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Phlebeurism

symptoms of varicose veins

A team of qualified cardiovascular surgeons/phlebologists at the medical clinic diagnoses and treats all types of varicose veins at any stage of the disease, as well as associated pathologies. Our asset, which we are proud of, is treatment according to Israeli protocols, which show maximum efficiency in clinical practice.

Varicose veins - the cause for the development of varicose veins is considered to be a disruption of the normal functioning of the venous valves with the appearance of the opposite flow (reflux) of blood.

As a rule, the valves subjected to maximum mechanical stress are the first to be affected. In this case, the pathological discharge of blood occurs through the mouth of the large and small saphenous veins, sometimes through the large perforating veins. The excessive volume of blood arising in the superficial veins gradually leads to excessive stretching of the venous wall. The total volume of blood contained in the superficial venous bed of the lower extremities increases. This increased volume of blood continues to flow into the deep system through the perforating veins, stretching them. As a result, dilatation and valvular insufficiency occur in the perforating veins.

Symptoms and signs of the disease

The signs of the disease are not necessarily accompanied by pain. On the contrary, most patients claim that at the beginning of the disease they are more concerned about aesthetic problems than pain.

The clinical framework depends on the localization of the pathological process, as well as on the stage of the disease.

Varicose veins of the lower extremities are manifested as follows:

  • Heaviness in the legs, feeling of fullness in the legs.
  • The appearance of cramps in the calf muscles, leg and toe spasms.
  • You feel tired after walking for a long time.
  • Swelling of the ankle in the evening.
  • Venous relief pattern on the skin, spider veins, spider veins.
  • The signs that accompany the disease are cellulite, itchy legs, dry joints and calves, thin and sagging skin, long-healing ulcers, uneven pigmentation - from dark spots to colorless areas, pronounced nodular formations with a color frombluish to dark purple or burgundy. , trophic ulcers.

Progressive venous disease is associated with a deterioration of general health:

  • Unstable blood pressure, hypertension, hypotension.
  • Feeling of chronic fatigue, apathy develops.
  • Arrhythmia, tachycardia.
  • Breathing, frequent diseases of the respiratory system.

Visible symptoms of varicose veins of the lower extremities in women may appear stronger before menstruation and decrease after it.

Symptoms of venous pathology in the upper limbs are characterized by numbness of the hands, spastic condition of the fingers, jumping sensation, tingling sensation and coldness.

Esophageal varices are manifested by belching, burning sensation, pain behind the sternum, inflammation in the esophagus and stomach, difficulty in swallowing and signs of reflux esophagitis, anemia.

Diagnosis of the disease

Effective treatment of varicose veins cannot be carried out without comprehensive preliminary diagnosis. The diagnosis is clarified by the clinical picture and data analysis after hardware studies.
The following methods are most often used for diagnosis:

  • angioscan with duplex or triplex ultrasound;
  • phlebography with contrast;
  • MRI with venography;
  • contrast angiography.

To determine the presence of reflux in the affected veins and to evaluate blood flow, several test manipulations are performed:

  • Inspection of veins with compression in different segments.
  • Valsalva maneuver, or strain test.
  • Parana test with imbalance to evaluate veins in calf areas.
  • Walking test with different intensity.

Additional methods to clarify the diagnosis:

  • Plethysmography to determine venous reflux, obstruction.
  • CT, MRI for visualization of tissues and structures in the affected area.
  • Infrared thermography to assess the temperature balance in the affected area of the body.
  • Intravascular ultrasound uses a catheter to visualize the vascular walls from the inside.

The results of each diagnostic study performed are comprehensively evaluated. Any diagnosis is a great help in determining further treatment tactics.
Clinical laboratory tests of blood and urine complement the picture of the disease and may show accompanying pathology.

How are varicose veins treated?

If alarming symptoms of varicose veins appear, you should consult a doctor to diagnose and start treatment in a timely manner. In regional medical institutions, this issue is handled by general surgeons, in clinics - by phlebologists and angiosurgeons.

The multidisciplinary medical clinic has a well-equipped phlebology department, staffed by a team of surgeons with extensive practical experience. The center offers a high level of service and quality of treatment, which is reflected in the excellent clinical results of which we are proud.

Varicose veins of the lower extremities and other types of pathologies can be treated in the first stages of development. As the process progresses, it turns out to be more and more ineffective, partially retaining only symptomatic significance.

Therapeutic effects cannot completely eliminate the disease, but as long as it is possible to delay the destruction of blood vessels and the development of complications, this should be done with all available means.

Conservative treatment

  • At the beginning of the treatment of varicose veins, drugs are limited to venotonic agents.
  • To reduce the risk of thrombosis and occlusion, anticoagulant injections and low molecular weight heparin-fragmin are used.
  • New oral anticoagulants.
  • For inflammatory phenomena in blood vessels and surrounding tissues, the use of external non-steroidal anti-inflammatory drugs with diclofenac and indomethacin is indicated.

How to treat additional varicose veins?

