According to statistics, up to 20% of the population suffers from varicose veins of the lower extremities, while in women the disease occurs 2 times more often. It has been proven that women have additional predisposing factors that contribute to a decrease in vascular tone (pregnancy, taking estrogen-progestin contraceptives, imbalance of sex hormones).Types of treatment of leg veins do not differ between men and women, however, the frequency of postoperative relapses in women is higher due to the additional influence of hormones (influence of estrogen and progesterone).
What causes varicose veins on women's legs?
Venous diseases of the legs should be treated by a phlebologist who deals specifically with this pathology. Various methods of treating varicose veins are not radical, since they are not aimed at eliminating the main pathogenetic cause - failure of the valvular apparatus of the vein. Surgical and conservative treatments delay disease progression for long periods. The recurrence rate is high and reaches 10 to 50% 5 years after surgery.
Treatment of varicose veins must be comprehensive. There are three groups of methods for eliminating varicose veins:
- phlebosclerosing,
- surgical,
- conservative.
Each type of treatment has its own advantages and disadvantages as well as a certain relapse rate. The choice of method is conditional, since the phlebologist often has to combine all three methods to obtain the most favorable result.
Characteristic symptoms of varicose veins in women
Symptoms of varicose veins begin with the appearance of functional disorders such as a feeling of heaviness in the legs, swelling of the ankle joints at the end of the working day. Spider veins first form on the skin of the legs.
Spider veins are one of the first symptoms of the development of varicose veins of the legs. The main signs of the disease – associations of saphenous varicose veins – appear several years after the onset of the disease. If not treated at this stage, symptoms such as cramps in the calf muscles and itchy skin on the legs appear.
Signs of trophic disorders: skin pigmentation of the lower third of the leg, cyanosis, sclerotic changes in the subcutaneous tissue, eczema, against which a trophic ulcer is formed.
Characteristic symptoms of varicose veins in women
- Painful symptoms appear cyclically and intensify before menstruation, which is associated with changes in the level of sex hormones;
- During pregnancy, signs of varicose veins may disappear after delivery;
- in the second half of the menstrual cycle, due to the action of progesterone, the diameter of varicose veins increases, so the symptoms of swelling and heaviness in the legs are more pronounced;
- Signs of varicose veins worsen during hormone treatment.
Now let's talk about therapeutic methods.
Radiofrequency ablation and endovenous laser coagulation
Radiofrequency vein ablation
The method is based on the introduction, under ultrasound guidance, of a special disposable catheter into the lumen of the dilated vein. The catheter is equipped with a special electrode, the active part of which is heated to 120 degrees under the influence of radio frequency radiation. Advancing the catheter along the vein leads to bonding or "welding" of the vascular wall. Obliterated veins are excluded from the circulatory system of the legs.
Endovenous laser coagulation
The surgical technique consists of puncturing the affected vein and inserting a laser light guide into its lumen under ultrasound guidance. Under the influence of laser radiation, proteins in the vascular wall coagulate, as a result of which the vein collapses, and after a while it is overgrown with connective tissue. Radiofrequency ablation (RFA) and endovenous laser obliteration (EVLO) are relatively new methods of treating varicose veins of the legs. Despite the differences in execution techniques, they have common characteristics.
Advantages and disadvantages of RFA and EVLA
| Does not require hospitalization | High price |
| Speed of execution (30 minutes to 1 hour) | Relapse rate up to 10% |
| Painless | Impossibility of performing the procedure due to certain anatomical characteristics of the veins (severe tortuosity of the blood vessels) |
| Bloodless | |
| Performed under local anesthesia | |
| Absence of postoperative scar (cosmetic effect sought for women) | |
| Short periods of rehabilitation |
RFA or EVLO are chosen by women who wish to treat varicose veins on an outpatient basis with minimal restriction of physical activity in the postoperative period and while maintaining the aesthetic appearance of their legs.
Phlebosclerotherapy
A special drug is injected into the lumen of the affected segment of the vein, which has a sclerosing ("gluing") effect on the vessel wall. The sclerosing agent can be used in liquid or foam form. Preference should be given to foam sclerotherapy due to the greater contact surface of the substance with the vein wall.
Advantages and disadvantages of phlebosclerotherapy:
| No postoperative scar | Possibility of long-term pigmentation of the skin at the puncture site (up to 2 years) |
| Performed on an outpatient basis | In rare cases, postoperative inflammation of the vein (phlebitis) |
| The operation is performed without anesthesia | Swelling and redness of the tissues for 2 days after the procedure |
| The manipulation is practically painless (slight burn at the puncture site) | Allergic reaction due to individual intolerance to the drug |
| In 20% of cases, spider veins appear on the legs (telangiectasia) | |
| Relapse rate up to 50% |
Recurrence of varicose veins after sclerotherapy depends on the lumen of the affected vessel - the wider the lumen, the higher the risk of recanalization. Sclerosing therapy is chosen in the treatment of recurrent varicose veins after surgical phlebectomy.
