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Phlebeurism

symptoms of varicose veins

A team of qualified cardiovascular surgeons/phlebologists at the medical clinic diagnoses and treats all types of varicose veins at any stage of the disease, as well as associated pathologies. Our asset, which we are proud of, is treatment according to Israeli protocols, which show maximum effectiveness in clinical practice.

Varicose veins – the trigger for the development of varicose veins is considered to be a disruption of the normal functioning of venous valves with the occurrence of reverse flow (reflux) of blood.

As a rule, valves subjected to maximum mechanical stress are the first to be affected. In this case, the pathological discharge of blood occurs through the mouth of the large and small saphenous veins, sometimes through the large perforating veins. An excessive volume of blood forming in the superficial veins gradually leads to excessive stretching of the venous wall. It increases the total volume of blood contained in the superficial venous bed of the lower limbs. This increased blood volume continues to drain into the deep system through the perforating veins, overstretching them. As a result, valvular dilation and insufficiency occur in the perforating veins.

Symptoms and signs of the disease

Signs of illness are not necessarily associated with pain. On the contrary, most patients say that at the beginning of the disease they are more concerned about cosmetic problems than pain.

The clinical picture depends on the localization of the pathological process, as well as the stage of the disease.

Varicose veins of the lower extremities manifest themselves as follows:

  • Heaviness in the legs, feeling of fullness in the legs.
  • The appearance of cramps in the calf muscles, spasms of the feet and fingers.
  • Feeling tired after walking for a long time.
  • Swelling of the ankle in the evening.
  • Vein relief pattern on the skin, varicose veins, varicose veins.
  • Signs accompanying the disease are cellulitis, itchy legs, dry ankles and calves, thinning and sagging skin, long-healing ulcers, uneven pigmentation - from dark spots to colorless areas, pronounced nodular formations with a color from bluish to dark purple or burgundy, trophic ulcers.

Progressive venous disease is accompanied by a deterioration in general health:

  • Unstable blood pressure, hypertension, hypotension.
  • A feeling of chronic fatigue, apathy develops.
  • Arrhythmia, tachycardia.
  • Shortness of breath, frequent diseases of the respiratory system.

Noticeable symptoms of varicose veins of the lower extremities in women may appear stronger before menstruation and decrease afterward.

Symptoms of venous pathology of the upper extremities are characterized by numbness of the hands, spastic conditions of the fingers, sensation of goosebumps, tingling and cold.

Varicose veins of the esophagus are manifested by belching, burning sensation, pain behind the sternum, inflammation of the esophagus and stomach, difficulty swallowing and signs of reflux esophagitis, anemia.

Diagnosis of the disease

Effective treatment of varicose veins cannot be carried out without a complete preliminary diagnosis. The diagnosis is clarified by the clinical picture and data analysis after hardware studies.
The following methods are most often used for diagnosis:

  • duplex or triplex ultrasound angioscan;
  • phlebography with contrast;
  • MRI with venography;
  • Contrast angiography.

To determine the presence of reflux in the affected veins and evaluate blood flow, several test manipulations are performed:

  • Inspection of veins with compression on different segments.
  • Valsalva maneuver or stress test.
  • Parana test with imbalance to evaluate the veins in the calf areas.
  • Walking test of varying intensity.

Additional methods to clarify the diagnosis:

  • Plethysmography to determine venous reflux, obstruction.
  • CT, magnetic resonance imaging for visualization of tissues and structures in the affected area.
  • Infrared thermography to evaluate the temperature balance in the affected area of the body.
  • Intravascular ultrasound uses a catheter to view the vascular walls from the inside.

The results of any diagnostic studies performed are comprehensively evaluated. Any diagnosis is of great help in determining further treatment tactics.
Clinical laboratory tests on blood and urine complete the picture of the disease and may indicate concomitant pathologies.

How are varicose veins treated?

