Varicose veins (varices).

10 August 2018

Varicose veins (varices) is one of the most common and oldest diseases of the vascular system, which has opened since the time of ancient Egypt. With the help of the Egyptian papyri and the excavation was found a mummy signs of varicose veins. Disease interested the famous and ancient doctors: Hippocrates, Galen and Avicenna, and later Troyanova, Trendelenburg. IDO still the disease has not lost its relevance to modern medicine. Definition of "Varicose" comes from the Latin word "varix", which means "expansion", thus, the disease is called "Varicose veins." This disease is characterized by the expansion and increasing the length of the edge of the veins of the serpentine mutkittelevuus (shape changes), as well as the violation of the outflow of blood, resulting in valve insufficiency and the weakening of their walls. The disease most often affects the veins of the lower extremities, because of the large burden of the outflow of the blood (high volume) to hear them, that's why I prefer this section. Varicose veins occur in about 17 - 25% of the population. Young the disease occurs equally in boys and girls. At the ripe age of women is a sick 2 - 3 times more often than men, due to hormonal changes in the female body (menstruation, pregnancy, menopause).

Causes and risk factors for the development of varicose veins

The exact cause of the disease is not known, we only know that under the influence of some factors is developing deterioration of the valves, the pressure increases and the loss of elasticity of the walls of the superficial and connecting veins. Risk factors:

Genetic predisposition: the transfer of the varicose veins by inheritance due to mutation of the gene responsible for the structure of the vessel wall, as a result of mutation, children are born with congenital weakness of the connective tissue or muscle of the vascular wall, or lack of it of the valve (negative number), and as a result there is a weakness in the vessel wall and increased pressure in the veins.
Hormonal changes (pregnancy, menopause): pregnancy alter the hormonal makeup of the organism (increases the level of progesterone and reduce estrogen) that influence the formation of clotting factors (growth) reduces the tone of the venous wall (as a result of the destruction of collagen and elastic fibers in the vascular wall) all of this leads to the formation of blood clots, blockage of blood vessels and their deformation.
Obesity : being overweight leads to lack of exercise, which is a slowing of blood circulation, plus excess fat increases the intra-abdominal pressure, which violates the outflow of blood in the veins, resulting in the development of stagnation in the veins and the possible development of the disease.
Diabetes :chronic elevated blood sugar over time damages blood vessels, which is a favorable environment for the development of blood clots.
Alcohol abuse : excessive alcohol consumption causes dryness and thickening of the blood, formed as a result of blood clots that clog veins and compromises blood flow.
Weight lifting (movers),long walk or long-term work (sellers, conductors): associated with a decrease in muscle tone, increased abdominal pressure and as a result slowing down and obstruction of blood flow to the heart and the development of its stagnation in the lower extremities.
Congenital coagulation disorder: congenital hypercoagulation (excessive production of clotting factors in the blood) leads to the formation of blood clots and disruption of the blood through the vessels.
Poor nutrition: a lack of certain vitamins in the diet (Vit.C -, E -, R -, plant fibers role in strengthening the vascular wall and improves blood circulation).
Wearing tight underwear: wearing it constantly leads to mechanical compression of the veins, causing obstruction of the venous outflow from the lower extremities.
Chronic constipation : frequent increase in abdominal pressure (during exercise) leads to difficulty of outflow of blood from the lower extremities.
Often walking in high heels: the lack of movement in the leg muscles and the development of stagnation.
Hot season: frequent thirst leads to dehydration of the body occurs blood clots and blood clotting.
Concomitant diseases of the cardiovascular system or diseases of the kidneys: impaired outflow of venous blood (heart valve insufficiency, congenital defects).
Overdose of drugs increasing blood coagulation: risk of blood clots and blockage of blood vessels.
Surgery a loss of some amount of blood is not a comfortable position on the operating table (the compression of certain blood vessels), which leads to blood clots.

Complications of varicose veins

The formation of blood clots, as a result of stagnation of blood in the veins;
detachment of the thrombus and occlusion of the vessel coincides with its diameter;
thrombophlebitis (clot formation in the lumen of the vein is the inflammation of its walls);
pulmonary embolism (detached blood clots in the blood into the pulmonary artery, which participates in blood circulation in a small circle. If the clot diameter is the same diameter of the trunk of this artery, it can cause sudden death. If the clot is smaller in diameter, it passes through the branches of the pulmonary artery, causing pulmonary infarction or edema).
sores or rash on the foot caused eating disorders (poor blood circulation leads to lack of oxygen in the tissue, which is the main nourishment of the body tissues);
swelling different areas of the body as a result stagnation in the veins (they are soft, flexible, bluish color, their training is not dependent on the time of day, often in the form of the affected area);
dermatitis (skin inflammation in the affected area), because of the malnutrition of the site;
to change the color of the skin of the affected area;
sealing subcutaneous fatty tissue in the affected area due to swelling.

