According to statistics, up to 20% of the population suffers from varicose veins on the lower legs, while in women this 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-progestogen contraceptives, sex hormone imbalance).The type of treatment for leg veins does not differ between men and women, however, the frequency of recurrence after surgery in women is higher due to the additional influence of hormones (the influence of estrogen and progesterone).
What causes varicose veins in women's legs?
Venous diseases of the legs must be treated by a phlebologist who deals specifically with this pathology. Various methods of treating varicose veins are not radical, because they do not aim to eliminate the main pathogenetic cause - failure of the venous valve apparatus. Surgical and conservative treatment slows the progression of the disease for a long time. Recurrence rates are high and range from 10 to 50% 5 years after surgery.
Treatment of varicose veins should be comprehensive. There are three groups of methods to eliminate varicose veins:
- phlebosclerosing,
- surgery,
- conservative.
Each type of treatment has its own advantages and disadvantages and a certain relapse rate. The choice of method is conditional, because phlebologists often need to combine all three methods to achieve the most favorable results.
Characteristic symptoms of varicose veins in women
Symptoms of varicose veins begin with the appearance of functional disorders such as 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 in the legs. The main symptoms of the disease - varicose saphenous vein association - 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 feet occur.
Signs of trophic disorders: pigmentation of the skin on the lower third of the legs, cyanosis, sclerotic changes in the subcutaneous tissue, eczema, in which trophic ulcers are formed.
Characteristic symptoms of varicose veins in women
- Painful symptoms appear cyclically and intensify before menstruation, which is associated with changes in sex hormone levels;
- 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 the varicose veins increases, so the symptoms of swelling and heaviness in the legs are more pronounced;
- symptoms of varicose veins worsen during hormone therapy.
Now let's talk about therapy methods.
Radiofrequency ablation and endovenous laser coagulation
Radiofrequency ablation of veins
This method is based on the introduction, under ultrasound guidance, of a special disposable catheter into the dilated vein lumen. The catheter is equipped with a special electrode, the working part of which is heated to 120 degrees under the influence of radiofrequency radiation. Advancement of the catheter along the vein leads to adhesion or "welding" of the vascular wall. The obliterated vein is excluded from the circulatory system of the leg.
Endovenous laser coagulation
The surgical technique consists of puncturing the affected vein and inserting a laser light guide into its lumen under ultrasound control. Under the influence of laser radiation, the proteins of the vascular wall freeze, as a result of which the vein collapses and after some time is overgrown with connective tissue. Radiofrequency ablation (RFA) and endovenous laser obliteration (EVLO) are relatively new methods to treat varicose veins in the legs. Although there are differences in implementation techniques, they have the same characteristics.
Advantages and disadvantages of RFA and EVLA
| Does not require hospitalization | High price |
| Execution speed (from 30 minutes to 1 hour) | Relapse rate up to 10% |
| not sick | The impossibility of performing the procedure due to certain anatomical characteristics of veins (severe severity of blood vessels) |
| Without blood | |
| Performed under local anesthesia | |
| Absence of scars after surgery (desirable cosmetic effect for women) | |
| Short recovery period |
RFA or EVLO is 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 vein segment, which has a sclerosing ("sticking") effect on the vascular wall. Sclerosing agents can be used in liquid or foam form. Preference should be given to foam sclerotherapy due to the greater contact area of the material with the vein wall.