Surgical phlebectomy
Surgery is a more radical way to eliminate varicose veins. The principles of surgical treatment are to eliminate the pathological flow of blood from deep veins to the superficial veins of the legs and to eliminate the dilated vessels themselves. Steps of combined phlebectomy:
- Cross and ligate the mouth of the great saphenous vein (incision at the groin) or the small saphenous vein (incision at the popliteal fossa);
- Removal of varicose veins. It is performed using a special metal probe that pulls the vein into the skin incision.
| Radicality | Hospitalization of 5 to 7 days |
| Possibility of performing surgery at any stage of the disease | Scar on legs |
| Spinal or general anesthesia | |
| Damage to surrounding tissues when a vein is pulled | |
| Possible complications: bleeding, wound infection | |
| Relapse rate up to 20% |
It is preferable to surgically treat trunk type lesions, when varicose deformations of the large or small saphenous veins occur over a significant extent. And also when there are signs of trophic disorders of soft tissues and symptoms of decompensation of venous insufficiency.
Miniphlebectomy
Miniphlebectomy is a separate surgical option that helps treat leg varicose veins in the early stages. It is most often used in the presence of single varicose veins on the legs. A puncture is made in the skin above the pathological formation and the vein is extracted and crossed using a hook. The operation does not require general anesthesia or skin sutures.
Conservative therapy
It is necessary to start treating varicose veins of the legs using medication and compression therapy.Prescribing drugs that improve blood circulation and wearing medical compression stockings are the main conditions that determine the result of any surgical intervention on the veins of the legs.
Compression therapy
Elastic compression of the legs is the main method of treatment in cases where surgery is contraindicated. Elastic bandages and special medical knitwear can be used as compression products: stockings, knee-highs, tights. Medical products are very durable, maintain the original compression level for a long time and are comfortable to wear, which is important for women.
There are 4 classes of elastic knits depending on the degree of compression. It is recommended to treat varicose veins with class 2 products in the absence of progression of the disease for no more than 6 months and with subsequent use during physical activity or prolonged standing. If there are signs of damage to the valves of deep veins or serious symptoms of impaired lymphatic drainage, class 3 jerseys are prescribed until the progression of varicose veins stops.
The therapeutic effect of compression stockings is due to:
- a decrease in the volume of the vein, which leads to a decrease in blood flow through the varicose vessels;
- increased absorption of tissue fluid into the bloodstream, leading to the disappearance of signs of swelling and symptoms of heaviness in the legs;
- improve blood circulation, which prevents the formation of blood clots.
Varicose veins are one of the oldest diseases known to mankind. Mentions of it can be found in the works of Avicenna, Hippocrates, Paracelsus and other legendary healers, and the Italian scientist Marcello Malpighi devoted many years to its study. The pathology can affect all organs where large veins are found (stomach, esophagus, male testicles), but varicose veins of the lower limbs are the most common. Let's talk about the causes of varicose veins in the legs, methods of diagnosis and elimination.
About varicose veins of the lower limbs
Varicose veins are an irreversible dilation of the veins due to a dysfunction of the valves involved in the circulatory mechanism of the veins of the lower limbs. With normal muscle contraction and relaxation, it moves vigorously upward from one valve to another, but when the vein dilatesvalves stop closing and blood flow slows, which leads to a series of clinical symptoms.
According to statistics, people today suffer from symptoms of varicose veins in the legs: one in ten men and one in three women aged 30 to 40. Among the leading countries in terms of the prevalence of pathology are the developed countries of Europe, where it is diagnosed in 30-40% of the population; Varicose veins are least common in Africa and Asia (around 0. 1%).
Why does it appear, risk factors
The exact causes of the disease are not known, but most expertsleans towards hereditary theory: people who have had cases of varicose veins in their family are at risk. Factors that provoke the development of pathology also include:
- gender. Women are more susceptible to varicose veins than men - this is due to increased venous load during pregnancy and childbirth, as well as taking hormonal drugs;
- bad habits and excess weight. Smoking, abuse of fatty foods and alcohol have a negative impact on blood circulation in the body, increase the load on the veins and can cause corresponding disorders;
- labor conditions. People who, due to the nature of their profession, are forced to stand or sit still for a long time (hairdressers, salespeople, waiters, office workers) suffer from this disease more often than others;
- excessive physical activity. Another category of people at risk of developing varicose veins is those who do heavy physical work or who practice certain strength sports (for example weightlifting);
- uncomfortable clothes or shoes. Tight, restrictive clothing and high-heeled shoes also contribute to impaired venous blood flow.
