Varicose veins on the legs: treatment, symptoms, surgery

Signs of varicose veins on the legs

Varicose veins are not just a cosmetic defect that appears on the thighs, legs and upper part of the foot in the form of a woody blue web, accompanied by pain and convulsive twitching in the lower leg muscles when walking or exercising, 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 every fourth person on the planet.

Thrombotic complications lead to the appearance of trophic ulcers on the legs, acute blood flow pathologies and tissue necrosis of the lower extremities. Often a blood clot that detaches from the vessel wall and enters the circulatory system of the lower extremities ends its journey through the human circulatory system in the heart or brain. A high risk of stroke or heart attack is the main factor for starting treatment and prevention of varicose veins, not the unaesthetic appearance of the legs.

Since its inception, the disease has steadily progressed, affecting new areas of the internal and external venous system of the legs. Therefore, it would be logical to start the problem with disease prevention. Competent preventive measures in most cases predetermine the speed of the development of the pathology, which develops against the background of a hereditary defect in the valve 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 so that it cannot help push the blood through contractions. To control the directed flow of blood and prevent its stagnation, veins have specialized valves. In some people, the valves cannot function properly due to heredity. However, valve pathology can develop with age due to:

  • heavy physical activity;

  • increased intra-abdominal pressure;

  • prison;

  • frequent pregnancies.

Initially, the process develops in the external veins, but as the disease progresses, it affects the deep venous network. The process of developing the disease can take decades, and the speed depends on the lifestyle, the strength of the blood vessel walls and the intensity of physical activity.

The first task of prevention– minimize the increase in intra-abdominal pressure, avoid increased overload and fight constipation.

Second task- they encourage 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 even better several times during the day. The essence of the technique is to place the outstretched legs on the ground at an angle of 45 degrees to the horizontal. You must lie in this position for at least half an hour. For those who already have varicose veins, it is recommended to sleep with the legs elevated as often as possible.

If you have a disease, you should not use tight shoes and socks with a tight elastic band, so as not to complicate the already impaired blood circulation.

Also, when doing sedentary work or just sitting for long periods of time, try to put your legs in a horizontal position and, if possible, put your feet on an elevation. Of course, this does not mean that when you work in the office you have to sit with your feet on the table. no. Just try to put something under the table that allows you to rest your feet undisturbed while sitting. You should also avoid the habit of crossing your legs while sitting. At home, you can elevate your legs by placing a few pillows.

Conservative treatment

The non-surgical treatment program consists of diet, medication and compression therapy.

Diet

Normal operation of valves in a healthy vein and valve pathology in varicose veins

One of the risk factors for varicose veins is excess weight. Therefore, diet is one of the treatment factors. The diet must be balanced so that the calories received do not exceed the amount necessary to meet daily needs. Moreover, the number of calories varies depending on the presence or absence of exercise. Hot spices, marinades, pepper, excess salt, alcohol, smoked foods should be eliminated from the diet, and fried foods should be eaten less.

The menu should consist of a sufficient amount of vegetables and fruits that contain vitamin C, dishes that contain a large amount of fiber, seafood and integral bread. Frequent small meals are recommended. It is important to note that animal fats should be present in moderate amounts. Do not listen to those who say that cholesterol is absolutely evil. Cholesterol in reasonable amounts helps to strengthen the vascular walls, reducing the risk of vein ruptures and recurrent thrombotic deposits.

To give up smoking

Smoking is the most harmful habit for varicose veins. The fact is that tars contained in cigarettes clog blood vessels, and carbon dioxide causes vascular spasms. Smoking increases the risk of blood clots and, as a result, secondary complications such as heart attack and stroke. Smoking is especially dangerous for those who take hormonal drugs for varicose veins.

Compression underwear (socks, socks, knee socks)

This prevention and treatment option is well suited in the early stages of the disease. Underwear can be selected according to several parameters of pressure on soft tissues, color scheme and model option. Underwear is put on in the morning, without getting out of bed, until the veins are full of blood. The main obstacle to using this method of prevention is the inflated price. Therefore, the main consumers of knitwear are not those who need prevention, but those who use underwear after surgery for the purpose of secondary prevention.

Varicose veins: drug treatment

Medicines cannot completely cure or stop the disease.

Venotonics - ointments and gels

Spider veins on legs with varicose veins

Venotonics are aimed at strengthening the vein walls, stimulating blood flow and slightly improving microcirculation. These medications, when taken as a course, can reduce pain and swelling. The course of drug administration is carried out twice a year and lasts at least two months.

Ointments and gels, although safe, are practically useless. They cannot penetrate beyond the skin and consequently affect the condition of the blood vessels. Ointments and gels are prescribed in the early stages of the disease, when it is not yet known what can remove swelling and heaviness in the legs: drugs or postural drainage and cessation of physical activity. Sometimes ointment manufacturers are cunning and recommend using the product in combination with tablets.

  • flavonoid-based ointment rutin.

  • ointment containing horse chestnut extract is applied twice a day.

  • gel, whose active ingredient is an extract from grape leaves. There are also medicine capsules that are taken on an empty stomach twice a day.

Venotonics in tablets

Venotonic tablets are used for varicose veins.

  1. Saponin derivatives of the drug are obtained on the basis of horse chestnut, which contains the plant bioflavonoid escin. This includes medicine that exists in the form of drops and tablets.

  2. The most effective preparations are made on the basis of plant flavonoids obtained from citrus fruits - a powerful venotonic. The course of treatment with these drugs can last up to six months.

  3. Rutosides are the first venotonics. Their action is the improvement of microcirculation and anti-inflammatory action.

    • Natural rutoside, which is available in the form of tablets and capsules.

    • Semi-synthetic rutosides.

