Phlebeurismis a pathological condition characterized by changes in the structure of the venous system, which leads to an increase in the diameter of the lumen of the superficial veins and disruption of the valve system, which is manifested in valve failure, i. e. in their incomplete venous closure.
Normally, blood flows through the veins against the force of gravity - from the bottom up, which may be due solely to the work of the venous valves. Under the influence of several reasons, primary valve failure (due to changes in the valve itself) or secondary (due to venous dilation), this condition is characterized by incomplete closing of the venous valve and reversed blood flow. The reverse flow of blood aggravates the changes in the vein wall, and also contributes to the pooling of blood in the lower part of the leg, causing swelling in the lower part and a feeling of heaviness in the leg.
In addition to the stagnation of blood in the lower part of the legs, the above process leads to the disruption of the linear flow of blood through the veins from top to bottom, the appearance of reflux (reversed blood flow) and turbulent blood flow in the expansion area. Changes in blood flow characteristics are the main cause of thrombosis.
Possible causes of the development of varicose veins on the lower legs
- Physical inactivity- the main cause of varicose veins. A sedentary lifestyle and prolonged sitting position contribute to a prolonged high load on the venous valves. During physical activity - walking, running, swimming - the constantly working muscles of the thighs and lower legs help to "eject" blood from the venous system in the lower legs. Static sitting in a sitting position for a long time leads to an increase in the load on the venous valve and, over time, the venous valve, unable to withstand the load, may stop performing its function completely.
- Obesityshould be considered as the second most important reason. Heavy weight also increases the load on the venous valve system in the lower leg, contributing to the disruption of proper functioning.
- Pregnancyis the third most common cause. Hormonal changes, weight gain, pelvic vein compression by the fetus are sufficient reasons for venous valve dysfunction. However, up to 50% of changes in the vein wall detected during pregnancy are functional in nature and disappear on their own in the first year after birth.
- Smoking– the fourth most common cause of varicose veins. Changes in the vein wall can be attributed to the unfavorable effect of the composition of the smoking mixture on the tone of the vein wall.
- Ancestry– 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 gene responsible for the development of varicose veins has not yet been discovered; It is generally accepted that genes responsible for changes in the structure of the connective tissue structure are the main cause of varicose veins. However, the influence of heredity can be exaggerated, and lifestyle changes, weight normalization and smoking cessation will help prevent varicose veins even in patients with an unfavorable hereditary history.
Signs of varicose veins
- The presence of a dilated saphenous vein, the non-linear course of veins is the most objective, but not the only manifestation of varicose veins. Often, even if the vein is dilated several times, it may not be visible, especially with a clear subcutaneous layer.
- Edema on the lower legat the end of the working day, especially with asymmetric swelling, is the earliest and most common sign of varicose veins.
- You should also think about the presence of varicose veins whenheaviness in the legsin evening and night, leg cramps at night.
- Spider veins and vein patternsintradermal veins, although they are more of an aesthetic problem, may also indicate the presence of changes in the saphenous vein.
- Persistent redness, thickening of the skin, lipodermatosclerosis, trophic ulcers on the legs and feet indicate an uncompensated course of varicose veins.
Diagnosis of varicose veins
The diagnosis of varicose veins on the lower leg can be made only on the basis of ultrasound diagnostic data.
During an ultrasound scan of the veins of the lower leg, the doctor examines in detail the characteristics of the deep and superficial veins from the groin to the ankle, measures the diameter of the vein, analyzes the characteristics of the blood flow in the vein, and detects. the presence of reflux. Based on the data obtained, the doctor made a conclusion.
Prevention of varicose veins
Prevention of varicose veins is a rational motor regimen, weight normalization, and smoking cessation.
If there are early signs of varicose veins, venotonics and wearing compression stockings will help reduce the rate of disease progression.
Compression stockings should be chosen by the doctor depending on the severity of the varicose veins and the patient's anthropometric data.
Treatment of varicose veins
Treatment of varicose veins is exclusively surgical.
Currently, many different surgical treatment methods have been developed - from open techniques - combined phlebectomy to minimally invasive methods - laser or radiofrequency vein coagulation, mechanochemical methods.
- Varicose veins can be removed using a miniphlebectomy, a technique in which the varicose veins are removed from the subcutaneous tissue from a separate puncture and bandaged.
- Small varicose veins can be removed using sclerotherapy - the introduction of a special glue-like substance - sclerosant - into the lumen of the vein.
- Spider veins and intradermal veins can be removed using sclerotherapy.
However, even after complete treatment, the risk of recurrence of varicose veins on the lower leg is 10-15%. Sufficient physical activity, playing sports (running, walking, exercise bike, swimming), normalizing body weight and abandoning bad habits will help reduce the possibility of relapse after surgical treatment. Regular 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!