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Phlebeurism

symptoms of varicose veins

A team of qualified cardiovascular surgeons/phlebologists of 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 the venous valves with the appearance of blood backflow (reflux).

As a general rule, valves subject to maximum mechanical stress are the first to be affected. In this case, the pathological flow of blood occurs through the mouth of the large and small saphenous veins, sometimes through the large perforating veins. Excessive blood volume appearing in the superficial veins gradually leads to excessive stretching of the vein wall. The total volume of blood contained in the superficial venous bed of the lower limbs increases. This increased blood volume continues to flow into the deep system through the perforating veins, stretching them excessively. As a result, valvular dilatation and insufficiency occurs 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 aesthetic problems than about 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 limbs 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 a long walk.
  • Swelling of the ankle in the evening.
  • Veinous relief pattern on the skin, spider veins, spider veins.
  • Signs accompanying the disease are cellulite, itchy legs, dry ankles and calves, thinning and sagging skin, long-healing ulcers, uneven pigmentation - from dark spots to colorless areas, pronounced nodular formationswith a color ranging 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.
  • Feeling of chronic fatigue, apathy develops.
  • Arrhythmia, tachycardia.
  • Shortness of breath, frequent diseases of the respiratory system.

Obvious symptoms of varicose veins of the lower extremities in women may appear stronger before menstruation and diminish after it.

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

Esophageal varicose veins are manifested by belching, burning sensation, pain behind the breastbone, 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 analysis of data after material studies.
The following methods are most often used for diagnosis:

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

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

  • Vein inspection with compression on different segments.
  • Valsalva maneuver, or stress test.
  • Parana test with imbalance to evaluate the veins in the calves.
  • Variable intensity walk test.

Additional methods to clarify the diagnosis:

  • Plethysmography to determine venous reflux, obstruction.
  • CT, MRI for visualization of tissues and structures in the affected area.
  • Infrared thermography to assess thermal balance in the affected area of the body.
  • Intravascular ultrasound uses a catheter to view the vessel walls from the inside.

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

How are varicose veins treated?

If alarming symptoms of varicose veins appear, you should consult a doctor to get a diagnosis and start treatment as soon as possible. In regional medical institutions, this issue is dealt with 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 at the earliest stages of development. As the process progresses, it turns out to be more and more ineffective, partly retaining only symptomatic significance.

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 should be done by all available means.

Conservative treatment

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

How to additionally treat varicose veins?

Along with therapeutic treatment, the patient is recommended to perform certain exercises that strengthen the muscular corset of the lower extremities and have a general strengthening effect. For example, the best exercises while lying down are the "bicycle, " alternately pulling your toes toward you and stretching them, like in ballet.

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

If the veins in the legs are enlarged, the doctor may recommend periodic or constant wearing 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 disease

Family history of occurrence 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. Researchers concluded that the culprit was a combination of several internal and external factors.

Causes of varicose veins:

  • congenital defect of the valve system;
  • physical inactivity, lack of activity;
  • pregnancy;
  • working conditions with prolonged demands on the legs, long periods of standing, in a static position;
  • treatment with certain hormonal drugs;
  • uncomfortable shoes, high heels;
  • obesity;
  • tight underwear, clothing that tightens the hips, knees (e. g. very tight jeans, shapewear);
  • lift weights regularly;
  • systemic pathology of the kidneys, heart and blood vessels;
  • diabetes;
  • regular intestinal problems, frequent diarrhea or constipation.

Lower limb varicose veins (varicose veins)- dilation of the superficial veins of the lower extremities, accompanied by valvular incompetence and impaired blood flow. The term "varicose veins" comes from Latin. varicose veins - "swelling".

As a result, the veins cease to function properly, the entire circulatory system is disrupted, complicated by congestion, disruption of tissue trophism and blockage of blood vessels by blood clots.

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

Types of diseases

Blood flow in the vessels changes, slows down, and blood clots can form in the uneven walls. Changes in the functionality of blood vessels cause blood stagnation, venous insufficiency and persistent disorders 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 CEAP classification, 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 spider veins on the skin.
  • C2 – visible thickening of veins under the skin, vein pattern in the lower extremities in the form of blue threads.
  • C3 – swelling of the legs appears following prolonged standing or a state of rest (night sleep).
  • C4 – the surface of the skin changes, unevenly pigmented areas appear, venous eczema, accompanied by itching and ulcers, lipodermatosclerosis.
  • C5 – venous ulcers on the surface of the skin that heal after a while.
  • C6 – non-healing venous trophic ulcers.

