Phlebeurismis a pathological condition characterized by a change in the structure of the venous system, leading to an increase in the diameter of the lumen of superficial veins and disruption of the valve system, manifested by valve failure, i. e. in their incomplete closurein the vein.
Normally, blood flows through the veins against the force of gravity - from bottom to top, which is possible only thanks to the work of the venous valves. Under the influence of a number of reasons, primary (due to changes in the valve itself) or secondary (due to dilation of the vein) valve failure occurs; This condition is characterized by incomplete closure of the venous valve and reversed blood flow. Reverse blood flow aggravates changes in the vein wall and also contributes to stagnation of blood in the lower extremities, causing swelling of the lower extremities and a feeling of heaviness in the legs.
In addition to stagnation of blood in the lower extremities, the above processes lead to disruption of linear blood flow in the veins from top to bottom, the appearance of reflux (reverse blood flow) and turbulent blood flows in the areaof expansion. Changes in blood flow characteristics are the main 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 high and prolonged load on the venous valves. During physical activity - walking, running, swimming - the constant work of the muscles of the thigh and lower leg helps to "expel" blood from the venous system of the lower extremities. Static sitting for a long time leads to increased load on the venous valves, and over time, the venous valves, unable to withstand the load, may cease to fully perform their function.
- Obesityshould be considered the second most important reason. High weight also increases the load on the valvular system of the veins of the lower extremities, thereby contributing to disrupting 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 dysfunction of the venous valves. However, up to 50% of changes in the vein wall detected during pregnancy are functional in nature and disappear on their own during the first year after birth.
- Smoking– the fourth most common cause of varicose veins. Changes in the vein wall may be associated with the unfavorable effect of the composition of smoking mixtures on the tone of the vein wall.
- Heredity– another possible reason for the development of varicose veins. It is generally accepted that heredity plays a major 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 responsible for changes in the structure of connective tissue structures are the main cause of varicose veins. However, the influence of heredity can be significantly exaggerated, and lifestyle changes, normalization of body weight and smoking cessation will help 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 veins dilated several times may not be visible, especially with a pronounced subcutaneous layer.
- Lower limb edemaat the end of the working day, especially with asymmetrical swelling, are the earliest and most common sign of varicose veins.
- You should also think about the presence of varicose veins whenpresence of heaviness in the legsevening and night, cramps in legs at night.
- Spider veins and vein patternIntradermal veins, although more of a cosmetic problem, can also indicate the presence of changes in the saphenous veins.
- Persistent redness, thickening of the skin, lipodermatosclerosis, trophic ulcers of the foot and leg indicate a decompensated course of varicose veins.
Diagnosis of varicose veins
The diagnosis of varicose veins of the lower limbs can only be made on the basis of ultrasound diagnostic data.
When performing 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, measuring the diameter of the veins, analyzing the characteristics of blood flow in the veins and detects the presencereflux. Based on the data obtained, the doctor draws a conclusion.
Varicose vein prevention
Prevention of varicose veins consists of a rational motor diet, normalizing body weight and quitting smoking.
If there are early signs of varicose veins, venotonics and wearing compression stockings will help reduce the rate of progression of the disease.
Compression stockings must be chosen by a doctor based on the severity of the varicose veins and the patient's anthropometric data.
Treatment of varicose veins
The treatment of varicose veins is exclusively surgical.
Currently, many different methods of surgical treatment have been developed - from open techniques - phlebectomy combined with minimally invasive methods - laser or radiofrequency venous coagulation, mechanochemical methods.
- Varicose veins can be removed using miniphlebectomy, a technique in which varicose veins are removed from the subcutaneous tissue from separate, bandaged punctures.
- Small varicose veins can be eliminated by sclerotherapy - the introduction of a special glue-like substance - a sclerosant - into the vein lumens.
- Spider veins and intradermal veins can be removed by sclerotherapy.
However, even after the end of treatment, the risk of recurrence of varicose veins of the lower limbs is 10 to 15%. Adequate physical activity, playing sports (running, walking, exercise cycling, swimming), normalizing body weight and giving up bad habits will help reduce the risk of relapse 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 seeing a doctor!