Varicose veins are not just a cosmetic defect that appears on the thighs, legs and top of the foot in the form of a tree-shaped blue mesh, accompanied by pain and convulsive spasms in the leg muscles when walking or exercising, and heaviness in the legs . Firstly, there is a high risk of thrombosis of the inferior vena cava system. This is a serious disease, whose symptoms affect one in four people on the planet.
Thrombotic complications lead to the appearance of trophic ulcers on the legs, acute blood flow pathologies and tissue necrosis of the lower extremities. Often, a blood clot that breaks away from the wall of a vessel entering the blood flow system of the lower extremities ends its journey through the human circulatory system in the heart or brain. The high risk of stroke or heart attack is the main factor in starting treatment and preventing varicose veins, not the unsightly appearance of the legs.
Since its inception, the disease has progressed constantly, affecting new areas of the internal and external venous system of the legs. Therefore, it would be logical to start analyzing the issue by preventing the disease. In most cases, competent preventive measures predetermine the rate of development of pathology, which develops against the background of a hereditary defect in the valve apparatus of venous blood flow of the legs.
Varicose vein prevention
The walls of the veins of the lower extremities are very weak, the muscular system is designed in such a way that it cannot help push blood through contractions. To control the directional flow of blood and prevent stagnation, veins have specialized valves. In some people, the valves do not function properly due to heredity. However, valve pathology can develop with age due to:
intense physical activity;
increased intra-abdominal pressure;
cold;
frequent pregnancies.
Initially, the process develops in the external veins, but as the disease progresses, it reaches the deep venous network. The disease development process can last decades, and the speed depends on lifestyle, the resistance of the blood vessel walls and the intensity of physical activity.
The first task of prevention– minimize the increase in intra-abdominal pressure, avoid increasing overload and combat constipation.
Second task– promote the passive outflow of venous blood from the legs. For this there is a technique that must be performed at the end of the day, or better yet, several times throughout the day. The essence of the technique is to place outstretched legs on the surface at an angle of 45 degrees to the horizontal. You need to lie in this position for at least half an hour. For those who already have varicose veins, it is recommended to sleep with their legs elevated whenever possible.
If you have any illness, you should not wear tight shoes and socks with tight elastic, so as not to complicate the already impaired blood circulation.
Also, when doing sedentary work or simply sitting for a long time, you should try to place your legs in a horizontal position and, if possible, place them on an elevation. Of course, this does not mean that when working in an office you need to sit with your feet on the desk. No. Try placing something under the table that allows you to rest your feet unobstructed while sitting. You should also avoid the habit of crossing your legs while sitting. At home, you can elevate your legs by placing several pillows.
Conservative treatment
The non-surgical treatment program consists of diet, medication and compression therapy.
Diet
One of the risk factors for developing varicose veins is being overweight. Therefore, diet is one of the treatment factors. The diet must be balanced so that the calories received do not exceed the amount necessary to meet daily needs. Additionally, the number of calories varies depending on the presence or absence of exercise. You should also remove hot seasonings, marinade, pepper, excess salt, alcohol, smoked foods from your diet, and also eat less fried foods.
The menu should consist of a sufficient amount of vegetables and fruits containing vitamin C, dishes with a large amount of fiber, seafood and whole grain bread. Small, frequent meals are recommended. It is important to emphasize that animal fats must be present in moderation. You shouldn't listen to anyone who says that cholesterol is an absolute evil. Cholesterol in reasonable amounts helps strengthen vascular walls, reducing the risk of venous ruptures and recurrent thrombotic deposits.
To stop smoking
Smoking tobacco is the most harmful habit for varicose veins. The fact is that the tar contained in cigarettes clogs blood vessels, and carbon dioxide causes vascular spasms. Smoking increases the risk of blood clots and, as a result, secondary complications such as heart attacks and strokes. Smoking is especially dangerous for those who, having varicose veins, take hormonal medications.
Compression underwear (tights, stockings, knee socks)
This prevention and treatment option is suitable in the early stages of the disease. Lingerie can be selected according to various parameters of pressure on soft tissues, color scheme and model option. Underwear is put on in the morning, without getting out of bed, until the veins overflow with blood. The main obstacle to using this prevention method is the inflated price. Therefore, the main consumers of mesh are not those who need prevention, but rather those who, after surgery, use underwear for secondary prevention purposes.