The classification of varicose veins of the lower limbs distinguishes pathologies on superficial and/or deep vessels, perforating the communicating veins.

By origin, venous deformation can be:

  • congenital, manifesting itself in infants;
  • acquired;
  • secondary injuries, occurring against the background of other pathologies;
  • idiopathic, cause unknown.

The comprehensive classification of varicose veins of the lower extremities and organs also includes complications - reverse blood flow, reflux and/or occlusion, lumen blockage.
Varicose veins of the lower extremities are not the only manifestation of varicose veins, although they are 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 genitalia- vulva, labia, uterus.

Surgical treatment of varicose veins

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

Benefits

  • The procedure takes place without general anesthesia; local anesthesia is sufficient;
  • Maximum safety for patient health
  • RFA does not require any special preparation;
  • During manipulation, the patient does not feel pain or discomfort;
  • Radiofrequency ablation of lower limb veins is very effective;
  • Low risk of complications, almost all patients tolerate this procedure well;
  • Radiofrequency ablation can be combined with mini-phlebectomy of the tributaries or sclerotherapy;
  • After radiofrequency ablation, no scars or marks remain;
  • Just a few days after the procedure, the patient will be able to return to their normal lifestyle.

How does it happen

The procedure 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 see 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. Next, 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 dressing and helps the patient put on support clothing.
  • The procedure lasts 30 to 50 minutes. To stop blood flow in a weakened vessel, it must be destroyed. Then the body itself will redirect the blood to healthy veins. As a result, after ablation, the walls of the veins stick together and form scar tissue inside (it is safe and invisible), and the 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 limbs, it is necessary to scrupulously follow the recommendations of doctors:

  • During the week, increased physical activity and heavy lifting are prohibited;
  • You need to walk more, be in the same position as little as possible (with the exception of sleeping);
  • For 3-4 weeks you need to stop taking a hot bath, you can only take a shower;
  • You must stop visiting public baths for at least a month;
  • It is necessary to drink as much plain water as possible, on average about 2. 5 liters, while minimizing the amount of salt consumed;
  • A week after the operation, you should 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.

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

A week after the operation, it is necessary to re-examine (ultrasound examination of the veins of the lower extremities). You can find more detailed information about radiofrequency ablation of lower extremity veins during an in-person consultation with a specialist.

Laser coagulation of veins

Endovasal (endovenous) laser coagulation (obliteration) of varicose veins (EVLK, EVLO) is a modern method designed to eliminate blood reflux in superficial and perforating veins using thermal energy of laser radiation. EVLO eliminates the need for incisions and does not require the patient to be hospitalized in a hospital. The international term is EVLA (endovenous laser ablation).

Main steps

  • Venipuncture. Carried out under ultrasound guidance.
  • Positioning of the light guide. The light guide is a thin optical fiber. Laser radiation is delivered to its tip. The light guide is inserted into the diseased vein. Its end is installed at the place where the varicose vein flows into the healthy deep veins, that is, at the level of 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 venous coagulation. Laser radiation is supplied to the active part of the light guide.
  • At the same time, the light guide is slowly withdrawn from the vein. Thus, the vein is uniformly heated by the laser 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, increased physical activity and heavy lifting are prohibited;
  • You need to walk more, be in the same position as little as possible (with the exception of sleeping);
  • For 3-4 weeks you need to stop taking a hot bath, you can only take a shower;
  • You must stop visiting public baths for at least a month;
  • It is necessary to drink as much plain water as possible, on average about 2. 5 liters, while minimizing the amount of salt consumed;
  • A week after the operation, you should start physical therapy, which the doctor will tell you about;
  • The doctor may prescribe certain medications after the operation.

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

Benefits of Vein Sclerotherapy:

  • absolute outpatient care, requiring no additional preparation,
    timeliness,
  • no need for anesthesia,
  • absence of complications typical of surgical treatment methods such as nerve damage,
  • the absence of "thermally induced phlebitis", characteristic of coagulation methods, accompanied by shooting pain along the coagulated vein.

So, 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 sclerotherapy method is based on obliteration of the vein by introducing a chemical into its lumen, which "washes" the inner layer (endothelium) with the subsequent development of endofibrosis. The degree of endothelial injury 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 relieve you of varicose veins in the shortest possible time, without complications and the need for long-term rehabilitation.

Being treated in a modern clinic is synonymous with health and a significant improvement in the quality of life.