Advantages and disadvantages of phlebosclerotherapy:
| No scars after surgery | Possible long-term pigmentation of the skin at the puncture site (up to 2 years) |
| Done on an outpatient basis | In rare cases, inflammation of the veins after surgery (phlebitis) |
| The operation is performed without anesthesia | Swelling and redness of the tissue for 2 days after the procedure |
| Manipulation is practically painless (small burning at the puncture site) | Allergic reactions are caused by individual intolerance to the drug |
| In 20% of cases, spider veins appear on the legs (telangiectasia) | |
| Relapse rate up to 50% |
The recurrence of varicose veins after sclerotherapy depends on the lumen of the affected vessel - the wider the lumen, the higher the risk of recanalization in it. 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 principle of surgical treatment is to eliminate the pathological release of blood from deep into the superficial veins of the legs and remove the dilated vessels themselves. Stages of combined phlebectomy:
- Crossing and tying the mouth of the great saphenous vein (incision in the groin area) or the small saphenous vein (incision in the popliteal fossa);
- Removal of varicose veins. It is carried out using a special metal probe that pulls the vein into an incision in the skin.
| Radicality | Hospital admission from 5 to 7 days |
| It is possible to perform surgery at any stage of the disease | Scars on legs |
| Spinal or general anesthesia | |
| Injury to the surrounding tissue when the vein is pulled | |
| Possible complications: bleeding, wound infection | |
| Relapse rate up to 20% |
It is better to treat with surgery for the trunk type of lesion, when the varicose deformation of the great or small saphenous vein occurs to a significant extent. And also when there are signs of soft tissue trophic disorders and symptoms of venous insufficiency decompensation.
Miniphlebectomy
Miniphlebectomy is a separate surgical option that can treat varicose veins of the legs at an early stage. 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 pulled out and crossed using a hook. The surgery does not require general anesthesia or skin sutures.
Conservative therapy
It is necessary to start the treatment of varicose veins in the legs with the use of medication and compression therapy.Prescribing drugs that improve blood circulation and wearing medical compression stockings are the main conditions that determine the outcome of any surgical intervention on the leg veins.
Compression therapy
Elastic compression of the foot is the main method of treatment in cases where surgery is contraindicated. Elastic bandages and special medical knitwear can be used as compression products: socks, knee socks, tights. Medical products are very durable, maintain the original level of compression for a long time, and are comfortable to wear, which is important for women.
There are 4 classes of elastic knitwear depending on the degree of compression. It is recommended to treat varicose veins using class 2 products if there is no progression of the disease for up to 6 months and with further use during physical activity or during prolonged standing. If there are signs of damage to the deep vein valve or severe symptoms of impaired lymphatic drainage, then a class 3 jersey is prescribed until the development of varicose veins stops.
The therapeutic effect of compression stockings is due to:
- a decrease in the volume of veins, which leads to less discharge of blood into the varicose veins;
- increased absorption of tissue fluid into the bloodstream, as signs of swelling and symptoms of heaviness in the legs disappear;
- increases blood flow, which prevents the formation of blood clots.
Varicose veins are one of the oldest diseases known to man. Mentions of it are 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 any organ where there are large veins (stomach, esophagus, male testicles), but varicose veins on the lower legs are the most common. Let's talk about the causes of varicose veins in the legs, methods of diagnosing and eliminating them.
About varicose veins on the lower leg
Varicose veins are irreversible expansion of veins due to valve disorders involved in the venous circulation mechanism in the lower leg. With normal muscle contraction and relaxation, it moves strongly upward from valve to valve, but when the vein expands.the valve stops closing and blood flow slows, which leads to various clinical symptoms.
According to statistics, people today experience symptoms of varicose veins in the legs:every tenth man and every third woman are 30-40 years old. Among the leading countries in terms of pathology prevalence are developed European countries, where it is diagnosed in 30-40% of the population; Varicose veins are rarest in Africa and Asia (about 0. 1%).
Why it appears, risk factors
The exact cause of this disease is unknown, but most expertsbased on the theory of descent: people with a family history of varicose veins are at risk. Factors that trigger 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 overweight. Smoking, abuse of fatty foods and alcohol have a negative effect on blood circulation in the body, increasing the load on the veins and can cause corresponding disorders;
- working conditions. People who, due to the nature of their profession, have 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 who are at risk of getting varicose veins are those who are involved in heavy physical labor or certain strength sports (for example, weight lifting);
- uncomfortable clothing or shoes. Tight, tight clothes and high-heeled shoes also contribute to the deterioration of venous blood flow.
