Varicose veins: diagnosis and treatment

17 November 2021

The circulatory system consists of two types of vessels: arteries, which carry blood from the heart to organs, and veins. The venous system in the human body carries out the function of carrying blood from tissues and organs to the heart.

Each vein, regardless of size, consists of a wall and a lumen filled with blood, and is equipped with venous valves to prevent downflow of blood (flow through the veins of the lower extremities normally moves frombottom up). Vein diseases are often caused by abnormalities in the structure of the vein walls and valves. One of the most common venous diseases is varicose veins.

What is varicocele?

Varicose veins are a disease that is accompanied by a weakening of the venous walls and valves, as a result of which the blood flow slows down, blood stagnates in the veins, leading to their dilation, forminginto networks of veins and nodes. Women are more susceptible to varicose veins than men (due to the effects of estrogen on the venous walls and increased strain on the venous system during pregnancy). The risk of varicose veins increases with age (due to the loss of elasticity in the veins), so varicose veins are extremely rare in children and adolescents.

Since the load on the veins of the lower half of the body is greater than that of the veins of the upper half, varicose veins develop in the legs and in the area of \u200b\u200bthe pelvic organs. With varicose veins of the lower extremities, as a rule, the superficial (external) veins of the legs are affected. There are several types of varicose veins of the superficial veins on the legs:

spider veins (enlargement of small veins in the skin);
reticular varicose veins (damage to the hemispheric veins of the system of small and large hemispheric veins with the formation of venous nodes);
nonsaphenic varicose veins (varicose veins not belonging to the vessels of the system of small and large hemispheric veins).

Varicose veins of the small pelvis is a form of internal varicose veins and manifests as inguinal varicose veins, uterine varicose veins, and penile varicose veins. One of the most common forms of varicocele in men is varicocele (varicose veins in the testicles), which manifests as pain in the scrotum, sexual dysfunction, and premature ejaculation.

Signs of varicose veins

In the early stages, varicose veins have no symptoms. The signs of varicose veins appear when the affected vessels are no longer responsible for carrying blood out.

Varicose veins contribute to blood pooling in the dilated area. Symptoms of varicose veins include:

the appearance of a visually visible network of blood vessels and bulging veins (in contrast to atherosclerosis, a chronic arterial disease in which blood flow to the lower extremities is impaired);
feeling of heaviness in the legs and swelling in the veins;
leg edema;
itching and darkening of the skin on the legs due to varicose veins.

Varicose veins are a chronic, progressive disease that leads to the formation of venous insufficiency (dysfunction of the venous system). The progression of varicose veins occurs in stages:

varicose veins of the first degree (an increase in veins without symptoms);
second degree varicose veins (edema appears, worsens in the legs, itching);
Grade 3 varicose veins (edema and persistent severity, skin sores, pain in damaged veins).

Symptoms of varicose veins usually increase in the evening and intensify after strenuous exercise. In the summer, the signs of varicose veins are more obvious than in the winter (because when the weather is hot, there is a tendency to dilate blood vessels and increase blood viscosity).

Why do varicose veins appear?

There is no single reason for the appearance of varicose veins. The development of varicose veins is facilitated by overweight, heavy physical exertion and work associated with prolonged sitting in one position, a genetic predisposition to weakening of the venous valves, and phlebitis. Varicose veins in women often develop during pregnancy and after childbirth because the expanding and straining uterus during childbirth increases the load on a woman's venous system.

Complications of varicose veins

As a result of prolonged progression of venous insufficiency, it is possible to develop unpleasant consequences of varicose veins. One of the complications of varicose veins is the appearance of blood clots (blood clots) in the dilated vein, which can burst, reach the smaller vessels with the blood stream and block them, leading toto thrombosis. As a result of chronic venous insufficiency, nutritional disorders of the skin are formed: ulcers appear on enlarged veins, poor wound healing and susceptibility to infection.

Diagnosis of varicose veins

Veniologists are involved in the diagnosis and treatment of varicose veins. During the consultation, the phlebologist will examine the veins and palpate (palpate them), measure the circumference of the left and right legs to detect hidden edema.

To diagnose varicose veins, ultrasound (ultrasound) examination of the vessels with Doppler ultrasound (determination of blood flow) is also prescribed. Ultrasound allows not only to visualize the vein wall but also to determine the presence of blood clots in the lumen of varicose veins.

Varicose veins treatment

In the vein department, both surgical and varicocele treatments are used. Careful (non-surgical) treatment of varicose veins includes medication and medical compression underwear. Correctly selected therapy can relieve the symptoms of varicose veins and prevent the appearance of new varicose veins, however, existing venous disorders can only be eliminated surgically. art.

The surgical treatment of varicose veins is the removal of dilated veins (varicectomy). An alternative to varicose vein surgery is minimally invasive varicose vein treatments. Minimally invasive surgical approaches to varicose veins include sclerotherapy and laser varicose vein treatment.

Laser treatment for varicose veins

Laser treatment of varicose veins is carried out by endothelial laser coagulation: under the control of ultrasound waves, an electrode is inserted into the vein lumen, with the help of which the inner surface of the vein is inserted. vein wall by laser. As a result of laser ablation, venous wall coagulation occurs, after which the vein spontaneously atrophy. Minimally invasive laser varicose vein treatment is performed under local anesthesia. The advantage of laser varicose vein treatment is that it leaves no scars and is painless (compared to vein removal).

The minimally invasive treatment of varicose veins is done on an outpatient basis (no hospital stay). Recovery after laser treatment of varicose veins, as a rule, takes no more than a month. During this period, you need a compression bandage, and you should limit playing sports.

To prevent varicose veins, you should lose weight, exclude heavy lifting and sit for a long time, prefer loose clothes. To prevent varicose veins in the early stages of the disease, regular wearing of special medical compression underwear and moderate physical activity (walking, swimming, exercise) will help.