In parallel with the therapeutic treatment, the patient is recommended to perform certain exercises that strengthen the muscular corsets of the lower extremities and have a general strengthening effect. For example, the best exercises in a lying position are "bicycles", alternately pulling the toes towards you and stretching them, as in ballet.

  • You should be careful with water and thermal procedures, because hot baths and showers, beach vacations in the sun with sunbathing can worsen the situation. Vessels should be strengthened, this is facilitated by hardening with a contrast shower, when warm and cold water is poured alternately on the legs.
  • For pain, inflammation and heaviness in the legs, daily cold foot baths with decoctions of oak bark, chamomile, calendula, birch leaves, St. John's wort, white acacia flowers and horse chestnut are recommended.
  • It is useful to rub fresh juice squeezed from aloe leaves on the skin; it softens the skin and prevents inflammation.
  • It is worth changing your habits and quitting smoking. The diet should be dominated by vitamin-rich foods with lots of fiber, fresh vegetables, citrus fruits and seafood.
  • You should adjust your drinking regime by drinking enough water per day (1. 5 to 2 liters). At the same time, you should reduce the consumption of coffee, strong tea, chocolate and alcohol.

If the veins in the legs are enlarged, the doctor may recommend periodic or continuous wearing of compression stockings.

Careful! In any case, you should listen to your doctor's recommendations and follow them strictly. Self-medication is unacceptable!

Causes of the disease

The family history of the occurrence allows us to conclude that varicose veins are genetically determined and can be inherited.

In many clinical cases, it is impossible to determine the exact cause of the disease. The researchers concluded that the culprit is a combination of several internal and external factors.

Causes of varicose veins:

  • congenital defect of the valve system;
  • physical inactivity, lack of activity;
  • pregnancy;
  • working conditions with prolonged standing stress, long periods of standing, in a static position;
  • treatment with certain hormonal drugs;
  • uncomfortable shoes, high heels;
  • obesity;
  • tight underwear, clothes that tighten the hips, knees (for example, very tight jeans, shapewear);
  • regular lifting of weights;
  • systemic pathology of kidneys, heart and blood vessels;
  • diabetes;
  • regular bowel problems, frequent diarrhea or constipation.

Varicose veins of the lower extremities (varicose veins)- expansion of the superficial veins of the lower extremities, accompanied by valve incompetence and blood circulation disorder. The term "varicose vein" comes from Latin. varix - "swelling".

As a result, the veins stop working properly, the entire blood circulation system is broken, complicated by overloading, disruption of trophism in tissues and blockage of blood vessels with blood clots.

Many complications are life-threatening, therefore, if varicose veins are suspected, diagnosis and treatment should be carried out immediately and professionally.

Types of disease

Blood flow in vessels changes, slows down, and blood clots can form on uneven walls. Changes in the functionality of blood vessels cause blood stagnation, venous insufficiency and continuous disturbances of capillary circulation in the periphery.

According to the WHO, varicose veins occur in 45% of women and 20% of men.

According to the generally accepted international classification CEAP, varicose veins are divided into six classes-stages of the disease, based on the fact that C0 is a complete absence of subjective, visual and clinical signs.

  • C1 - the initial stage, manifested by a capillary network and spider veins on the skin.
  • C2 – visible thickening of the veins under the skin, venous pattern in the lower extremities in the form of blue threads.
  • C3 – swelling of the legs occurs as a result of prolonged standing or the state of rest (night sleep).
  • C4 – the skin surface changes, unevenly pigmented areas appear, venous eczema, accompanied by itching and ulcers, lipodermatosclerosis.
  • C5 – venous ulcers on the surface of the skin that heal after some time.
  • C6 – non-healing venous trophic ulcers.

The classification of varicose veins of the lower extremities distinguishes between pathology in superficial vessels and/or deep, perforating communicating veins.

By origin, venous deformation can be:

  • congenital, manifesting in babies;
  • won;
  • secondary, arising on the background of other pathologies, injuries;
  • idiopathic, with an unknown cause.

The complete classification of varicose veins of the extremities and lower organs also includes complications - reverse blood flow, reflux and/or occlusion, blockage of the lumen.
Varicose veins of the lower extremities are not the only manifestation of varicose veins, although they are the most common. There are also varicose veins of the esophagus, sublingual veins, retina, scrotum (varicose veins in men), stomach, cavernous bodies of the rectum (hemorrhoids), pelvic veins, female genital organs - vulva, labia, uterus.

Surgical treatment of varicose veins

RFO (radiofrequency saphenous vein ablation)is a modern method for treating varicose veins. The treatment involves the application of radiofrequency radiation to the inner wall of the vein. Using the thermal effect, the vein is "welded", it is separated from the general blood flow and after a few months it is replaced by connective tissue.

strengths

  • The procedure is performed without general anesthesia, local anesthesia is sufficient;
  • Maximum safety for the patient's health
  • RFA does not require special preparation;
  • During manipulation, the patient does not feel pain or discomfort;
  • Radiofrequency ablation of lower extremity veins is very effective;
  • Low possibility of complications, almost all patients tolerate this procedure well;
  • Radiofrequency ablation can be combined with mini-phlebectomy of branches or sclerotherapy;
  • After the radiofrequency removal, no scar or mark remains;
  • Literally a few days after the procedure, the patient will be able to return to his normal lifestyle.