Varicose veins: treatment with medication
Medicines cannot completely cure or stop the disease.
Venotonics – ointments and gels
Venotonics aim to strengthen the walls of the veins, stimulate blood flow and slightly improve microcirculation. These medications, when taken continuously, can reduce pain and swelling. The course of taking the drug is carried out twice a year and lasts at least two months.
Ointments and gels, although safe, are practically useless. They cannot penetrate beyond the skin and, consequently, affect the condition of blood vessels. Ointments and gels are prescribed in the early stages of the disease, when it is not yet known what can relieve swelling and heaviness in the legs: medications or postural drainage and stopping physical activity. Sometimes ointment manufacturers are cunning and recommend using the product in combination with tablets.
ointment based on the flavonoid rutin.
an ointment containing horse chestnut extract is applied twice a day.
gel, the active substance of which is an extract of grape leaves. There are also capsules of the medicine that are taken on an empty stomach twice a day.
Venotonics in tablets
Tablet venotonics are used for varicose veins.
The saponin derivatives of the medicine are obtained from horse chestnut, which contains the plant bioflavonoid escin. This includes the medicine, which exists in the form of drops and tablets.
The most effective preparations are made on the basis of a plant flavonoid obtained from citrus fruits - a powerful venotonic. The course of treatment with these medications can last up to six months.
Rutosides are the first venotonics. Its effect is to improve microcirculation and have an anti-inflammatory effect.
Natural rutoside, available in the form of tablets and capsules.
Semi-synthetic rutosides.
Combined rutoside. It combines a semi-synthetic derivative of rutin and ginkgo biloba extract. The medicine in capsule form is taken twice a day for a month.
Phlebosclerosing medications
Allows you to exclude veins from the bloodstream without surgery. The action is achieved through the growth of connective tissue, which gradually closes the lumen of the vessel. Connective tissue is stimulated by increased coagulation of endothelial proteins, as well as irritation of the smooth muscles of the vessel.
An ointment based on sulfur-containing acid glycosaminoglycan, glucocorticoid and nonionic surfactant is the simplest option. However, the effect is so weak that injectable solutions are used.
Synthetic phlebosclerotics.
Products containing iodine or based on animal proteins. Medications are used to selectively close small vessels in affected areas of veins. Among doctors, drugs that do not cause vascular thrombosis are popular,
They only burn the walls at the endothelial level.
Phlebosclerotic therapy involves drug injections or elastic bandages. This is a fairly simple and painless technique that does not affect the patient's well-being and is quite popular among doctors.
However, sclerotherapy alone does not provide lasting results and cannot prevent the progression of the disease. Therefore, it is best to use it in combination with surgical treatment. Before therapy, it is necessary to perform an ultrasound scan of the lower limbs to exclude extensive lesions of the saphenous and deep veins.
Contraindications to phlebosclerosis are: allergy to medications, atherosclerosis of large vessels and the presence of ischemia, obliterative endarteritis, diabetic angiopathy, damage to the blood coagulation system, pregnancy, acute thrombophlebitis of the legs.
Additional medications
Agents that improve blood microcirculation: low molecular weight dextrans, purine derivative. These medications stimulate the breakdown of platelets, reduce blood viscosity, and increase the elasticity of red blood cells. These processes improve blood supply to tissues and oxidative reactions in them.
Direct or indirect action anticoagulants. Reduce the risk of thrombosis. Popular products in the form of ointments and gels have anti-edematous, anti-inflammatory and antithrombotic effects.
Nonsteroidal anti-inflammatory drugs – suppress inflammatory processes and relieve pain.
Phleboclerosing therapy options
Before surgery, venous sclerosis is performed to reduce the risk of thrombosis and postoperative bleeding.
During surgery as an alternative to vein removal.
After surgery to close unoperated veins.
The puncture method for administering medications is used at any time, and the catheter method is used exclusively during surgery.
