According to statistics, up to 20% of the population suffers from varicose veins in the lower extremities, while in women the 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, use of estrogen-progestogen contraceptives, imbalance of sex hormones).The types of treatment for leg veins do not differ between men and women, however, the frequency of postoperative recurrences in women is higher due to the additional influence of hormones (estrogen and progesterone influence).
What causes varicose veins in women's legs?
Venous diseases of the legs must be treated by a phlebologist who specifically deals with this pathology. Various methods of treating varicose veins are not radical, as they are not aimed at eliminating the main pathogenetic cause - the failure of the valve apparatus of the vein. Surgical and conservative treatment delay the progression of the disease for long periods. The recurrence rate is high and reaches 10 to 50% 5 years after surgery.
Treatment of varicose veins must be comprehensive. There are three groups of methods for eliminating varicose veins:
- phlebosclerosis,
- surgical,
- conservative.
Each type of treatment has its own advantages and disadvantages and a certain relapse rate. The choice of method is conditional, as the phlebologist often needs to combine all three methods to obtain the most favorable result.
Characteristic symptoms of varicose veins in women
The symptoms of varicose veins begin with the appearance of functional disorders such as a feeling of 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 developing varicose veins in the legs. The main signs of the disease - associations of varicose saphenous veins - 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 legs occur.
Signs of trophic disorders: pigmentation of the skin in the lower third of the leg, cyanosis, sclerotic changes in the subcutaneous tissue, eczema, against which a trophic ulcer forms.
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 varicose veins increases, so the symptoms of swelling and heaviness in the legs are more pronounced;
- signs of varicose veins worsen during hormone therapy.
Now let's talk about therapy methods.
Radiofrequency ablation and endovenous laser coagulation
Radiofrequency vein ablation
The method is based on the introduction, under ultrasound guidance, of a special disposable catheter into the lumen of the dilated vein. The catheter is equipped with a special electrode, the working part of which is heated to 120 degrees under the influence of radiofrequency radiation. Advancing the catheter along the vein leads to gluing or "welding" of the vascular wall. Obliterated veins are excluded from the circulatory system of the legs.
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, proteins in the vascular wall coagulate, as a result of which the vein collapses and after some time becomes covered with connective tissue. Radiofrequency ablation (RFA) and endovenous laser obliteration (EVLO) are relatively new methods of treating varicose veins in the legs. Despite the differences in execution techniques, they have common 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% |
| Painless | Impossibility of carrying out the procedure due to certain anatomical characteristics of the veins (strong tortuosity of the blood vessels) |
| No blood | |
| Performed under local anesthesia | |
| Absence of postoperative scar (desirable cosmetic effect for women) | |
| Short periods of rehabilitation |
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 maintaining the aesthetic appearance of the legs.
Phlebosclerotherapy
A special drug is injected into the lumen of the affected segment of the vein, which has a sclerosing ("gluing") effect on the vascular wall. The sclerosing agent can be used in liquid or foam form. Preference should be given to foam sclerotherapy due to the greater contact area of the substance with the vein wall.
Advantages and disadvantages of phlebosclerotherapy:
| No postoperative scar | Possible long-term skin pigmentation at the puncture site (up to 2 years) |
| Carried out on an outpatient basis | In rare cases, post-operative inflammation of the vein (phlebitis) |
| The operation is performed without anesthesia | Swelling and redness of tissues for 2 days after the procedure |
| The manipulation is practically painless (small burning at the puncture site) | Allergic reaction due to individual drug intolerance |
| 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 larger the lumen, the greater the risk of recanalization. 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 principles of surgical treatment are to eliminate the pathological discharge of blood from the deep to the superficial veins of the legs and to remove the dilated vessels themselves. Stages of combined phlebectomy:
- Cross and connect the mouth of the great saphenous vein (incision in the groin region) or the small saphenous vein (incision in the popliteal fossa);
- Removal of varicose veins. It is performed using a special metal probe that pulls the vein into the skin incision.
| Radicality | Hospitalization of 5 to 7 days |
| Possibility of performing surgery at any stage of the disease | Scar on legs |
| Spinal or general anesthesia | |
| Injury to surrounding tissues when a vein is pulled | |
| Possible complications: bleeding, wound infection | |
| Relapse rate up to 20% |
It is preferable to surgically treat trunk-type injuries when varicose deformation of the large or small saphenous veins occurs to a significant extent. And also when there are signs of trophic disorders of soft tissues and symptoms of decompensation of venous insufficiency.
Miniphlebectomy
Miniphlebectomy is a separate surgical option that can treat leg varicose veins in the early stages. It is most often used in the presence of single varicose veins on the legs. A puncture is made in the skin over the pathological formation and the vein is pulled out and crossed with a hook. The operation does not require general anesthesia or skin sutures.
Conservative therapy
It is necessary to start treating varicose veins in the legs with medication and compression therapy.Prescribing medications that improve blood circulation and wearing medical compression stockings are the main conditions that determine the outcome of any surgical intervention on leg veins.