The diagnosis of varicose veins

Flagellum (functional) tests (a determination that the veins and their valves): Troyanova - Trendelenburg,Pratt, Chania, Delbene-pertes and others. One of the most common test Troyanova - Trendelenburg, with which the patient is in a horizontal position, raise the legs to 45 ⁰, the doctor makes stroking a leg up (as a result, the superficial veins are emptied), then placed a tourniquet on the thigh and ask the patient to stand normally, the filling of the veins of the lower leg should take place more than 15 seconds;
Duplex ultrasound scanning of the veins (ultrasound angioscanning lower) the most informative method to evaluate the blood flow of the ship and see the ship;
Dopplerhophy method, which can be used to assess the blood flow in the vessels;
Venography is the injection of a contrast agent intravenously and the study of x-ray image;
Phleboscintigraphy - vein, radiopharmaceutical and findings of the special device.

The treatment of varicose veins

Non-surgical treatment

Traditional methods of treatment (to complement medical treatment): wearing compression stockings (tights); special exercises (swimming, bike, skis, feet above his head about 20 ⁰ towards the bed, special exercises ("bicycle", lie on your back and breathe in, imagine that the pedal bicycle; alternately bend and straighten the leg at the ankle joint forward and backward) are used to enhance the outflow of blood, but only in complex cases); contrast shower (under running water to keep the legs gradually reduce the water temperature reaches the cold); a foot bath (not a hot) decoction of oak bark, chestnut, chamomile, st. john's wort; rubbing alcohol tincture of the flowers of acacia, the leaves of Kalanchoe, Apple cider vinegar; thrombophlebitis treatment with leeches.
Day: in the morning, slow to get up out of bed (about 5-10 minutes), during sleep bring a pillow under the heel so as to lift the foot about 15-20 ⁰ relative to bed, the walk must be calm, can sit with crossed legs, leg, bandaging the legs with elastic bandages leg thigh, wearing medical support stockings, good nutrition, avoid boring moves and any substances or factors that contribute to thickening of the blood, with the exception of Smoking, the prevention of constipation.
Diet : the body needs food that contains vitamins, strengthens blood vessels and improves blood flow: vitamin C (contains a, where citruses, tomatoes, rose hips, etc.), Vitamin E (legumes, liver, egg yolk, green onion), vitamin R (grapefruit, walnut, black currant), bioflavonoids (dark cherry, sour cherry), copper (seafood). Sufficient daily amount of liquid is at least 1.5 liters. Limited use of alcoholic beverages, coffee, marinades, smoked products.

Surgical treatment

Phlebectomy:the Indications for removal of veins: extensive varicose veins, saphenous vein pathologically expanded, trophic disorders, of the skin, which are not amenable to conservative treatment, acute thrombophlebitis, varicose veins of the saphenous veins is accompanied by a violation of the general condition (severe fatigue, swelling of the legs) of the patient. Only after the removal of the veins: coronary heart disease, a serious infectious processes, the older age of the patient, pregnancy 2. and 3. trimester of pregnancy, inflammation of the leg (erysipelas, pyoderma, eczema). The advantages of the surgical treatment: the only treatment in severe cases, the only radical method of correction of the valves of the deep veins. Disadvantages of surgical treatment: traumatic (cosmetic defect), requires anesthesia, what you need is a couple of days in the hospital under the supervision of the surgeon. Laser treatment (intravenous microtermocoagulation) :Indications: the Combination of varicose veins of the following diseases: diseases of the cardiovascular system (coronary heart disease, high blood pressure), peripheral vascular disease (phlebitis, thrombophlebitis), respiratory diseases (asthma, bronchitis, pleurisy), diseases of the gastrointestinal tract (cholecystitis, gastric ulcer and duodenal ulcer), diseases of the nervous system (craniocerebral injuries, neuroinfections), diseases of the genitourinary system (pyelonephritis, endometritis, fallopian tube inflammation), skin diseases (eczema, Neurodermatitis), peritonitis, abscesses. Contraindications: people suffering from oncological diseases, diseases of the liver, kidneys and heart in the phase of decompensation, cerebral hemorrhage, multiple sclerosis, pregnancy. Advantages: eliminates the unpleasant vascular pattern, a quick procedure (15-20 min), did not require hospital treatment, safe and painless, does not damage the vessel tissue and the surrounding tissue. Disadvantages: not available everywhere method the most expensive method, removing the largest vessels possible heat damage, it is possible the formation of scars and depigmentation (whitening) of the skin in the treated area. Radiofrequency coagulation (ablation) of varicose veins: Indications: varicose veins damage to the frame of the great and small saphenous veins, trophic ulcers as a result of varicose veins. Contra-indications: acute thrombophlebitis of the subcutaneous veins, the impossibility of active walking, pregnancy, mental disorder. Advantages: there is no cosmetic defect, painless, requires no hospitalization, does not violate the capacity. Disadvantages: the only drawback is the price. Sclerotherapy: Indications: small varicose veins, large varicose veins, when you use the duplex dopplerography, varicose veins in the early stages (if the damage is only superficial veins. Contra-indications: pregnancy and breast-feeding, allergic sclerosus, deep vein thrombosis, purulent-inflammatory diseases of the feet. Advantages: lower cost compared to surgery, fast time of restoration, does not require a hospital (home), the best cosmetic results. Disadvantages:the possibility of having deep vein thrombosis sclerosus, decreased efficiency because of the mixing sclerosus blood, are ineffective in advanced cases.