Varicose veins of the lower limbs chronic venous disease, which is characterized by thinning of the walls, expansion of the cavity and the formation of an aneurysm-sicut nodes. Most often varicose veins the disease affects the lower extremities; it is one of the most common diseases – it affects approximately 40% of women and 20% men.
Causes and risk factors
The veins of the lower extremities blood flows upward, that is, he has overcome the force of gravity. This current is provided by the pressure, which is located near the veins and tendons of the remaining blood pressure. The movement of blood in the veins of the lower limbs and promotes a "muscle pump": when you move, leg muscles contract and compress veins, a placebo is not the pulsar is what is their blood, because of the reverse-current preventing venous valves.
Weakness in the muscle layer of the venous wall and valvular incompetence be the cause, which affected the actions of the "muscle pump" the blood begins to flow in the opposite direction, i.e. down. This leads to increased pressure on the walls of blood vessels, the progression of valve disease, enlargement of the lumen of blood vessels, and nodules. The muscle fibers of vein walls atrophy, disrupted nerve receptors, which regulate venous tone, which in turn further improves the manifestations of venous insufficiency.
Risk factors for the development of varicose disease of the lower limbs:
- genetic predisposition;
- pregnancy;
- obesity;
- daily prolonged sitting or standing;
- activities related to heavy lifting;
- systematic wearing tight clothes, corset;
- wrong diet, inadequate intake of fiber and vitamins;
- violations of the hormonal status.
Prevention of varicose veins is an important role active in the hobby: sport (swimming, Cycling, gym), dancing, Hiking, etc.
Forms of the disease
Based on the characteristics of the clinical symptoms are the following forms of varicose veins of the lower limbs:
- segmental lesions, intradermal and subcutaneous veins without reverse flow;
- segmental lesion of the veins of the lower limbs, accompanied by abnormal blood flow;
- general vessels with reversed flow of blood in the superficial veins;
- common vascular lesions, accompanied by abnormal discharge of blood from the deep venous system.
The stage of the disease
In 2000, the Russian phlebologists was adopted in the classification of varicose veins of the lower extremities, taking into account the form of the disease, the degree of venous insufficiency, presence or absence of complications. In accordance with it, there are three stages of varicose disease of the lower limbs:
- The compensation stage. Patients do not show any complaints. During the audit in one or both legs detected in the dilated superficial veins.
- The stage of subcompensation. Patients complain of night cramps, a disorder of the skin sensory disturbances (paresthesias) in the legs, swelling. In the evening there is often swelling in the legs, ankles and feet, disappears after a night's sleep. During the inspection, the legs distinctly dilated varicose veins.
- In the stage of decompensation. The above mentioned signs associated with eczema and dermatitis. Skin age spots, dry, shiny, tightly associated with the subcutaneous fat.
Symptoms
The clinical picture is varicose veins of the lower extremities is to determine the stage of the disease. So, when the compensated stage, only the symptoms of venous insufficiency is the appearance of leg spider veins (telangiectasias).
The transition of the disease subcompensated stage is accompanied by pain in the legs, swelling of legs and ankles, cramps in calf muscles. After resting in a horizontal position, these symptoms cease.
More clearly the clinical picture is varicose veins of the lower extremities occurs in decompensated stage of the disease. Leg pain becomes persistent. Patients complain of itching, which intensifies in the evening and night hours. Over time, there are dermatitis, eczema, difficult healing of ulcers. On stage are often common symptoms: dizziness, low blood pressure. They are related to the deposition of extended venous network of the legs of large amounts of blood.
Complication of varicose veins is phlebitis, thrombophlebitis, bleeding varices, ulcers, pulmonary embolism.
Diagnosis
The diagnosis of varicose veins of the lower extremities is not difficult. It is based on characteristic clinical symptoms and data of objective inspection.
To assess the severity of hemodynamic disorders to apply the instrumental methods of diagnostics:
- Doppler ultrasound of the lower limbs venous;
- duplex angioscanning lower;
- rheovasography of the lower extremity veins.
Treatment
The treatment of varicose disease of the lower extremities according to the testimony of the following ways or their combination:
- conservative treatment;
- sclerosing therapy;
- surgery.
Conservative treatment of varicose disease of the lower extremities, may be recommended for patients early stages of the disease, its aim – prevention of progression of chronic venous insufficiency. It is also used when subcompensated and decompensated stages of the disease, during the preparation of the patient's surgical treatment or in cases when other methods are contraindicated. Conservative treatment of varicose veins based on the use of phlebotonics, wearing support socks. In addition, patients are advised to regularly engage in physical therapy, to avoid prolonged static loads.
Varicose veins of the lower extremities is not complicated by significant hemodynamic disturbances, can be used for compression sclerotherapy. The method consists in the management of the affected vein to the drug, which causes it to spasm. After the legs wear support stockings or bandaging, exercise the leg an elastic bandage to maintain the wall of the vein dormientes condition. A few days after the beginning of the process of gluing the vein walls. A Compression garment is worn after sclerotherapy for at least six weeks, until the formation between the walls of the veins rather dense adhesions.
Advanced stages of the varicose disease of the lower extremities, is the most effective method – surgery. Technical work techniques are selected on the basis of the stage of the disease, its forms, characteristics of hemodynamic disorders:
- laser coagulation;
- radiofrequency coagulation;
- mini phlebectomy;
- phlebectomy.
Possible complications and consequences
Complications of varicose veins develop mainly in the stage of decompensation. These are:
- phlebitis (inflammation of veins extended);
- thrombophlebitis (inflammation of a vein with formation of a cavity blood clotting);
- bleeding varices;
- ulcers;
- pulmonary embolism (PE).
Most often varicose veins the disease affects the lower extremities; it is one of the most common diseases – it affects approximately 40% of women and 20% men.
Forecast
The prognosis of varicose veins of the lower extremities with timely treatment favorable.
Prevention
To prevent varicose veins of the lower extremities is necessary to avoid long-term static loads. If the work requires a long-term stay standing or sitting, you need to make regular breaks for small exercises or at least walking. After the working day is recommended to lie down, leaving the legs in a horizontal or elevated position.
Prevention of varicose veins is an important role active in the hobby: sport (swimming, Cycling, gym), dancing, Hiking, etc.