Compression Therapy
Elastic compression of the legs is the main method of treatment in cases where surgery is contraindicated. Elastic bandages and special medical knitwear can be used as compression products: stockings, knee socks, tights. Medical products are highly durable, retain 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 with class 2 products in the absence of disease progression for up to 6 months and with subsequent use during physical activity or prolonged stay. If there are signs of damage to the valves of deep veins or severe symptoms of impaired lymphatic drainage, class 3 liners are prescribed until the progression of varicose veins stops.
The therapeutic effect of compression stockings is due to:
- decrease in vein volume, which leads to less blood discharge in varicose vessels;
- increased absorption of tissue fluid into the bloodstream, due to which signs of swelling and symptoms of heaviness in the legs disappear;
- improving blood flow, which prevents the formation of blood clots.
Varicose veins are one of the oldest diseases known to humanity. Mentions of him are found in the works of Avicenna, Hippocrates, Paracelsus and other legendary healers, and the Italian scientist Marcello Malpighi devoted many years to his study. The pathology can affect any organ where there are large veins (stomach, esophagus, male testicles), but varicose veins of the lower extremities are more common. Let's talk about the causes of varicose veins on the legs, methods of diagnosing and eliminating them.
About varicose veins of the lower extremities
Varicose veins are an irreversible expansion of veins due to rupture of the valves involved in the circulatory mechanism of the veins of the lower extremities. With normal muscle contraction and relaxation, it moves vigorously upward from valve to valve, but when the vein dilatesthe valves stop closing and blood flow decreases, which leads to a series of clinical symptoms.
According to statistics, people today suffer from symptoms of varicose veins in the legs: every tenth man and every third woman aged between 30 and 40. Among the leading countries in terms of prevalence of the pathology are the developed countries of Europe, where it is diagnosed in 30-40% of the population; Varicose veins are less common in Africa and Asia (about 0. 1%).
Why does it appear, risk factors
The exact causes of the disease are not known, but most expertsleans towards the hereditary theory: People who have had cases of varicose veins in the family are at risk. Factors provoking the development of pathology also include:
- gender. Women are more susceptible to varicose veins than men - this is due to the increased venous load during pregnancy and childbirth, as well as the use of hormonal medications;
- bad habits and excess weight. Smoking, abuse of fatty foods and alcohol have a negative impact on the body's blood circulation, increase the load on the veins and can cause corresponding disorders;
- work conditions. People who, due to the nature of their profession, are forced 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 developing varicose veins are those who perform heavy physical work or certain strength sports (for example, weight lifting);
- uncomfortable clothes or shoes. Tight, restrictive clothing and high-heeled shoes also contribute to the deterioration of venous blood flow.
Classification
Most 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 of the lower extremities, experts distinguish two forms and four groups.
Shapes:
- downward– the process spreads from top to bottom along the great femoral vein, starting at its mouth;
- ascending– the disease begins in the foot and is caused by a malfunction of the valve apparatus of the deep veins.
Groups:
- subcutaneous or intradermal pathology not aggravated by venous secretion;
- segmental with reflux through perforating and superficial veins;
- generalized with venous reflux (through superficial and perforating veins);
- dilation with reflux through the deep veins.
According to the degree of venous insufficiency, there are four main stages of varicose veins:
- – symptoms of the disease may be present, but are not determined by diagnostic methods;
- I - this phase is characterized by transient swelling, "heavy legs" syndrome and the appearance of "vein veins";
- II - appearance of persistent swelling that appears at night, skin discoloration, eczema;
- III - presence of trophic ulcers, including those that do not heal.
Danger and complications
The risk to the patient's health and life is not caused by the disease itself, but by the complications it causes. These include impaired nutrition of the skin, which causesTrophic ulcers and erysipelas can form, as well as the most dangerous complication – thrombophlebitis. It leads to an increase in the formation of thrombi, as a result of which blood clots, breaking off from the venous walls, can disrupt the functioning of internal organs and, in the most difficult cases, cause the death of the patient.
Additionally, dilated vessels with thinner walls are at risk of mechanical damage that can cause severe bleeding.
Symptoms
The first symptoms of the disease are heaviness and tiredness in the legs, which generally appear at night and decrease when lying down.The veins acquire a bluish hue and stand out on the surface of the skin, causing "vasculatures" to appear.(a network of dilated capillaries visible through the skin), and a characteristic sign is that the venous pattern disappears if the limbs are elevated (e. g. placed on a chair).
Over time, varicose veins become more pronounced and appearappearance of small nodules or large conglomerates.
Unpleasant symptoms intensify and bother patients even at night, appearsoft tissue swellingmore frequently in the feet, legs and ankles, as well as a feeling of fullness in the legs and cramps in the calf muscles.
In the absence of adequate treatment, varicose veins progressthe skin becomes dry, lumps and dark spots appearand, later, trophic ulcers. As thrombophlebitis develops, the veins become bright red, cord-like, and painfully compacted on palpation.
When should you see a doctor?
Many people ignore the first signs of varicose veins, attributing them to common tiredness. 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 tiredness and heaviness in the legs, changes in the color of the veins and skin, swelling, spider veins, etc.
