The term "varicose veins" comes from the Latin varix-abdominal distension. The treatment of varicose veins was first mentioned in ancient Greek papyrus.
Varicose veins are the most common disease. As many as 40% of the adult population suffers from chronic diseases of lower limb veins. Complications include dermatitis, cellulitis, bleeding, thrombosis, and trophic ulcers, often leading to long-term disability and sometimes disability.
The structure and work of the venous system
How our blood vessels work is a complicated process. To understand this, you need preliminary knowledge about vein structure. The vein wall consists of three layers. Inner-endothelium, represented by a layer of cells on the connective tissue membrane. The middle layer is the muscle. It is mainly composed of round smooth muscle cells located in the framework of collagen fibers. The superficial vein contains a thicker muscle layer than the deep vein. The outer sheath of the vein, the so-called adventitia, is a dense tissue of collagen fibers. If we compare the structure of veins and arteries, it should be said that the ratio of the thickness of the vessel lumen to the wall thickness of the vein is much larger than that of arteries. Veins have much less elastic fibers than arteries.
The main feature of veins is the huge extensibility of their walls, which will affect blood flow indicators. In particular, when the pressure in the blood vessel increases, the vein swells and tends to acquire a circular shape from the slit-like blood vessel. The degree of expansion of the vein wall is short-lived and depends on many other factors. It is this factor that does not allow the use of strict mathematical formulas to calculate the movement of blood along them. The thickness of the vein wall in the blood vessel of the leg is much larger than, for example, the thickness of the neck.
The venous valve originates from its wall. Usually, they consist of two valves facing the heart. In the area where the valve connects to the wall, the vein diameter is slightly larger. Normally, when the valve flap is closed, blood from the upper part will not penetrate into the lower part. When this happens, it is called backflow. Reflux is also controversial. It can be relative ((some call it physiology) and absolute). The main difference is the duration of reflux during the functional test. There is also a view that normal valves should not have backflow. The valves are unevenly distributed through the veins. Among them, more muscle pumps work most obviously-namely on the calves.
The main venous system of the lower limbs is represented by the following groups:
- The veins of the feet;
- The deep veins of the legs and thighs (deep venous system);
- Great saphenous vein and small saphenous vein (superficial venous system);
- Connecting (perforated) veins-provides communication between superficial and deep veins.
The deep and superficial venous systems together form a "sponge" from which blood flows into the heart when walking. The work of this system is supported by the work of a muscle pump located in the lower leg, which generates intermittent pressure in the veins.
These systems move the blood column upwards and the valves in the veins prevent backflow.
The blood flowing out of the lower limbs through deep and superficial veins is uneven. About 85-90% of blood flows through deep veins, and only 10-15% flows through subcutaneous veins. Therefore, in a healthy person, the outflow of blood is carried out through the deep, subcutaneous and connected vein systems.
Varicose veins are a serious problem
Saying that varicose veins is a "disease of the twentieth or twenty-first century" means a departure from the truth. Varicose veins have troubled people for a long time. Even in ancient medical papers, there are descriptions of varicose veins. In ancient Rome, people wrapped their legs with leather "bandages" to get rid of venous insufficiency.
If your legs are often tired, this may be the first sign that the venous system starts to become sick. Discomfort at night, accompanied by swelling of the feet and ankles, especially after staying on the legs for a long time, it is obvious signs of venous congestion. Unfortunately, soon you find the first varicose veins. The changed blood vessels will form blue-blue or red "patterns" on your legs, stars, and capillary network (telangiectasia), and finally form dilated veins and nodules of varicose veins.
Severe, burning, tingling and itching, pain and swelling, "stars", swelling of leg veins-this is an emergency signal for urgent action, it can save the beauty and health of the legs.
Questions about your vein status should be asked immediately to an expert-a vein biologist who studies and treats vein diseases.
Venous disease starts harmlessly, but if left untreated, it can become a serious problem.
Causes of varicose veins
So far, a large number of theories have been proposed to explain the causes of varicose veins. The most common are hereditary, mechanical, hormonal, etc. However, they mainly reflect the factors that lead to the development of the disease or accelerate the appearance of clinical signs of the disease.
The lower limbs are often affected. But, first, the vein dilation appears on one limb, and after a while-appears on the other limb. Varicose veins in the right leg are more common.