how is it going

The intervention is performed under ultrasound control. Before starting the procedure, local anesthesia is given so that the patient does not feel pain or discomfort during the treatment.
Let's see how RFA is performed step by step:

  • Before the operation, the lower limbs are thoroughly treated with antiseptic agents. The doctor then uses a marker to mark the vein that is prone to varicose veins. The doctor then inserts a radiofrequency catheter into the vein and treats the desired area with radiofrequency waves.
  • At the end of the procedure, the catheter is removed, the doctor puts on a bandage and helps the patient put on compression garments.
  • The procedure lasts from 30 to 50 minutes. To stop the flow of blood through a weakened vessel, it must be destroyed. Then the body itself will redirect the blood through the healthy veins. As a result, after removal, the walls of the veins stick together and form scar tissue inside (it is safe and not visible), and the varicose veins disappear.

reHabiLitatiON

Immediately after the operation, the patient should walk (about 30 minutes) to avoid stagnation of blood and lymph. After the radiofrequency removal of the veins of the lower extremities, it is necessary to carefully follow the doctors' recommendations:

  • During the week, increased physical activity and weight lifting are prohibited;
  • It is necessary to walk more, to be in the same position as little as possible (with the exception of sleep);
  • For 3-4 weeks you should stop taking a hot bath, you can only take a shower;
  • You should stop visiting the bathroom for at least a month;
  • It is necessary to drink as much plain water as possible, on average about 2. 5 liters, while you should minimize the amount of salt consumed;
  • One week after the operation, you should start physical therapy, which the doctor will tell you about;
  • It is possible that after the radiofrequency ablation of the veins of the lower extremities, the doctor will prescribe some medications.

Following these rules will help you avoid complications and prevent the further development of varicose veins.

A week after the operation, re-examination (ultrasound examination of the veins of the lower extremities) is necessary. You can learn more detailed information about radiofrequency ablation of lower extremity veins during a personal consultation with a specialist.

Laser coagulation of veins

Endovasal (endovenous) laser coagulation (deletion) of varicose veins (EVLK, EVLO) is a modern method designed to eliminate blood reflux in superficial and perforating veins using the thermal energy of laser radiation. EVLO allows you to do without incisions and does not require hospitalization of the patient in the hospital. The international term is EVLA (endovenous laser ablation).

The main stages

  • Venous puncture. It is performed under ultrasound guidance.
  • Positioning of the light guide. The light guide is a thin optical fiber. Laser radiation is supplied at its end. The light guide is inserted into the diseased vein. Its end is installed at the point where the varicose vein flows into healthy deep veins, that is, at the anastomosis.
  • Tumescent anesthesia. An anesthetic "cushion" is created around the vein in order to better press the vein against the light guide and avoid damage to the surrounding tissue.
  • Coagulation of veins with laser. Laser radiation is supplied to the working part of the light guide.
  • At the same time, the light guide is slowly withdrawn from the vein. Thus, the vein is uniformly heated by the laser to a temperature of 85 °C. A heated vein, like any protein, shrinks when heated. The lumen of the vein disappears, the flow of blood through it stops.

reHabiLitatiON

Immediately after the operation, the patient should walk (about 40 minutes) to avoid stagnation of blood and lymph. After EVLO of the veins of the lower extremities, it is necessary to follow the recommendations of doctors:

  • During the week, increased physical activity and weight lifting are prohibited;
  • It is necessary to walk more, to be in the same position as little as possible (with the exception of sleep);
  • For 3-4 weeks you should stop taking a hot bath, you can only take a shower;
  • You should stop visiting the bathroom for at least a month;
  • It is necessary to drink as much plain water as possible, on average about 2. 5 liters, while you should minimize the amount of salt consumed;
  • One week after the operation, you should start physical therapy, which the doctor will tell you about;
  • The doctor may prescribe some medicines after the surgery.

Sclerotherapyis a method of non-surgical (minimally invasive) elimination of varicose veins and spider veins of the lower extremities.

Benefits of vein sclerotherapy:

  • absolute ambulatory care, which does not require additional preparation,
    execution speed,
  • no need for anesthesia,
  • lack of complications typical for surgical treatment methods such as nerve damage,
  • the absence of "thermally induced phlebitis", characteristic of coagulation methods, accompanied by nagging pain along the coagulated vein.

Thus, today vein sclerotherapy for varicose veins is an effective and safe method, which in some cases can be used as an alternative to other types of surgical interventions.

The sclerotherapy method is based on wiping the vein by introducing a chemical into its lumen, which "washes" the inner layer (endothelium) with the development of subsequent endofibrosis. The degree of endothelial damage depends on the concentration and volume of the drug administered.

The modern medical center uses advanced technologies for the treatment of varicose veins, ensuring the maximum effectiveness of all treatment measures. The use of modern equipment by experienced professionals will free you from varicose veins in the shortest possible time, without complications and the need for long-term rehabilitation.

Treatment in a modern clinic means health and a significant improvement in the quality of life.