Diagnosis
The diagnosis of "varicose veins of the lower extremities" is made after a comprehensive examination, which includes:
- general blood analysis– by the number of red blood cells, platelets, leukocytes and hemoglobin level, blood clotting disorders and the presence of inflammation can be assessed;
- ultrasoundrepresents the most effective method for identifying affected vessels and sections of veins;
- rheovasographycarried out to determine the lack of nutrition of tissues with blood (the so-called rheographic index), on the basis of which the stage of the disease can be determined;
- phlebography, during which a contrast agent is injected into the veins, after which the state of the venous system is assessed using an X-ray machine;
- physiological tests(Troyanov-Trendelenburg test, Hackenbruch test) make it possible to assess the functioning of the valve apparatus of superficial veins.
Treatment
In the initial stages of varicose veins, it can be combated with conservative methods: use of medications, use of ointments and gels, use of compression belts and moderate physical activity. To correct cosmetic defects, patients may receive minimally invasive surgery or laser treatment. In more advanced cases, varicose veins can be eliminated only through surgery, and their type is selected individually for each specific case.
Varicose veins in the legs are a disease whose occurrence is best prevented, as it is quite difficult to cure. Therefore, every woman needs to know the causes and signs of this problem.
What are the dangers of varicose veins in the legs?
With the initial development of the disease, many believe that its worst manifestation is the appearance of a swollen limb. Unfortunately, it isn't. The worst-case scenario for developing leg varicose veins in women is death. In addition, the complications of the disease can be very different.
The most common are:
- trophic ulcers;
- thrombosis;
- phlebitis and thrombophlebitis.
Phlebitis is the process of damage to the inner walls of a vein. In this case, the leg swells more and the protruding vessels become hard on palpation. As phlebitis develops, the patient's body temperature increases and each movement of the leg causes severe pain. And then phlebitis stops turning into thrombophlebitis. In this case, blood clots appear on the walls of the veins - small clots of stagnant blood.
Thrombosis is the formation of blood clots in the absence of phlebitis. This problem is scary because it is almost impossible to diagnose.
Attention! A thrombus detached from the vessel wall is the cause of death in most clinical cases. Furthermore, this process occurs instantly (sometimes in a matter of minutes) and it is almost impossible to recognize a separate blood clot before it stops blood circulation.
Now you know what the causes of varicose veins on women's legs are. To prevent varicose veins, it is necessary to constantly take preventive measures. This is especially true for those women who have a hereditary predisposition to the disease. To reduce the risk of the disease, it is necessary to practice moderate physical activity, wear comfortable shoes and avoid hypotension.
Consequences and complications
There is no single course for varicose veins. Different groups of patients have individual features of the course of the disease associated with the pathogenesis of varicose veins. Varicose veins can be primary - that is, associated with congenital insufficiency of the venous valve 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 tend to progress, as they develop and in the absence of conservative treatment, the symptoms of the disease worsen. The heaviness in the legs is replaced by persistent and persistent swelling, against the background of which tissue damage develops, open trophic ulcers appear, as a result of which the person completely loses the ability to work and requires constant maintenance therapy.
Home treatment
Many women are interested in how to treat varicose veins on female legs at home? Therapeutic exercises, herbal medicine and some recommendations for a healthy lifestyle for patients with varicose veins will help alleviate the symptoms of the disease and prevent its development.
Therapeutic exercises
Every day, morning and evening, you need to perform simple exercises for varicose veins:
- Lying on your back, raise your legs vertically, resting them on 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 a bicycle exercise for 3 to 5 minutes.
- While standing, lift both feet on toes 1 cm from the floor and lower them. Perform 30 times in two approaches.
- While standing, alternately lift one heel off the floor and then the other, at an angle no greater than 45o. Start with 15 minutes a day, working your way up to 30 minutes.
You should set aside time to walk every day, at least 30 minutes. It is useful to go to the pool to swim once a week.
Folk remedies
Take the herbal mixture internally: mix 1 tablespoon each of birch buds, motherwort, string, calamus roots, coltsfoot leaves, thyme.
Pour boiling water over half a glass of the mixture and heat in a water bath for 40 minutes. Let it ferment, strain. Drink 0. 5 cups before each meal for a month.
Make compresses with homemade ointments:
- Mix half a glass of curdled milk with chopped fresh wormwood leaves. Apply to diseased veins, fix with gauze on top and cover with film. Keep it for 30 minutes daily.
- Grate the beets on a fine grater, add 2 tablespoons of melted honey, stir, cool and apply to sore feet.
To eliminate nighttime swelling, apply fresh cabbage leaves to your ankles, first piercing them with a fork until the juice appears. Secure with a bandage.
Forecasts and preventive measures
From varicose veinsIt is 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 giving up 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 perform simple exercises, bend and straighten their legs and give a light massage to improve blood circulation.
In your free time, you should take walks outdoors as often as possible and engage in moderate physical activity.
Ladies who follow fashion or the work dress code and constantly gohigh 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 in women's legs.
Varicose veins of the lower extremities are today considered a widespread disease, which is often not given much importance.
It is very important to remember that thisInattention to foot health can cost a person not only his ability to work, but also his life, while in the initial stages varicose veins can be quite successfully corrected using the simplest methods.