Varicose veins of the lower extremities only occur in humans. This is due to the effect of the vertical position of the body, hydrostatic pressure and arteriovenous pressure on the valve device and the vein walls of the limbs. Because of congenital low self-esteem, the weakening of the vein wall and the impaired function of the valve device in the main vein, pathological reflux occurred. The most common causes of varicose veins:
- Hormonal changes (pregnancy, menopause, puberty, hormonal contraceptive use, etc. )-gradually weaken and destroy the structure and tone of the blood vessel wall.
- Pregnancy is one of the main risk factors for the development of varicose veins. In addition to hormonal changes, the enlargement of the uterus and fetus also presses on the veins and significantly hinders blood flow in the lower limbs.
- Obesity has been proven to be a risk factor for varicose veins. This is due to the increased load on the venous system of the lower extremities.
- Lifestyle: People (hairdressers, teachers, chefs, surgeons) who have been exposed to static loads for a long time suffer more.
- Wearing tight underwear, you can squeeze the main vein in the groin fold. Women wear high heels.
- Strenuous physical activity (loading, lifting).
- Hyperthermia procedures (sauna and bathing), abuse of these procedures can also cause varicose veins.
Diagnosis of varicose veins
For many years, the hand has been the only doctor's tool for examining patients with varicose veins. For the past century, X-rays have been used with the help of surgeons. However, the X-ray contrast examination of the vein is a rather complicated process, requiring heavy and expensive equipment, and the X-ray contrast agent itself is definitely not safe for the human body. With the development of microelectronics and computer technology, there have been diagnostic methods that were previously unusable: ultrasound Doppler ultrasound, ultrasound vascular scanning, and plethysmography. The emergence of duplex ultrasound scanning provides new information, making it possible to re-examine the causes of varicose veins and understand the complexity of the pathological process.
Doppler ultrasound
This is an ultrasound diagnostic method that allows you to determine the speed and direction of movement of particles (in this case, blood cells) in your body. Therefore, the doctor can find out the direction and speed of blood flow in the blood vessels of the lower limbs. And when performing many physiological tests and the status of the lower limb venous valve device. Understanding the structure of blood flow in the veins of the legs is the main requirement for choosing a treatment.
Ultrasound blood vessel scan
The essence of this method is to form real-time images of the blood vessel wall and blood flowing through the blood vessel wall on the display screen of the ultrasound scanner. The doctor has the opportunity to observe the shape of the blood vessel, the structure of the wall, the state and direction of the blood flow through the blood vessel. This method has a high amount of information and is much safer than X-ray inspection, but it is quite expensive, so it is only used in difficult situations and during scientific research.
plethysmography
This is a diagnostic method based on determining the resistance of lower limb tissues. The essence is that the total resistance of human tissues directly depends on the amount of blood flowing into and out of the tissues and the time change of each heartbeat. Pulseography can be used to diagnose the general blood flow function status of the lower limbs. It can be used to monitor the drug treatment of venous or arterial insufficiency, the treatment of nutritional disorders, and the evaluation of the degree of venous insufficiency.
Of course, all of these technologies cannot exclude the doctor’s direct examination of the patient, to figure out the history of the disease and to determine the complaints made by the patient. According to the overall condition of the disease, the doctor chooses a treatment method.
Treatment of varicose veins
In the past 50 years, varicose veins and other branches of medicine have undergone a qualitative leap. In the past few decades, various drugs have been developed, and these drugs will continue to be improved to treat chronic venous insufficiency. Surgical techniques for the treatment of varicose veins have been significantly improved. The technology of compression sclerotherapy has been developed and practically perfected.
Currently, the so-called sclerotherapy is gaining popularity worldwide. Sclerotherapy is a wise combination of surgical treatment and sclerotherapy. It is well known that sclerotherapy can only be used for the initial and simple forms of varicose veins. Varicose vein surgery is not without problems. Varicose vein removal surgery is quite traumatic, requires hospitalization and a long recovery period. The reasonable combination of these two methods can minimize the trauma in the treatment process and obtain extremely high quality of treatment.
Drug treatment of varicose veins
Very often, patients have almost no varicose veins or very few varicose veins. However, the person suffers from heavy, painful, and swollen legs. All of these are signs of chronic venous insufficiency. In these cases, and when the varicose veins are significantly enlarged, it is necessary to take drugs that improve blood circulation in the legs. Currently, there are dozens of drugs in the venous hematologist's arsenal aimed at combating venous insufficiency.