Classification
Often (in 75-80% of cases) the disease affects the trunk and branches of the great saphenous vein, in 5-10% - the small saphenous vein, and in 7-10% of patients both veins are involved in the process. In the clinical course of varicose veins on the lower legs, experts distinguish two forms and four groups.
shape:
- decreased– the process spreads from top to bottom along the large femoral vein, starting from its mouth;
- ascending– this disease starts in the legs and is caused by damage to the deep vein valve.
Group:
- subcutaneous or intradermal pathology is not burdened by venous discharge;
- segmental with reflux through perforating and superficial veins;
- widespread with venous reflux (through superficial and perforated veins);
- dilatation with reflux through deep veins.
According to the degree of venous insufficiency, there are four main stages of varicose veins:
- – disease symptoms 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 that appears in the evening, skin discoloration, eczema;
- III - the presence of trophic ulcers, including non-healing ones.
Dangers and complications
The risk to the patient's health and life is not caused by the disease itself, but by the complications it causes. This includes nutrition affected skin, which causesTrophic ulcers and erysipelas may form, as well as the most dangerous complication – thrombophlebitis. It leads to an increase in the formation of thrombus, as a result of which blood clots break from the vein wall, can interfere with the functioning of internal organs, and in the most difficult cases cause the death of the patient.
In addition, dilated vessels with thinner walls are at risk of mechanical damage that can cause serious bleeding.
symptoms
The first symptom of this disease is heaviness and fatigue in the legs, which usually appears in the evening and decreases when lying down.Veins acquire a bluish color and stand out on the surface of the skin, "spider veins" appear(the dilated capillary network is visible through the skin), and the characteristic sign is that the vein pattern disappears if the limb is raised higher (for example, placed on a chair).
Over time, varicose veins become more noticeable and appearthe appearance of small nodules or large conglomerates.
Unpleasant symptoms intensify and disturb the patient even at night, appearsoft tissue swellingmost often in the legs, feet and ankles, as well as fullness in the legs and cramps in the calf muscles.
If there is no adequate treatment, varicose veins developthe skin becomes dry, lumps and black spots appear on it, and then trophic ulcers. With the development of thrombophlebitis, the vein becomes bright red, rope-like and painfully dense when palpated.
When should you see a doctor?
Many people ignore the first signs of varicose veins, associating them with normal fatigue. This greatly complicates the treatment of the disease and can lead to the most serious consequences, thereforeYou should contact a phlebologist immediately after symptoms of the disease appear.constant feeling of fatigue and heaviness in the legs, changes in the color of veins and skin, swelling, spider veins, etc.
Diagnostics
The diagnosis of "varicose veins on the lower leg" is made after a comprehensive examination, which includes:
- general blood analysis– with the number of red blood cells, platelets, leukocytes and hemoglobin levels one can judge about blood clotting disorders and the presence of inflammation;
- ultrasonographyrepresents the most effective method for identifying affected channels and parts of veins;
- rheovasographycarried out to determine the lack of tissue nutrition with blood (the so-called rheographic index), on the basis of which the stage of the disease can be determined;
- phlebography, while the contrast agent is injected into the vein, after which the state of the venous system is assessed using an X-ray machine;
- physiological test(Troyanov-Trendelenburg test, Hackenbruch test) makes it possible to evaluate the function of the valve device of the superficial veins.
Treatment
In the early stages of varicose veins, it can be fought using conservative methods: taking medication, using ointments and gels, wearing compression garments, 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 eliminated only through surgery, and the type is selected individually for each specific case.
Varicose veins on the legs is a disease whose occurrence is best prevented, because it is quite difficult to cure. Therefore, every woman needs to know the causes and signs of the problem.
What are the dangers of varicose veins on the legs?
With the early development of this disease, many believe that the worst manifestation is the appearance of swollen limbs. Unfortunately, it doesn't. The worst case scenario for the development of varicose veins on the legs in women is death. In addition, complications from this disease can be very different.
