Varicose veins of the lower limbs chronic venous disease, which is characterized by the thinning of the walls of the extension, the lumen, the formation of aneurysm-sicut nodes. Most often, the varicose disease affects the lower limbs; this is one of the most common disorders – affecting approximately 40% of women, 20% men.
Causes and risk factors
Through the veins of the lower limbs blood flow up to, is that you have to overcome the gravitational force. This current is provided by pressure is located near the veins, tendons, the residual arterial pressure. The movement of the blood through the veins of the lower limbs, and promote the "muscle-pump": when moving, the leg muscles contract and compress veins, place was build out pulsar thereby, the blood, whereas the reverse-current inhibit the venous valves.
The weakness of the muscular layer of the venous wall and valvular incompetence is the reason to influence the actions of the "muscle-pump" the blood begins to flow in the opposite direction, i.e. down. This leads to increased pressure, the walls of the blood vessels, the further progression of the valve disease, enlargement of the lumen of blood vessels lumps. The muscle fibers of vein walls atrophy, disrupted nerve receptors, which regulate venous tone, which, in turn, further increases the manifestations of venous insufficiency.
Risk factors for development of varicose disease of the lower limbs:
- genetic predisposition;
- pregnancy;
- obesity;
- daily prolonged sitting or standing;
- related activities heavy lifting;
- regular wearing of tight clothing, corsets;
- improper diet, inadequate intake of dietary fiber, vitamins;
- violation of hormonal status.
The prevention of varicose veins play an important role in the active pastime: sports (swimming, Cycling, fitness), dancing, Hiking, etc.
Form of the disease
Based on the characteristics of the clinical symptoms, the following form of the varicose veins of the lower limbs:
- segmental arch lesions, intradermal, subcutaneous blood vessels and without reverse flow;
- segmental arch lesion of the veins of the lower limbs, accompanied by abnormal blood flow;
- common to the vessels reverse the flow of blood in the superficial veins;
- common vascular lesions accompanied by the abnormal flow of blood in the deep venous system.
The stage of the disease
In 2000, the Russian phlebologists were adopted in the classification of varicose veins of the lower limbs, considering that the form of the disease, the degree of venous insufficiency, presence or absence of complications. In accordance with the three stages of the varicose disease of the lower limbs:
- The compensation stage. The patients do not show any complaints. During the investigation, one or both of the legs are detected superficial dilated veins.
- The stage subcompensation. Patients complain of night cramps, prevent the skin sensation (paresthesias) in the legs, bloating. Night often swelling of the legs, ankles, feet, disappears after a night's sleep. During the audit, the feet visible dilated varicose veins.
- Stage of decompensation. The above signals are connected to the eczema, dermatitis. Skin pigment spots, dry, shiny, closely related to the subcutaneous fat.
Symptoms
The clinical picture is varicose veins of the lower limbs is determined by the stage of the disease. So, when compensated stage the only symptom of venous insufficiency, the appearance of the legs, the spider veins (telangiectasias).
The transition of the disease in subcompensated stage, accompanied by pain in the legs, swelling of the legs, the ankle, cramps in the calf muscles. After resting in a horizontal position, these symptoms disappear.
Most clearly, the clinical picture is varicose veins of the lower limbs is manifested in decompensated stage of the disease. Foot pain to become permanent. The patients complain of itching of the skin, which intensifies in the evening, overnight hours. Over time, dermatitis, eczema, difficult healing wounds. The stage of common symptoms: dizziness, low blood pressure. They are associated with deposition in the dilated venous network on the legs, a large amount of blood.
Complication of varicose veins is phlebitis, thrombophlebitis, varices bleeding, ulcers, pulmonary embolism.
Diagnosis
Diagnosis of varicose veins of the lower limbs is not difficult. It is based on the typical clinical symptoms and the data of objective examination.
To assess the severity of hemodynamic disorders to apply the instrumental methods of diagnostics:
- Doppler ultrasound of lower limb veins;
- duplex angioscanning;
- rheovasography of the lower extremity veins.
Treatment
The treatment of varicose disease of the lower limbs according to the testimony the following methods, or a combination of these:
- conservative treatment;
- sclerosing therapy;
- the surgery.
Conservative treatment of varicose disease of the lower limbs is also recommended in patients in the early stages of the disease, the aim – prevention of progression of chronic venous insufficiency. It is also used when subcompensated, decompensated stages of the disease during the patient preparation for the surgical intervention, or in cases when other methods are contraindicated. Conservative treatment of varicose veins is based on the use of phlebotonics, wearing compression stockings. In addition, the patients are encouraged to regularly participate in physical therapy to avoid long-lasting static load.
Varicose veins of the lower limbs is not complicated by significant hemodynamic disturbances, can be used in the compression sclerotherapy. The method consists in that, while the affected vein medicine the cramps. After the legs, wear compression stockings or bandaging, exercise to the legs in an elastic bandage to maintain the wall of the vein dormientes condition. A few days later begins the process of gluing the vein walls. The compression garment should be worn after sclerotherapy for at least six weeks, until the formation between the walls of the veins, more dense adhesions.
The advanced stages of the varicose disease of the lower limbs is the most effective method of surgery. Techniques operating techniques are selected according to the stage of the disease, form, properties, hemodynamic disorders:
- the laser coagulation;
- radio frequency coagulation;
- mini phlebectomy;
- phlebectomy.
Possible complications consequences
Complications of varicose veins, especially in the stage of decompensation. These are the following:
- phlebitis (inflammation of veins extended);
- thrombophlebitis (inflammation of a vein with the formation of the lumen of blood clots);
- varices bleeding;
- wounds;
- the pulmonary embolism (PE).
Most often, the varicose disease affects the lower limbs; this is one of the most common disorders – affecting approximately 40% of women, 20% men.
Forecast
The prognosis of varicose veins of the lower extremities timely treatment favorable.
Prevention
To prevent the varicose veins of the lower limbs is necessary to avoid prolonged static load. If the job requires a long time to stay in the position, or sitting, I'm sure that regular breaks are the little exercises or at least walking. After the working day is recommended to lie down, so the leg horizontal or higher position.
The prevention of varicose veins play an important role in the active pastime: sports (swimming, Cycling, fitness), dancing, Hiking, etc.