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 a disorder of the valve system, which is 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 the bottom up, which is possible solely due to the work of the venous valves. Under the influence of a number of reasons, there is a primary (due to changes in the valve itself) or secondary (due to the expansion of the vein) valve stoppage, this condition is characterized by incomplete closing of the venous valve and reverse blood flow. Backflow of blood worsens changes in the vein wall, and 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 mentioned processes lead to a 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 expansion area. Changes in blood flow characteristics are the leading cause of thrombosis.
Possible causes of the development of varicose veins of the lower extremities
- Physical inactivity- the leading cause of varicose veins. A sedentary lifestyle and prolonged sitting contribute to a long-term heavy load on the venous valves. During physical activity - walking, running, swimming - the constantly working muscles of the upper leg and lower leg help to "eject" blood from the venous system of the lower extremities. Long-term static sitting in a sitting position leads to an increased load on the venous valves, and over time, the venous valves, unable to withstand the load, can stop performing their function completely.
- Obesityshould be considered the second most important reason. Heavy weight also increases the load on the valve system of the veins of the lower extremities, which contributes to the disruption of their proper functioning.
- Pregnancyis the third most common cause. Hormonal changes, increased body weight, compression of the pelvic veins by the fetus are sufficient reasons for venous valve dysfunction. However, up to 50% of changes in the venous wall detected during pregnancy are of a functional nature and disappear by themselves in the first year after birth.
- Smoking- the fourth most common cause of varicose veins. Changes in the venous wall may be related to the adverse effect of the composition of the smoking mixture on the tone of the venous wall.
- Heredity– another possible reason for the development of varicose veins. It is generally accepted that heredity plays a leading 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 are responsible for changes in the structure of connective tissue structures. leading 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 varicose veins may not be visible, especially with a pronounced subcutaneous layer.
- Edema of the lower extremitiesat the end of the working day, especially with asymmetric swelling, are the earliest and most common sign of varicose veins.
- You should also think about the presence of varicose veins whenthe presence of heaviness in the legsin the evening and at night, leg cramps at night.
- Spider veins and vein patternintradermal veins, although more of an aesthetic problem, may also indicate the presence of changes in the saphenous veins.
- Permanent redness, thickening of the skin, lipodermatosclerosis, trophic ulcers on the foot and leg indicate a decompensated flow of varicose veins.
Diagnosis of varicose veins
The diagnosis of varicose veins of the lower extremities can only be made on the basis of ultrasound diagnostic data.
During an ultrasound scan 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 joint, measures the diameter of the veins, analyzes the characteristics of the blood flow in the veins and detects the presence of reflux. Based on the obtained data, the doctor draws a conclusion.
Prevention of varicose veins
Prevention of varicose veins is a rational motor regime, normalization of body weight and smoking cessation.
If there are initial signs of varicose veins, venotonics and wearing compression stockings will help reduce the rate of progression of the disease.
Compression stockings should be chosen by the doctor depending on the severity of varicose veins and the patient's anthropometric data.
Treatment of varicose veins
Treatment of varicose veins is exclusively surgical.
Currently, many different methods of surgical treatment have been developed - from open techniques - combined phlebectomy to minimally invasive methods - laser or radiofrequency coagulation of veins, mechanochemical methods.
- Varicose veins can be removed by miniphlebectomy, a technique in which the varicose veins are removed from the subcutaneous tissue through separate punctures and bandaged.
- Small varicose veins can be removed by sclerotherapy - introducing a special glue-like substance - sclerosant - into the vein lumens.
- Spider veins and intradermal veins can be removed with sclerotherapy.
However, even after complete treatment, the risk of recurrence of varicose veins of the lower extremities is 10-15%. Adequate physical activity, playing sports (running, walking, exercise bike, swimming), normalizing body weight and giving up bad habits will help reduce the likelihood of recurrence after surgical treatment. Periodic use of phlebotonics and wearing properly selected compression stockings will help reduce the rate of spread.
The main thing is not to delay the visit to the doctor!