Puncture method
In addition to the surgical center, it can only be performed in a specialized surgical room respecting all asepsis standards. Large veins close first, then small ones. Medicines are administered from top to bottom. The vein is punctured with the patient in a vertical position and the medications are administered in a horizontal position. If dilated vessel sclerosis is required, the procedure is performed in several sessions. After the sessions, the patient is registered with a phlebologist for three years for observation.
After administering the medication, the limb is subjected to elastic bandaging, which is repeated for two weeks. During the first week, the bandage is not removed.
The patient must walk half an hour after the procedure.
The patient should sleep with their limbs elevated every day and avoid sitting or standing for long periods, as well as walking a lot.
Radiofrequency vein ablation
Venous ablation using a radiofrequency emitter is a recently emerging area of phlebology. This method allows you to eliminate varicose veins painlessly, without complications and with minimal risk of vascular damage. Radiofrequency radiation acts on the inner lining of the vascular wall and destroys it. Thus, the lumen of the vein collapses and neighboring tissues are practically not affected. This is a very effective method.
The procedure is performed under local anesthesia on an outpatient basis. For greater precision during the procedure, control is carried out using duplex angioscanning.
After the anesthetics take effect, a venipuncture is performed. A catheter with an emitter is inserted into the vein. It advances to the point where the saphenous vein joins the deep venous system. With gradual removal of the catheter, sequential irradiation of the vessel from the inside occurs. After the procedure, the puncture site is treated and covered with a bandage. A special elastic stocking is placed on the leg. After half an hour of walking under supervision, the patient can return home. If the patient's job does not involve physical labor, he or she is entitled to work the day after the procedure.
Varicose veinsextensionveins: operation
The advisability of surgical intervention is considered by a phlebologist or vascular surgeon. For women who need surgery to correct a cosmetic defect, doctors suggest delaying surgery if they are planning a pregnancy. This is due to the fact that during pregnancy varicose veins progress and the effect of the operation can be neutralized.
Combined phlebectomy
The most common option for solving the problem of varicose veins through surgery is combined phlebectomy. The surgery is performed under general anesthesia or local anesthesia. All incisions are made as small as possible. For example, the great saphenous vein is removed through a one and a half centimeter incision in the groin area. A phlebeextractor probe with a special tip is inserted into the vein through the incision. After that, the probe is removed along with the vein. Small veins are removed through small ducts, called miniphlebectomy. After surgery, you must wear compression garments.
Endovasal electrocoagulation
Removal of saphenous veins with current. A more dangerous method compared to radiofrequency obliteration and classical surgery.
Cryosurgery
Removal of veins by exposure to low temperatures. The method is relatively safe. True, the depth of freezing is not always calculated accurately, which leads to damage to adjacent tissues or incomplete removal of the vein.
Intraoperative sclerobliteration
Use of catheter injection of a sclerosing agent into the saphenous veins. Before surgery on the leg, the saphenous veins and altered areas of the veins are marked. During the operation, the anastomosis of the great saphenous vein and the femoral vein is exposed. The tributaries of the great saphenous vein are ligated. At a distance of 1 centimeter from the femoral vein, the saphenous vein is crossed and ligated. A catheter is inserted into the cut vein, the vein is sutured, and the wound is bandaged. A roll of gauze is placed along the projection of the saphenous vein along the entire length of the leg and pressed. Simultaneously with the removal of the catheter, a sclerosing agent is injected.
Endoscopic dissection
Transillumination phlebectomy of perforating veins allows the veins to be ligated and excluded from the bloodstream. These veins connect the subcutaneous network of veins with the deep network. An endoscopic probe is used.
Laser coagulation
The vein is sealed from the inside with a laser and excluded from the bloodstream. It requires a highly qualified doctor and sufficient experience in working with lasers.
Home treatment for varicose veins
At home, varicose veins can be treated with tablets, rubbing ointments, leeches, apple cider vinegar and cabbage leaves. Home treatment can also be carried out using compression belts or elastic bandages. But if the disease is advanced, none of the methods will help without surgical treatment.
Today, the only qualitative way to get rid of varicose veins is surgical methods, as well as cases of combining surgery with sclerotherapy and compression methods.