Varicose veins: diagnosis and treatment

Varicose veins on a woman's legs

The circulatory system is made up of two types of vessels: arteries, which carry blood from the heart to organs, and veins. The function of the venous system of the human body is to return blood from tissues and organs to the heart.

Each vein, regardless of its size, consists of a wall and lumen filled with blood, and is equipped with venous valves that prevent the flow of blood downward (the flow through the veins of the lower extremities movesnormally from bottom to top). Diseases of the veins are usually caused by abnormalities in the structure of the venous walls and valves. Varicose veins are one of the most common venous diseases.

What are varicose veins?

Varicose veins are a disease that is accompanied by weakness of the venous wall and venous valves, as a result of which blood flow slows down, blood stagnates in the veins, leading to their expansion, the formation of venous networks andganglia. Women are more prone to developing varicose veins than men (due to the effect of estrogen on the venous wall and increased stress on the venous system during pregnancy). The risk of varicose veins increases with age (due to the fact that the veins lose their elasticity), so varicose veins are extremely rare in children and adolescents.

Due to the fact that the load on the veins of the lower half of the body is greater than on the venous vessels of the upper half, varicose veins develop on the legs and in the area of the pelvic organs. With varicose veins of the lower extremities, as a rule, the superficial (external) veins of the legs are affected. There are several types of varicose veins of the superficial veins of the legs:

  • spider veins (expansion of small intradermal veins);
  • reticular varicose veins (damage to the saphenous veins of the small and large saphenous vein system with the formation of venous nodes);
  • non-saphenous varicose veins (varicose veins that do not belong to the vessels of the small and large saphenous vein system).

Varicose veins of the small pelvis are a type of internal varicose veins and are represented by inguinal varicose veins, varicose veins of the uterus, varicose veins on the penis. One of the common types of varicose veins in men is varicocele (varicose veins of the testicles), which manifests as aching pain in the scrotum, sexual dysfunction, and premature ejaculation.

Signs of varicose veins

In the initial stages, varicose veins are asymptomatic. Signs of varicose veins appear when the affected vessels no longer cope with the blood flow function.

Varicose veins contribute to the stagnation of blood in the area of expansion. Symptoms of varicose veins include:

  • the appearance of a visually noticeable vascular network and bulging veins (unlike atherosclerosis, a chronic arterial disease in which blood flow to the lower extremities is impaired);
  • a feeling of heaviness in the legs and distension in the veins;
  • swelling of the legs;
  • itching and darkening of the skin on the legs above the varicose vein.

Varicose veins are a chronic disease, with continuous progression, and lead to the formation of venous insufficiency (dysfunction of the venous system). The progression of varicose veins takes place in stages:

  • varicose veins of the first degree (an increase in the veins is asymptomatic);
  • second-degree varicose veins (the appearance of edema, heaviness in the legs, itching);
  • varicose veins of the third degree (edema and severity continuously disturb, ulcers appear on the skin, pain in the area of the affected veins).

Symptoms of varicose veins often increase in the evening and intensify after intense physical exertion. In summer, the signs of varicose veins are more pronounced than in winter (since in hot weather there is a tendency to vasodilation and increased viscosity of the blood).

Why do varicose veins appear?

There is no single reason for the appearance of varicose veins. The development of varicose veins is facilitated by overweight, intense physical exertion and work associated with a long stay in a sitting position, a genetic predisposition to weakness of venous valves and inflammation of the veins. Varicose veins in women often develop during pregnancy and after childbirth due to the fact that the enlargement of the uterus and the strain during childbirth increase the load on the woman's venous system.

Complications of varicose veins

Due to the prolonged progression of varicose veins, unpleasant consequences of varicose veins can develop. One of the complications of varicose veins is the appearance of blood clots (blood clots) in the lumen of dilated veins, which can rupture, reach smaller vessels with the blood flow and clog them, resulting in thrombosis. Due to chronic venous insufficiency, trophic disorders of the skin are formed: ulcers appear above the enlarged veins, which heal poorly and are susceptible to infections.

Diagnosis of varicose veins

A phlebologist is involved in the diagnosis and treatment of varicose veins. During the consultation, the phlebologist examines the veins and palpates (feels them), measures the circumference of the left and right legs to reveal hidden edema.

For the diagnosis of varicose veins, an ultrasound (ultrasound) of the vessels with Doppler ultrasound (determination of blood flow) is also prescribed. Ultrasound not only visualizes the venous wall, but also determines the presence of blood clots in the lumen of varicose veins.

Methods of treating varicose veins

In the phlebology department, conservative and surgical methods of treating varicose veins are used. Conservative treatment (without surgery) of varicose veins consists of the use of medication and the wearing of compressive medical underwear. Properly selected treatment can reduce the symptoms of varicose veins and prevent the appearance of new varicose veins, however, existing venous disorders can only be removed with surgery.

Surgical treatment for varicose veins involves removing the dilated veins (phlebectomy). An alternative to phlebectomy is minimally invasive methods of treating varicose veins. Minimally invasive surgical methods for the treatment of varicose veins include sclerotherapy and laser treatment of varicose veins.

Laser treatment of varicose veins

Laser treatment of varicose veins is carried out by endovenous laser coagulation: under ultrasound control, an electrode is inserted into the lumen of the vein, with the help of which the inner surface of the venous wall is cauterized with a laser. As a result of laser cauterization, coagulation of the venous wall occurs, after which the vein atrophies on its own. Minimally invasive laser treatment for varicose veins is performed under local anesthesia. The advantages of laser treatment for varicose veins are the absence of scarring and the relative indolence (compared to vein removal) of the procedure.

The minimally invasive treatment of varicose veins is performed on an outpatient basis (without hospitalization). Usually, recovery after laser treatment for varicose veins does not take more than a month. During this period, it is necessary to wear a compression bandage and limit sport.

For the prevention of varicose veins, you need to reduce weight, exclude heavy loads and prolonged sitting, give preference to loose clothing. To prevent varicose veins in the early stages of the disease, regular wearing of special medical compression underwear and moderate physical activity (walking, swimming, exercising) is helpful.

frequently asked Questions

  1. What can not be done with varicose veins?

    Varicose veins are a disease whose progression is closely related to lifestyle. In the presence of varicose veins, you can not lift weight, play sports that increase the load on the vessels of the lower half of the body (heavy sports). It is necessary to exclude a long stay in a sitting position (if you work in an office and need to sit for a long time - take a five-minute break for walking or exercising every hour), and also try not towear tight tights clothes.

  2. How to treat varicose veins on the legs in women?

    With the problem of varicose veins on the legs, a woman should consult a phlebologist. In the presence of varicose veins on the legs or thighs, the doctor will help you choose the necessary compression underwear. In the presence of indications (signs of venous insufficiency, protruding venous nodes, aesthetic discomfort), surgical removal of varicose veins may be recommended. The decision on what type of intervention will be recommended for a woman is made by the doctor based on the results of the examination and examination.

  3. How to treat varicose veins at home?

    Varicose veins are a disease of the veins that must be treated by a phlebologist. Most phlebologist appointments can be done at home: do a special exercise that improves blood flow from the lower limbs and pelvis, wear compression underwear, and take medications prescribed by your doctor. Self-treatment of varicose veins with folk remedies is ineffective, and exposure to the veins with herbal compresses can lead to skin ulceration.