If alarming symptoms of varicose veins appear, you need to consult a doctor to get a diagnosis and start treatment in a timely manner. In regional medical institutions, this problem is addressed by general surgeons, in clinics - by phlebologists and angiosurgeons.

The multidisciplinary medical clinic has a well-equipped phlebology department, staffed by a team of surgeons with extensive practical experience. The center offers a high level of service and quality of treatment, which is reflected in the excellent clinical results of which we are proud.

Varicose veins of the lower extremities and other types of pathologies can be treated in the early stages of development. As the process progresses, it proves to be increasingly ineffective, partly retaining only a symptomatic meaning.

Therapeutic effects cannot completely eliminate the disease, but as long as it is possible to delay the destruction of blood vessels and the development of complications, this must be done by all available means.

Conservative treatment

  • At the beginning of the treatment of varicose veins, drugs are limited to venotonic agents.
  • To reduce the risk of thrombosis and occlusion, injections of anticoagulants and low molecular weight heparin-fragmine are used.
  • New oral anticoagulants.
  • For inflammatory phenomena of the blood vessels and surrounding tissues, the use of external non-steroidal anti-inflammatory drugs with diclofenac and indomethacin is indicated.

How to further treat varicose veins?

In parallel with therapeutic treatment, the patient is advised to perform some exercises that strengthen the muscular corset of the lower extremities and have a general strengthening effect. For example, the best exercises in a lying position are the "bicycle", alternately pulling the toes towards you and stretching them, as in ballet.

  • You should be careful with water and spa procedures, because hot baths and showers, beach holidays in the sun with sunbathing can worsen the situation. Blood vessels need to be strengthened, this is facilitated by hardening with a contrast shower, when hot and cold water are poured alternately on the legs.
  • For pain, inflammation and heaviness in the legs, daily fresh foot baths with decoctions of oak bark, chamomile, calendula, birch leaves, St. John's wort, white acacia flowers and horse chestnut are recommended.
  • It is useful to rub freshly squeezed juice of aloe leaves into the skin, it softens the skin and prevents inflammation.
  • It is worth changing your habits and quitting smoking. The diet should be dominated by vitamin-rich foods with plenty of fiber, fresh vegetables, citrus fruits and seafood.
  • You need to change your diet by drinking enough water every day (1. 5 to 2 liters). At the same time, you should reduce the consumption of coffee, strong tea, chocolate and alcohol.

If the veins in your legs are enlarged, your doctor may recommend periodic or constant use of compression stockings.

Attention! In any case, you should listen to your doctor's recommendations and strictly follow them. Self-medication is unacceptable!

Causes of the disease

The family history of onset allows us to conclude that varicose veins are genetically determined and can be transmitted hereditarily.

In many clinical cases it is impossible to determine the exact cause of the disease. The researchers concluded that the culprit is a combination of several internal and external factors.

Causes of varicose veins:

  • congenital defect of the valvular system;
  • physical inactivity, lack of activity;
  • pregnancy;
  • working conditions with prolonged stress on the legs, long periods of standing, in a static position;
  • treatment with some hormonal drugs;
  • uncomfortable shoes, high heels;
  • obesity;
  • tight underwear, clothes that constrict the hips, knees (e. g. very tight jeans, shapewear);
  • regular weight lifting;
  • systemic pathology of the kidneys, heart and blood vessels;
  • diabetes;
  • regular bowel problems, frequent diarrhea or constipation.

Varicose veins of the lower extremities (varicose veins)- dilation of the superficial veins of the lower limbs, accompanied by valve insufficiency and alteration of blood flow. The term "varicose veins" comes from Latin. varix - "swelling".

As a result, the veins stop functioning properly, the entire circulatory system is disrupted, complicated by congestion, violation of trophism in the tissues and blockage of blood vessels with blood clots.

Many complications are life-threatening, therefore, if the appearance of varicose veins is suspected, diagnosis and treatment must be carried out immediately and professionally.