    • Combined root wall. It combines a semi-synthetic derivative of rutin and ginkgo biloba extract. The medicine in the form of capsules is taken twice a day for a month.

Medicines for phlebosclerosis

It allows you to disconnect the veins from the blood stream without surgery. The action is achieved by the growth of connective tissue that gradually closes the lumen of the vessel. Connective tissue is stimulated by increased coagulation of endothelial proteins, as well as by irritation of the smooth muscles of blood vessels.

  • Ointment based on acid glycosaminoglycan containing sulfur, glucocorticoids and nonionic surfactant is the simplest option. However, the effect is so weak that solutions for injections are used.

  • Synthetic phlebosclerotics.

  • Products containing iodine or based on animal proteins. Medicines are used to selectively close the small vessels in the affected areas of the veins. Medicines that do not cause thrombosis of blood vessels are popular among doctors,Lower limbs before and after treatment of varicose veinsThey burn only the walls at the level of the endothelium.

Phlebosclerotic therapy includes drug injections or an elastic bandage. This is a fairly simple, painless technique that does not affect the patient's well-being and is quite popular among doctors.

However, isolated sclerotherapy does not provide lasting results and cannot stop the progression of the disease. Therefore, it is better to use it in combination with surgical treatment. Before therapy, it is necessary to undergo an ultrasound of the lower extremities in order to exclude extensive lesions of the saphenous and deep veins.

Contraindications for phlebosclerosis are: drug allergies, atherosclerosis of large blood vessels and the presence of ischemia, obliterating endarteritis, diabetic angiopathy, damage to the 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 breakdown of platelets, reduce blood viscosity and increase the elasticity of red blood cells. These processes improve blood flow to tissues and oxidative reactions in them.

  • Anticoagulants of direct or indirect action. Reduce the risk of thrombosis. Popular products in the form of ointments and gels have anti-edematous, anti-inflammatory and anti-thrombotic effects.

  • Non-steroidal anti-inflammatory drugs - suppress inflammatory processes and relieve pain.

Possibilities of phlebosclerosis therapy

  • Veins are sclerosed before surgery to reduce the risk of thrombosis and bleeding in the postoperative period.

  • During surgery as an alternative to vein removal.

  • After surgery to close unoperated veins.

The puncture method for drug administration is used at all times, and the catheter method is used exclusively during surgery.

Puncture method

Apart from the operating room, it can only be performed in a specialized surgical room with compliance with all aseptic rules. Large veins are closed first, then small ones. Medicines are given from top to bottom. The venipuncture is performed with the patient in an upright position, and the drugs are administered in a horizontal position. If sclerosis of the dilated vessel is necessary, the procedure is carried out in several sessions. After the sessions, the patient is registered with a phlebologist for three years for observation.

  • After applying the medicine, the limb is subjected to an elastic bandage, 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 his limbs elevated every day and avoid long sitting or standing, as well as a lot of walking.

Radiofrequency vein ablation

Ablation of veins using a radiofrequency emitter is a recent new field of phlebology. This method allows you to get rid of varicose veins painlessly, without complications and with minimal risk of injury to blood vessels. Radiofrequency radiation acts on the inner lining of the vascular wall and destroys it. Therefore, the lumen of the vein collapses, and the adjacent tissues are practically not affected. This is a very effective method.

The procedure is performed on an outpatient basis under local anesthesia. For the sake of precision during the procedure, the control is carried out using duplex angioscanning.

After the anesthetics start working, the vein is punctured. A catheter with an emitter is inserted into the vein. It progresses to the point where the saphenous vein joins the deep vein system. By gradually removing the catheter, the vessel is repeatedly irradiated from the inside. After the procedure, the injection site is treated and covered with a bandage. A special elastic sock is put on the leg. After half an hour of supervised walking, the patient is allowed to go home. If the patient's job does not involve physical labor, he has the right to work the day after the procedure.

Varicose veinsexpansionveins: surgery

The advisability of surgical intervention is considered 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 with surgery is combined phlebectomy. The operation 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. A phlebextractor probe with a special tip is inserted into the vein through the incision. After that, the probe is removed together with the vein. Small veins are removed through small channels, the so-called mini-phlebectomy. Compression garments should be used after surgery.

Endovasal electrocoagulation

Removal of saphenous veins using electricity. A more dangerous method compared to radiofrequency obliteration and classic surgery.

Cryosurgery

Removal of veins by exposure to low temperatures. The method is relatively safe. True, the depth of freezing is not always calculated correctly, which leads to damage to adjacent tissues or incomplete removal of the vein.

Intraoperative scleroobliteration

The use of catheter injection of a sclerosing agent into the saphenous veins. Before the 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 revealed. 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 ligated. A catheter is inserted into the severed vein, the vein is sutured, and the wound is bandaged. A roll of gauze and pressure is placed along the projection of the saphenous vein along the entire length of the leg. At the same time as the catheter is withdrawn, a sclerosant is injected.

Endoscopic dissection

Transillumination phlebectomy of perforating veins enables ligation and disconnection of veins from the blood stream. These veins connect the subcutaneous network of veins with the deep network. An endoscopic probe is used.

Laser coagulation

The vein is sealed from the inside with a laser and cut off from the blood stream. It requires a highly qualified doctor and sufficient experience in working with lasers.

Home treatment of varicose veins

At home, varicose veins can be treated with tablets, rubbing ointments, using leeches, apple cider vinegar and cabbage leaves. Home treatment can also be carried out by wearing a compression suit or an elastic bandage. But if the disease is advanced, none of the methods will help without surgical treatment.

Today, the only high-quality way to get rid of varicose veins is surgical methods, as well as cases of combining surgery with sclerotherapy and compression methods.