The treatment of varicose veins and chronic venous insufficiency can only be chosen by the doctor. Although the process of choosing a venotonic agent is simple, only a doctor can determine the full range of treatment measures and the appropriateness of a particular drug.
Compression therapy
Compression therapy has been used as an adjunct to medication or surgery for many years. Compression therapy for varicose veins has been used since ancient times. Only in the last ten years has elastic compression been considered as a separate and independent treatment-compression therapy. Compression therapy includes the use of various brands of medical elastic bandages and special medical compression stockings.
The global industry produces three types of elastic bandages: short, medium and high elasticity. High elongation bandages (elongation rate over 140%) are used to prevent thrombotic complications after abdominal and pelvic organ surgery, and to fix joints and prevent sports injuries after surgery. Short bandages (less than 70% elongation) are used to treat complex forms of chronic venous insufficiency, deep vein thrombosis, post-thrombotic venous thrombosis syndrome and lymphatic insufficiency. Medium elongation bandage (elongation increased from 70% to 140%) is used for varicose veins, chronic venous insufficiency and compression sclerotherapy.
Medical compression stockings include medical compression stockings, tights and knee-high. Many people mistakenly believe that various "anti-varicose" and "support" knitted fabrics with increased density are used for treatment. First, it is necessary to make sure that medical compression products are never marked in DEN. DEN is a technical feature of knitted fabrics, it is only indirectly related to the pressure generated by the product.
Medical jerseys are divided into several functional compression categories. The type of product depends on the pressure that the product generates on the ankle and lower third of the calf. People who show varicose veins use compression grade 2 knitwear. These tights or knee-high legs will create 23-32 mm Hg of pressure on the affected leg. That is, to completely balance the pressure in varicose veins and eliminate venous insufficiency. In addition, medical compression products produce so-called distributed pressure. As the legs move up 25-30% from the bottom, the pressure they generate gradually decreases, which helps the effective outflow of blood and lymph.
It should be noted immediately that medical knitted garments are never thin and transparent. To generate such a high pressure requires a lot of elastic fibers, so the knitted fabric is also very thick. It should also be said that medical jerseys are never cheap. The technique of knitting special knitted fabrics is much more complicated; when knitting, the contours of the legs must also be modeled to generate pressure distribution.
The ideal method of compression therapy is the constant and widespread use of elastic bandages and/or compression stockings. For example, using an elastic bandage every day for a month almost completely corresponds to the effectiveness of the monthly intake of effective drugs. The use of compression stockings is particularly effective for preventing the development and recurrence of varicose veins. Compared with the best medicines, the main advantage of using compressed products is their absolute health safety and their cost is comparable.
Prevent varicose veins
If you have the initial signs of varicose veins, following fairly simple rules will slow it down and, in some cases, avoid its further development. First of all, don't be taken away by hot baths, sauna baths and long periods of sun exposure. All of the above will reduce venous sounds and cause blood stagnation in the lower limbs. Do not wear tight clothes, stockings, and socks with elastic bands, as this will compress the veins. Excessive weight and exercises associated with larger static loads on the legs (tennis, weightlifting, fitness) can increase venous pressure. High heels (over 4 cm)-our veins don't like it. Take care of the veins and don't hurt them.
If you feel heavy in your legs at night after a working day, please keep your legs elevated while sleeping and resting. If your work is accompanied by long hours of sitting or standing at the table, you should change the position of your legs, step on and rotate your feet more frequently. There are special exercises for venous diseases. After showering or bathing, rinse your feet with cold water. There are some useful sports-swimming first, but also walking, biking, and skiing. Don't ignore folk preventive measures. Useful infused leaves of bilberry, St. John's wort, cranberry, and rose hip. A plant-based diet should be followed. Your doctor may also prescribe a drug called venous plant to increase venous tone and improve microcirculation. Recently, due to the emergence of high-quality medical products on the market, methods for the prevention and treatment of varicose veins have also achieved quite understandable success.
Special terms about prevention of pregnant women. Varicose veins continue to develop during pregnancy, especially during the first pregnancy, especially the first varicose veins, and holding a baby under 1 year does not help good blood vessel function. The basis of prevention is to wear special compression stockings and intravenous injections during pregnancy and after delivery. When prescribing hormonal drugs, do not neglect to mention your veins to your gynecologist, as these drugs can affect the function of your veins and reduce their tone.
Do not self-medicate. Talk to your doctor about the best method for your veins. This disease is treated by a doctor-phlebologist.