Classification
Most often (in 75-80% of cases), the disease affects the trunk and branches of the large saphenous vein, in 5-10% - the small saphenous vein, and in 7-10% of patients, both veinsare involved in the process. . In the clinical course of varicose veins of the lower limbs, experts distinguish two forms and four groups.
Shapes:
- descending– the process extends from top to bottom along the large femoral vein, starting from its mouth;
- Ascending– the disease begins in the foot and is caused by a dysfunction of the valve apparatus of the deep veins.
Groups:
- subcutaneous or intradermal pathology not affected by venous flow;
- segmental with reflux into perforating and superficial veins;
- widespread with venous reflux (through superficial and perforating veins);
- dilatation with reflux through deep veins.
Depending on the degree of venous insufficiency, four main stages of varicose veins are distinguished:
- – symptoms of the disease may be present, but they are not determined by diagnostic methods;
- I - this stage is characterized by temporary swelling, "heavy legs" syndrome and the appearance of "spider veins";
- II - the appearance of persistent swelling appearing in the evening, discoloration of the skin, eczema;
- III - the presence of trophic ulcers, including non-healing ones.
Dangers and complications
The risk to the patient's health and life does not come from the disease itself, but from the complications it causes. These include poor nutrition of the skin, which causesTrophic ulcers and erysipelas may form, as well as the most dangerous complication – thrombophlebitis. This leads to increased thrombus formation, as a result of which blood clots, breaking away from the vein walls, can disrupt the functioning of internal organs and, in the most difficult cases, cause the patient's death.
Additionally, dilated vessels with thinner walls are at risk of mechanical damage that can cause serious bleeding.
Symptoms
The first symptoms of the disease are heaviness and fatigue in the legs, which usually appear in the evening and decrease when lying down.The veins acquire a bluish tint and stand out on the surface of the skin, "spider veins" appear(a network of dilated capillaries visible through the skin), and a characteristic sign is that the vein pattern disappears if the limbs are elevated (e. g. placed on a chair).
Over time, varicose veins become more pronounced and appearappearance of small nodules or large conglomerates.
Unpleasant symptoms intensify and bother patients even at night, appearsoft tissue swellingmost commonly in the feet, legs and ankles, as well as a feeling of fullness in the legs and cramping in the calf muscles.
In the absence of adequate treatment, varicose veins progressthe skin becomes dry, bumps and brown spots appear on it, then trophic ulcers. With the development of thrombophlebitis, the veins become bright red, cord-like and painfully compacted on palpation.
When should you consult a doctor?
Many people ignore the first signs of varicose veins and attribute them to ordinary fatigue. This greatly complicates the treatment of the disease and can lead to the most serious consequences.You should contact a phlebologist immediately after the appearance of symptoms of the disease.constant feeling of fatigue and heaviness in the legs, changes in the color of veins and skin, swelling, spider veins, etc.
Diagnostic
The diagnosis of "varicose veins of the lower limbs" is made after a complete examination, which includes:
- general blood test– by the number of red blood cells, platelets, leukocytes and the hemoglobin level, we can judge blood clotting disorders and the presence of inflammation;
- ultrasoundrepresents the most effective method for identifying affected vessels and sections of veins;
- rheovasographycarried out in order to determine the lack of nutrition of tissues with blood (called rheographic index), based on which the stage of the disease can be determined;
- phlebography, during which a contrast agent is injected into the veins, after which the condition of the venous system is assessed using an X-ray machine;
- physiological tests(Troyanov-Trendelenburg test, Hackenbruch test) make it possible to judge the functioning of the valvular apparatus of the superficial veins.
Treatment
In the early stages of varicose veins, they can be fought by conservative methods: taking medications, using ointments and gels, wearing compression clothing and moderate physical activity. To correct cosmetic defects, patients may be recommended minimally invasive surgery or laser treatment. In more advanced cases, varicose veins can be removed only by surgery and their type is selected individually for each specific case.
Varicose veins of the legs are a disease, the occurrence of which is best prevented, since it is quite difficult to cure. Therefore, every woman should know the causes and signs of such a problem.
What are the dangers of varicose veins on the legs?
With the early development of the disease, many believe that its worst manifestation is the appearance of a swollen limb. Unfortunately, it is not the case. The worst scenario for the development of varicose veins on the legs in women is death. In addition, complications of the disease can be very different.
