Phlebeurismis a pathological condition characterized by a change in the structure of the venous system, leading to an increase in the diameter of the lumen of the superficial veins and rupture of the valve system, manifested in valve failure, that is, incomplete closure of the vein.
Normally, blood flows through the veins against the force of gravity - from bottom to top, which is only possible due to the functioning of venous valves. Under the influence of a number of reasons, primary (due to changes in the valve itself) or secondary (due to dilation of the vein) valve failure occurs, this condition is characterized by incomplete closure of the venous valve and reverse blood flow. Reverse blood flow aggravates changes in the venous wall and also contributes to blood stagnation in the lower extremities, causing swelling in the lower extremities and a feeling of heaviness in the legs.
In addition to stagnation of blood in the lower extremities, the above processes lead to disruption of the linear flow of blood through the veins from top to bottom, the appearance of reflux (reverse blood flow) and turbulent blood flows in the expansion area. Changes in blood flow characteristics are the main cause of thrombosis.
Possible causes of the development of varicose veins in the lower extremities
- Physical inactivity- the main cause of varicose veins. A sedentary lifestyle and prolonged sitting contribute to a high and prolonged load on the venous valves. During physical activity - walking, running, swimming - the constantly working muscles of the thigh and leg help to "expel" blood from the venous system of the lower extremities. Sitting statically for a long time leads to an increase in the load on the venous valves, and over time, the venous valves, unable to withstand the load, may no longer fully perform their function.
- ObesityThe second most important reason should be considered. Heavy weight also increases the load on the valve system of the veins in the lower extremities, contributing to the disruption of their proper functioning.
- Pregnancyis the third most common cause. Hormonal changes, increased body weight, compression of the pelvic veins by the fetus are sufficient reasons for venous valve dysfunction. However, up to 50% of changes in the venous wall detected during pregnancy are functional in nature and disappear spontaneously within the first year after birth.
- Smoke– the fourth most common cause of varicose veins. Changes in the venous wall may be associated with the unfavorable effect of the composition of smoking mixtures on the tone of the venous wall.
- Heredity– another possible reason for the development of varicose veins. It is generally accepted that heredity plays an important role in the development of varicose veins, however, the genes responsible for the development of varicose veins have not yet been discovered; It is generally accepted that genes responsible for changes in the structure of connective tissue structures are the main cause of varicose veins. However, the influence of heredity can be greatly exaggerated, and lifestyle changes, normalization of body weight and smoking cessation will help avoid varicose veins even in patients with an unfavorable hereditary history.
Signs of varicose veins
- Presence of dilated saphenous veins, the non-linear path of the vein is the most objective manifestation, but not the only one, of varicose veins. Often, even veins dilated several times may not be visible, especially with a pronounced subcutaneous layer.
- Edema of the lower extremitiesat the end of the working day, especially with asymmetrical swelling, these are the first and most common signs of varicose veins.
- You should also think about the presence of varicose veins whenpresence of weight in the legsin the evening and at night, leg cramps at night.
- Spider veins and venous patternIntradermal veins, although they are more of an aesthetic problem, can also indicate the presence of changes in the saphenous veins.
- Persistent redness, thickening of the skin, lipodermatosclerosis, trophic ulcers on the foot and leg indicate a decompensated course of varicose veins.
Diagnosis of varicose veins
Diagnosis of varicose veins of the lower extremities can only be made on the basis of ultrasound diagnostic data.
During ultrasound of the veins of the lower extremities, the doctor examines in detail the characteristics of the deep and superficial veins from the groin to the ankle, measuring the diameter of the veins, analyzing the characteristics of blood flow in the veins and detecting the presence of reflux. Based on the data obtained, the doctor comes to a conclusion.
Varicose vein prevention
Prevention of varicose veins is a rational motor regimen, normalization of body weight and smoking cessation.
If there are early signs of varicose veins, venotonics and the use of compression stockings will help reduce the rate of disease progression.
Compression stockings should be selected by the doctor depending on the severity of varicose veins and the patient's anthropometric data.
Varicose veins treatment
The treatment of varicose veins is exclusively surgical.
Currently, many different methods of surgical treatment 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 miniphlebectomy, a technique in which varicose veins are removed from the subcutaneous tissue using separate, bandaged punctures.
- Small varicose veins can be removed with sclerotherapy - the introduction of a special glue-like substance - sclerosant - into the venous lumen.
- Spider veins and intradermal veins can be removed with sclerotherapy.
However, even after fully completed treatment, the risk of recurrence of varicose veins of the lower extremities is 10-15%. Adequate physical activity, playing sports (running, walking, exercise bike, swimming), normalizing body weight and giving up bad habits help reduce the likelihood of relapse after surgical treatment. Periodic use of phlebotonics and wearing properly selected compression stockings will help reduce the rate of spread.
The main thing is not to delay going to the doctor!