Varicose veins: diagnosis and treatment

Varicose veins on the legs of a woman

The circulatory system consists of two types of vessels: arteries, which carry blood from the heart to organs, and veins. The venous system in the human body performs the function of returning blood from tissues and organs to the heart.

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

What is varicose veins?

Varicose veins are a disease that is accompanied by weakness of the venous wall and venous valves, as a result of which the blood flow slows down, the blood stagnates in the veins, leading to their expansion, the formation of venous networks and nodes. 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, 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 in the legs are affected. There are several types of varicose veins of the superficial veins on the legs:

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

Varicose veins of the small pelvis is a type of internal varicose veins and is 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 is manifested by 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 function of blood outflow.

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

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

Varicose veins are a chronic, continuously progressive disease, and leads 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 veins is asymptomatic);
  • varicose veins of the second degree (edema appears, heaviness in the legs, itching);
  • varicose veins of the third degree (edema and severity disturb continuously, 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 heavy 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 blood viscosity increases).

Why does varicose veins appear?

There is no single reason for the appearance of varicose veins. Overweight, heavy physical exertion and work associated with prolonged sitting, a genetic predisposition to weakness of the venous valves, and inflammation of the veins contribute to the development of varicose veins. Varicose veins in women often develop during pregnancy and after childbirth due to the fact that the enlargement of the uterus and tension during delivery increase the load on the woman's venous system.

Complications of varicose veins

As a result of 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 break off, reach smaller vessels with blood flow and clog them, leading to thrombosis. Due to chronic venous insufficiency, trophic disorders of the skin are formed: ulcers appear over the enlarged veins, which heal poorly and are susceptible to infection.

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 examination (ultrasound) of the vessels with Doppler ultrasound (determination of blood flow) is also prescribed. Ultrasound allows not only to visualize the venous wall, but also to determine the presence of blood clots in the lumen of varicose veins.

Varicose Veins Treatment Methods

In the department of phlebology, both conservative and surgical methods of treating varicose veins are used. Conservative (without surgery) treatment of varicose veins consists in the use of drugs and wearing medical compression underwear. Correctly selected therapy can reduce the symptoms of varicose veins and prevent the appearance of new varicose veins, however, existing venous disorders can only be eliminated by surgery.

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

Laser treatment of varicose veins

Treatment of varicose veins with a laser 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 of varicose veins is carried out under local anesthesia. The advantages of laser treatment of varicose veins are the absence of scars and the relative (in comparison with the removal of veins) painlessness of the procedure.

Minimally invasive treatment of varicose veins is carried out on an outpatient basis (without hospitalization). Recovery after laser treatment of varicose veins, as a rule, takes no more than a month. During this period, it is necessary to wear a compression bandage and limit sports.

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

Popular questions

  1. What can not be done with varicose veins?

    Varicose veins is a disease, the progression of which is closely related to lifestyle. In the presence of varicose veins, you cannot lift weights, engage in those sports that increase the load on the vessels of the lower half of the body (heavyweight sports). It is necessary to exclude a long stay in a sitting position (if you work in an office and have to sit for a long time - take a five-minute break for walking or exercising every hour), and also try not to wear tight tight 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 about which 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 should be treated by a phlebologist. Most of the phlebologist's appointments can be done at home: doing a special exercise that improves the outflow of blood from the lower extremities and pelvis, wearing compression underwear and taking 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 ulceration on the skin.