The most common are:
- trophic ulcers;
- thrombosis;
- phlebitis and thrombophlebitis.
Phlebitis is the process of damage to the inner walls of a vein. In this case, the leg swells more and the protruding vessels become hard on palpation. With the further development of phlebitis, the patient's body temperature rises and each movement of the leg causes severe pain. And then phlebitis ceases to become thrombophlebitis. In this case, blood clots appear on the walls of the veins - small clots of stagnant blood.
Thrombosis is the formation of blood clots in the absence of phlebitis. This problem is scary because it is almost impossible to diagnose.
Attention! A thrombus detached from the vessel wall is the cause of death in most clinical cases. Additionally, this process occurs instantly (sometimes within minutes) and it is almost impossible to recognize a loose blood clot before it stops blood flow.
Now you know what causes varicose veins on women's legs. In order to prevent varicose veins, it is necessary to constantly take preventive measures. This is especially true for women who have a hereditary predisposition to the disease. To reduce the risk of contracting the disease, it is necessary to engage in moderate physical activity, wear comfortable shoes and avoid hypotension.
Consequences and complications
There is no single course of varicose veins. Different groups of patients have individual features of the course of the disease associated with the pathogenesis of varicose veins. Varicose veins can be primary, that is, associated with congenital insufficiency of the venous valve and weakness of the vascular wall, which is almost always accompanied by reverse blood flow (reflux). And secondary (acquired), when reflux develops several years after the onset of the disease.
What are the dangers of varicose veins on women's legs? Varicose veins tend to progress; as they develop and in the absence of conservative treatment, the symptoms of the disease worsen. Heaviness in the legs is replaced by persistent and persistent swelling, against the background of which tissue damage develops, open trophic ulcers appear, as a result of which the person completely loses working capacity and requires constant maintenance treatment.
Home treatment
Many women are interested in how to treat varicose veins on women's legs at home? Therapeutic exercises, medicinal plants and some recommendations for a healthy lifestyle for patients with varicose veins will help alleviate the symptoms of the disease and prevent its further development.
Therapeutic exercises
Every day, morning and evening, you need to perform simple exercises against varicose veins:
- Lying on your back, raise your legs vertically, pressing them against the wall at a 90° angle. Hold them in this position for 3 minutes, breathing slowly through your chest and not your stomach.
- While lying on your back, perform a cycling exercise for 3 to 5 minutes.
- While standing, raise both feet on tiptoe 1 cm from the ground and lower them. Perform 30 times in two approaches.
- While standing, alternately lift one heel off the ground, then the other, at an angle of no more than 45°. Start with 15 minutes a day, building up to 30 minutes.
You should take time to walk every day, at least 30 minutes. It is useful to go swimming in the pool once a week.
Folk remedies
Take the herbal mixture internally: mix 1 tablespoon each of birch buds, motherwort, string, calamus roots, coltsfoot leaves, thyme.
Pour boiling water over half a glass of the mixture and heat in a water bath for 40 minutes. Leave to infuse, filter. Drink 0. 5 cups before each meal for a month.
Making compresses from homemade ointments:
- Mix half a glass of curdled milk with freshly chopped wormwood leaves. Apply to diseased veins, fix with gauze and cover with film. Keep 30 minutes a day.
- Grate the beets on a fine grater, add 2 tablespoons of melted honey, stir, cool and apply to sore feet.
To eliminate evening swelling, apply fresh cabbage leaves to your ankles, previously pierced with a fork until juice appears. Secure with a bandage.
Forecasts and preventive measures
Since varicose veinsis an irreversible process, there is no need to talk about complete recovery in this case. But with timely diagnosis, adequate treatment and prevention, patients can completely get rid of unpleasant symptoms and lead a full life.
Preventive measures against varicose veins includehealthy lifestyle, proper nutrition and giving up bad habits. People who are forced by their professional activities to stay in the same position for a long time are advised to avoid crossing their limbs, to perform simple exercises from time to time, to bend and straighten their legs and to do a light massage toimprove blood circulation.
In your free time, you should walk in the fresh air as often as possible and engage in moderate physical activity.
Women who follow the fashion or work dress code and constantly gohigh heels, you should change them from time to time for more comfortable shoes.
It is the same thing foruncomfortable clothes, because even tight underwear can cause poor circulation and the appearance of varicose veins on women's legs.
Varicose veins of the lower limbs are today considered a widespread disease that is often not given much importance.
It is very important to remember that thislack of attention to the health of your feet can cost a person not only his ability to work, but also his life, while at first varicose veins can be successfully corrected using the simplest methods.