at an angle of 45 degrees to the horizontal. You need to lie in this position for at least half an hour. For people who already suffer from varicose veins, it is recommended to sleep with your legs raised as often as possible.
If you have a disease, you should not use tight shoes and socks with a narrow elastic band, so as not to complicate the already impaired blood circulation.
Also, when you do a sedentary job or simply sit for a long time, you should try to give your legs a horizontal position and, if possible, position your legs in elevation. Of course, this doesn't mean that when working in the office you have to sit with your feet on the table. NO. Simply try putting something under the table that allows you to rest your feet unobstructed while sitting. You should also avoid the habit of crossing your legs while sitting. At home, you can raise your legs by placing several pillows.
Conservative treatment
The non-surgical treatment program includes diet, medications and compression therapy.
Diet
One of the risk factors for the development of varicose veins is excess weight. Therefore, diet is one of the treatment factors. Nutrition must be balanced so that the calories received do not exceed the amount necessary to satisfy daily needs. Furthermore, the number of calories varies depending on the presence or absence of physical exercise. You should also remove spicy seasonings, marinade, pepper, excess salt, alcohol, smoked foods from your diet, and also eat less fried foods.
The menu should consist of a sufficient amount of fruits and vegetables containing vitamin C, dishes containing a large amount of fiber, seafood and wholemeal bread. Small, frequent meals are recommended. It is important to note that animal fats should be present in moderation. We must not listen to those who say that cholesterol is an absolute evil. Cholesterol in reasonable quantities helps strengthen vascular walls, reducing the risk of venous ruptures and recurrent thrombotic deposits.
Stop smoking
Tobacco smoking is the most harmful habit for varicose veins. The fact is that the tar contained in cigarettes clogs blood vessels, and carbon dioxide causes vascular spasms. Smoking increases the risk of blood clots and, consequently, secondary complications such as heart attacks and strokes. Smoking is especially dangerous for those who, having varicose veins, take hormonal drugs.
Compression underwear (tights, hold-ups, knee-highs)
This prevention and treatment option is particularly suitable in the initial stages of the disease. Lingerie can be selected based on different parameters of pressure on soft tissues, color scheme and model option. Underwear is worn in the morning, without getting out of bed, until the veins are overflowing with blood. The main obstacle to using this prevention method is the inflated price. Therefore, the main consumers of knitwear are not those who need prevention, but those who, after surgery, use underwear for the purpose of secondary prevention.
Varicose veins: treatment with drugs
Medicines cannot cure or completely stop the disease.
Venotonics – ointments and gels
Venotonics is aimed at strengthening the walls of the veins, stimulating blood outflow and slightly improving microcirculation. These medications, when taken as a course, can reduce pain and swelling. The course of using the drug is carried out twice a year and lasts at least two months.
Ointments and gels, while safe, are virtually useless. They cannot penetrate beyond the skin and consequently affect the condition of the blood vessels. Ointments and gels are prescribed in the initial stages of the disease, when it is not yet known what can remove swelling and heaviness from the legs: drugs or postural drainage and the end of physical activity. Sometimes ointment manufacturers are cunning and recommend using the product in combination with tablets.
ointment based on the flavonoid rutin.
twice a day an ointment containing horse chestnut extract is applied.
gel, whose active ingredient is a vine leaf extract. There are also capsules of the drug to be taken on an empty stomach twice a day.
Venotonics in tablets
Venotonics in tablets is used for varicose veins.
Saponin derivatives of the drug are obtained on the basis of horse chestnut, which contains the plant bioflavonoid aescin. These include the drug, which exists in the form of drops and tablets.
The most effective preparations are made on the basis of a plant flavonoid obtained from citrus fruits, a powerful venotonic. The course of treatment with these drugs can last up to six months.
Rutosides are the first venotonics. Their effect is to improve microcirculation and have an anti-inflammatory effect.
Natural Rutoside, available in the form of tablets and capsules.
Semi-synthetic rutosides.
Combined Rutoside. It combines a semi-synthetic derivative of rutin and ginkgo biloba extract. The drug in capsules is taken twice a day for a month.
Phlebosclerosing drugs
It allows you to exclude veins from the bloodstream without surgery. The action is achieved through the growth of connective tissue, which gradually closes the lumen of the vessel. The connective tissue is stimulated by increased coagulation of endothelial proteins and irritation of the smooth muscles of the vessels.
An ointment based on sulfur-containing acid glycosaminoglycans, glucocorticoids and non-ionic surfactants is the simplest option. However, the effect is so weak that injectable solutions are used.
Synthetic phlebosclerotics.
Products containing iodine or based on animal proteins. The drugs are used to selectively close small vessels in the affected areas of the veins. Drugs that do not cause vascular thrombosis are popular among doctors,
Only the walls at the endothelial level burn.
Phlebosclerotic therapy involves injections of drugs or elastic bandages. This is a fairly simple and painless technique that does not affect the patient's well-being and is quite popular among doctors.
However, isolated sclerotherapy does not provide long-lasting results and cannot halt the progression of the disease. Therefore, it is best to use it in combination with surgical treatment. Before therapy it is necessary to undergo an ultrasound of the lower limbs to exclude extensive lesions of the saphenous and deep veins.