Types of disease

Blood flow in the vessels changes, slows, and blood clots can form in the uneven walls. Changes in the functionality of blood vessels cause blood stagnation, venous insufficiency and persistent disturbances of capillary circulation in the periphery.

According to the WHO, varicose veins occur in 45% of women and 20% of men.

According to the generally accepted international classification CEAP, varicose veins are divided into six classes-stages of the disease, based on the fact that C0 is the complete absence of subjective, visual and clinical signs.

  • C1 – the initial stage, manifested by a capillary network and varicose veins on the skin.
  • C2 – visible thickening of the veins under the skin, venous pattern in the lower extremities in the form of blue threads.
  • C3 – swelling of the legs appears as a consequence of prolonged standing or a state of rest (night sleep).
  • C4 – the surface of the skin changes, irregularly pigmented areas appear, venous eczema, accompanied by itching and ulcers, lipodermatosclerosis.
  • C5 – venous ulcers on the surface of the skin that heal after some time.
  • C6 – venous trophic ulcers that do not heal.

The classification of varicose veins of the lower limbs distinguishes between pathology of superficial and/or deep vessels and perforating communicating veins.

By origin, venous deformation can be:

  • congenital, which occurs in newborns;
  • acquired;
  • secondary, occurring against the background of other pathologies, injuries;
  • idiopathic, with unknown cause.

The complete classification of varicose veins of the lower extremities and organs also includes complications: reverse blood flow, reflux and/or occlusion, blockage of the lumen.
Varicose veins of the lower extremities are not the only manifestation of varicose veins, although the most common. There are also varicose veins of the esophagus, sublingual veins, retina, scrotum (varicose veins in men), stomach, corpora cavernosa of the rectum (hemorrhoids), pelvic veins, female genital organs - vulva, labia, uterus.

Surgical treatment of varicose veins

RFO (radiofrequency obliteration of the saphenous veins)is a modern method for treating varicose veins. The treatment involves the application of radiofrequency radiation to the internal wall of the vein. Using the thermal effect, the vein is "welded", disconnected from the general blood flow, and after a few months it is replaced by connective tissue.

Advantages

  • The procedure is performed without general anesthesia; local anesthesia is sufficient;
  • Maximum safety for the patient's health
  • RFA does not require special preparation;
  • During the manipulation the patient does not feel pain or discomfort;
  • Radiofrequency ablation of the veins of the lower extremities is very effective;
  • Low probability of complications, almost all patients tolerate this procedure well;
  • Radiofrequency ablation can be associated with miniphlebectomy of the tributaries or sclerotherapy;
  • After radiofrequency ablation no scars or marks remain;
  • Literally a couple of days after the procedure, the patient will be able to return to his normal lifestyle.

How is it going

The operation is carried out under ultrasound control. Before the procedure begins, local anesthesia is administered so that the patient does not feel pain or discomfort during the treatment.
Let's look at how RFA is performed step by step:

  • Before the operation, the lower extremities are carefully treated with antiseptic agents. The doctor then uses a marker to mark the vein prone to varicose veins. Then the doctor inserts a radiofrequency catheter into the vein and treats the desired area with radiofrequency waves.
  • At the end of the procedure, the catheter is removed, the doctor applies a bandage and helps the patient put on compression garments.
  • The procedure takes 30 to 50 minutes. To stop the flow of blood through a weakened vessel, it is necessary to destroy it. Then the body itself will redirect the blood through healthy veins. As a result, after ablation, the walls of the veins join together and form scar tissue inside (it is safe and not visible), and varicose veins disappear.