The most common are:
- tropic ulcer;
- thrombosis;
- phlebitis and thrombophlebitis.
Phlebitis is a process of damage to the inner wall of a vein. In this case, the leg swells more, and the protruding duct becomes hard when palpated. With the further development of phlebitis, the patient's body temperature rises, and every movement of the legs brings severe pain. And then phlebitis stops becoming thrombophlebitis. In this case, blood clots appear on the walls of the veins - small clots of stagnant blood.
Thrombosis is the formation of a blood clot in the absence of phlebitis. This problem is scary because it is almost impossible to diagnose.
Attention! Thrombus dislodged from the vessel wall is the cause of death in most clinical cases. In addition, this process occurs immediately (sometimes within minutes), and it is almost impossible to recognize a detached blood clot before it stops blood circulation.
Now you know what are the causes of varicose veins on women's legs. To avoid varicose veins, it is necessary to always take preventive measures. This is especially true for women who have a hereditary predisposition to this disease. To reduce the risk of disease, it is necessary to do 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 characteristics of the course of the disease related to the pathogenesis of varicose veins. Varicose veins can be primary - that is, associated with a congenital lack of venous valves 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 have a tendency to develop; when it develops and if there is no conservative treatment, the symptoms of the disease worsen. The heaviness in the legs is replaced by constant, persistent swelling, against the background of which tissue damage develops, open trophic ulcers appear, as a result of which the person completely loses his ability to work and requires constant maintenance therapy.
Treatment at home
Many women are interested in how to treat varicose veins on women's legs at home? Therapeutic exercise, herbal medicine and some recommendations for a healthy lifestyle for varicose vein patients will help reduce the symptoms of the disease and prevent further development.
Therapeutic exercises
Every day in the morning and evening you need to do simple exercises for varicose veins:
- Lying on your back, lift your legs vertically, resting them against the wall at a 90° angle. Hold them in this position for 3 minutes, breathing slowly through your chest, not your stomach.
- While lying on your back, do bicycle exercises for 3 – 5 minutes.
- While standing, lift both your feet on your toes 1 cm from the floor and lower them down. Do 30 times in two approaches.
- While standing, lift one heel off the floor alternately, then the other, at an angle no higher than 45o. Start with 15 minutes every day, up to 30 minutes.
You should make time for a walk every day, at least 30 minutes. It is useful to go to the swimming pool for a swim once a week.
People's recovery
Take the herbal mixture internally: mix 1 tablespoon each of birch buds, motherwort, string, calamus root, coltsfoot leaves, thyme.
Pour boiling water over half a glass of the mixture and heat in a water bath for 40 minutes. Let it brew, filter. Drink 0. 5 cups before each meal for a month.
Make a compress from homemade ointment:
- Mix half a glass of curdled milk with fresh chopped wormwood leaves. Apply to the diseased vein, secure with gauze on top and cover with film. Save for 30 minutes every day.
- Grate beets on a fine grater, add 2 spoons of liquid honey, stir, cool and apply to sore feet.
To get rid of evening swelling, apply fresh cabbage leaves to your ankles, first pricked with a fork until the juice appears. Safe with bandages.
Predictions 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 for varicose veins includehealthy lifestyle, proper nutrition and abandoning bad habits. People who are forced by their professional activities to remain in the same position for a long time are advised to avoid crossing their limbs, from time to time do simple exercises, bend and straighten their legs and do light massages to improve 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 fashion or work dress code and always go tohigh heels, you should change them from time to time for more comfortable shoes.
The same goes foruncomfortable clothes, because even tight underwear can cause poor circulation and the appearance of varicose veins on women's legs.
Varicose veins on the lower legs today are considered a widespread disease, which is often not given importance.
It is very important to remember that thisIndifference to the health of your feet can cost a person not only his ability to work, but also his life, whereas in the early stages, varicose veins can be corrected quite successfully using the simplest methods.