Contraindications to phlebosclerosis are: drug allergies, atherosclerosis of large vessels and the presence of ischemia, obliterating endarteritis, diabetic angiopathy, damage to the blood coagulation system, pregnancy, acute thrombophlebitis of the legs.
Additional medications
Agents that improve blood microcirculation: low molecular weight dextrans, purine derivative. These drugs stimulate the degradation of platelets, reduce blood viscosity and increase the elasticity of red blood cells. These processes improve blood supply to tissues and oxidative reactions in them.
Direct or indirect acting anticoagulants. Reduce the risk of thrombosis. Popular products in the form of ointments and gels have anti-edematous, anti-inflammatory and antithrombotic effects.
Nonsteroidal anti-inflammatory drugs: suppress inflammatory processes and relieve pain.
Phlebosclerosing therapeutic options
Before surgery, venous sclerosis is performed to reduce the risk of thrombosis and bleeding in the postoperative period.
During surgery as an alternative to vein removal.
After surgery to close the unoperated veins.
The puncture method of drug administration is used at any time, and the catheter method is used exclusively during surgery.
Puncture method
In addition to the operating room, it can only be performed in a specialized surgical room in compliance with all aseptic rules. First the large veins close, then the small ones. Drugs are administered from top to bottom. The vein is punctured with the patient in the upright position and the drugs are administered in the horizontal position. If sclerosis of an extensive vessel is necessary, the procedure is performed in several sessions. After the sessions, the patient is registered with a phlebologist for three years for observation.
After administration of the drug, the limb is subjected to elastic bandaging, which is repeated for two weeks. During the first week the bandage is not removed.
The patient must walk within half an hour of the procedure.
The patient should sleep with limbs elevated every day and avoid sitting or standing for long periods of time, as well as walking a lot.
Radiofrequency vein ablation
Ablation of veins using a radiofrequency emitter is an emerging area of phlebology recently. This method allows you to eliminate varicose veins painlessly, without complications and with minimal risk of vascular lesions. Radiofrequency radiation acts on the inner lining of the vascular wall and destroys it. Therefore, the lumen of the vein collapses and nearby tissues are practically not affected. This is a very effective method.
The procedure is performed under local anesthesia on an outpatient basis. For accuracy during the procedure, control is carried out using duplex angioscanning.
After the anesthetics have taken effect, a vein puncture is performed. A catheter with an emitter is inserted into the vein. It advances to the point where the saphenous vein joins the deep venous system. With the gradual removal of the catheter, sequential irradiation of the vessel occurs from the inside. After the procedure, the puncture site is treated and covered with a bandage. A special elastic sock is put on the leg. After half an hour of walking under supervision, the patient can return home. If the patient's job does not involve physical labor, he has the right to work the day after the operation.
Varicoseextensionveins: operation
The appropriateness of surgical intervention is assessed by a phlebologist or vascular surgeon. For women who need surgery to correct a cosmetic defect, doctors suggest postponing the surgery if they are planning to become pregnant. This is due to the fact that during pregnancy varicose veins progress and the effect of the operation can be neutralized.
Combined phlebectomy
The most common option for solving the problem of varicose veins by surgical intervention is combined phlebectomy. The surgery is performed under general anesthesia or local anesthesia. All incisions are made as small as possible. For example, the great saphenous vein is removed through a one-and-a-half-centimeter incision in the groin area. An IV extractor probe with a special tip is inserted into the vein through the incision. Next, the probe is removed together with the vein. The small veins are removed through small ducts, the so-called mini-phlebectomy. After surgery, you must use compression garments.
Endovascular electrocoagulation
Removal of the saphenous veins by current. A more dangerous method than radiofrequency obliteration and classical surgery.
Cryosurgery
Removal of veins by exposure to low temperatures. The method is relatively safe. True, the depth of freezing is not always accurately calculated, which leads to damage to adjacent tissues or incomplete removal of the vein.
Intraoperative sclerobliteration
The use of transcatheter injection of a sclerosing agent into the saphenous veins. Before leg surgery, the saphenous veins and altered areas of the veins are marked. During the operation the anastomosis of the great saphenous vein and the femoral vein is exposed. The tributaries of the great saphenous vein are ligated. At a distance of 1 centimeter from the femoral vein, the saphenous vein is crossed and tied. A catheter is inserted into the severed vein, the vein is sutured, and the wound is bandaged. A roll of gauze is placed along the projection of the saphenous vein along the entire length of the leg and pressed. A sclerosing agent is injected at the same time as the catheter is removed.
Endoscopic dissection
Transilluminative phlebectomy of perforating veins allows you to ligate and exclude the veins from the blood flow. These veins connect the subcutaneous venous network with the deep network. An endoscopic probe is used.
Laser coagulation
The vein is sealed from the inside with a laser and excluded from the blood flow. Requires a highly qualified doctor and sufficient experience working with lasers.
Home treatment for varicose veins
At home, varicose veins can be treated with compresses, rubbing ointments, using leeches, apple cider vinegar and cabbage leaves. Home treatment can also be carried out by wearing compression garments or elastic bandages. But if the disease is in an advanced stage, none of the methods will help without surgical treatment.
Today, the only high-quality way to get rid of varicose veins are surgical methods, as well as cases of combining surgery with sclerotherapy and compression methods.