Rehabilitation

Immediately after the operation the patient must walk (about 30 minutes) to avoid stagnation of blood and lymph. After radiofrequency ablation of the veins of the lower extremities, it is necessary to carefully follow the recommendations of doctors:

  • During the week, intensifying physical activity and lifting heavy loads is prohibited;
  • It is necessary to walk more, stay in the same position as little as possible (with the exception of sleeping);
  • For 3-4 weeks you need to stop taking hot baths, you can only take a shower;
  • It is necessary to interrupt the visit to the bathhouse for at least a month;
  • It is necessary to drink as much plain water as possible, on average about 2. 5 liters, while it is necessary to minimize the amount of salt consumed;
  • A week after the operation, you need to start physical therapy, which the doctor will tell you about;
  • It is possible that after radiofrequency ablation of the veins of the lower extremities, the doctor will prescribe certain medications.

Following these rules will help you avoid complications and prevent the further development of varicose veins.

A week after the operation, a re-examination (ultrasound examination of the veins of the lower extremities) is necessary. More detailed information about radiofrequency ablation of lower extremity veins can be obtained during an in-person consultation with a specialist.

Laser coagulation of veins

Endovascular (intravenous) laser coagulation (obliteration) of varicose veins (EVLK, EVLO) is a modern method designed to eliminate blood reflux in superficial and perforating veins using the thermal energy of laser radiation. EVLO allows you to do without incisions and does not require hospitalization of the patient. The international term is EVLA (endovenous laser ablation).

Main phases

  • Venous puncture. Performed under ultrasound guidance.
  • Positioning of the light guide. The light guide is a thin optical fiber. Laser radiation is supplied to its end. The light guide is inserted into the diseased vein. Its end is installed at the place where the varicose vein flows into healthy deep veins, that is, at the anastomosis.
  • Tumescent anesthesia. A "cushion" of anesthetic is created around the vein to better press the vein against the light guide and avoid damage to surrounding tissue.
  • Laser coagulation of veins. Laser radiation is supplied to the working part of the light guide.
  • At the same time, the light guide is slowly pulled out of the vein. In this way the vein is uniformly heated by the laser up to a temperature of 85°C. A heated vein, like any protein, contracts when heated. The lumen of the vein disappears, the blood flow through it stops.

Rehabilitation

Immediately after the operation the patient must walk (about 40 minutes) to avoid stagnation of blood and lymph. After EVLO of the veins of the lower extremities, it is necessary to follow the recommendations of doctors:

  • During the week, intensifying physical activity and lifting heavy loads is prohibited;
  • It is necessary to walk more, stay in the same position as little as possible (with the exception of sleeping);
  • For 3-4 weeks you need to stop taking hot baths, you can only take a shower;
  • It is necessary to interrupt the visit to the bathhouse for at least a month;
  • It is necessary to drink as much plain water as possible, on average about 2. 5 liters, while it is necessary to minimize the amount of salt consumed;
  • A week after the operation, you need to start physical therapy, which the doctor will tell you about;
  • Your doctor may prescribe some medications after the operation.

Sclerotherapyis a method of non-surgical (minimally invasive) elimination of varicose veins and varicose veins of the lower extremities.

Benefits of venous sclerotherapy:

  • absolute outpatient care, which does not require any additional preparation,
    execution speed,
  • no need for anesthesia,
  • absence of complications typical of surgical treatment methods such as nerve damage,
  • the absence of "heat-induced phlebitis", characteristic of coagulation methods, accompanied by annoying pain along the coagulated vein.

Therefore, today sclerotherapy of varicose veins is an effective and safe method, which in some cases can be used as an alternative to other types of surgical interventions.

The sclerotherapeutic method is based on the obliteration of the vein by introducing a chemical substance into its lumen, which "washes away" the internal layer (endothelium) with the development of subsequent endofibrosis. The extent of endothelial damage depends on the concentration and volume of the drug administered.

The modern medical center uses advanced technologies for the treatment of varicose veins, ensuring maximum effectiveness of all therapeutic measures. The use of modern equipment by experienced professionals will free you from varicose veins in the shortest possible time, without complications and without the need for long-term rehabilitation.

Treatment in a modern clinic means health and a significant improvement in the quality of life.