Varicose veins are not only a cosmetic defect that appears on the thighs, legs and upper part of the foot in the form of a tree-like blue network, accompanied by pain and convulsive twitching of the muscles of the lower leg when walking or exercise and weight. in the legs. First of all, there is a high risk of thrombosis of the inferior vena cava system. It is a serious disease whose symptoms affect every fourth person on the planet.
Thrombotic complications lead to the appearance of trophic ulcers on the legs, acute pathologies of blood flow and necrosis of the tissues of the lower extremities. Often, a blood clot that breaks free from the wall of a vessel, entering the circulatory system of the lower extremities, ends its journey through the human circulatory system in the heart or brain. A high risk of stroke or heart attack is the main factor in starting treatment and preventing varicose veins, not the unsightly appearance of the legs.
From the beginning, the disease continuously progresses, affecting new areas of the internal and external venous system of the legs. Therefore, it would be logical to start analyzing the issue of disease prevention. Competent preventive measures in most cases determine the speed of development of the pathology, which develops against the background of a hereditary defect in the valvular apparatus of the venous blood flow of the legs.
Prevention of varicose veins
The walls of the veins of the lower limbs are very weak, the muscular system is designed in such a way that it cannot help push blood through contractions. To control the direction of blood flow and prevent its stagnation, veins have specialized valves. In some people, the valves cannot function properly due to heredity. However, valve pathology can develop with age due to:
heavy physical exertion;
increased intra-abdominal pressure;
constipation;
frequent pregnancies.
Initially, the process develops in the external veins, but as the disease progresses, the deep venous network is affected. The process of developing the disease can last decades, and the speed depends on the lifestyle, the strength of the blood vessel walls and the intensity of physical activity.
The first task of prevention- minimizing the increase in intra-abdominal pressure, avoiding increased overload and combating constipation.
Second task- promote the passive outflow of venous blood from the legs. To do this, there is a technique that should be performed at the end of the day or even better several times throughout the day. The essence of the technique is to place the outstretched legs on the surface at an angle of 45 degrees to the horizontal. You should lie in this position for at least half an hour. For those people who already have varicose veins, it is recommended to sleep with their legs elevated as often as possible.
If you have a disease, you should not use narrow shoes and socks with a tight elastic, so as not to complicate the already impaired blood circulation.
Also, when you do sedentary work or just sit for a long time, you should try to give your legs a horizontal position and, if possible, put your legs at a height. Of course, this does not mean that when you work in an office, you should sit with your feet on the table. No. Just try to put something under the table that allows you to rest your legs unhindered while sitting. You should also avoid the habit of crossing your legs while sitting. At home, you can elevate your legs by placing a few pillows.
Conservative treatment
The non-surgical treatment program consists of diet, medication and compression therapy.
Diet
One of the risk factors for developing varicose veins is being overweight. Therefore, diet is one of the treatment factors. Nutrition should be balanced so that the calories received do not exceed the amount necessary to meet daily needs. In addition, the number of calories varies depending on the presence or absence of exercise. You should also remove from your diet hot spices, marinade, black pepper, excess salt, alcohol, smoked foods and eat less fried foods.
The menu should consist of a sufficient amount of vegetables and fruits containing vitamin C, dishes with a large amount of fiber, seafood and whole grain bread. Frequent small meals are recommended. It is important to note that animal fats should be present in moderation. You should not listen to those who say that cholesterol is absolutely evil. Cholesterol in reasonable amounts helps to strengthen vascular walls, reducing the risk of vein ruptures and recurrent thrombotic deposits.
To quit smoking
Smoking is the most harmful habit for varicose veins. The fact is that the tars contained in cigarettes clog blood vessels, and carbon dioxide causes vascular spasms. Smoking increases the risk of blood clots and, as a result, secondary complications such as heart attacks and strokes. Smoking is especially dangerous for those who, suffering from varicose veins, take hormonal drugs.
Compression underwear (tights, socks, knee socks)
This option for prevention and treatment is suitable in the early stages of the disease. Underwear can be selected according to several parameters of pressure on soft fabrics, color scheme and model variant. The underwear is put on in the morning without getting out of bed until the veins are filled with blood. The main obstacle to using this method of prevention is the high cost. Therefore, the main users of knitwear are not those who need prophylaxis, but those who, after surgery, use underwear for the purpose of secondary prevention.
Varicose veins: drug treatment
Medicines cannot completely cure or stop the disease.
Venotonics - ointments and gels
Venotonics are aimed at strengthening the walls of veins, stimulating blood flow and slightly improving microcirculation. These medications, when taken as a course, can reduce pain and swelling. The course of drug use is carried out twice a year and lasts at least two months.
Ointments and gels, although safe, are practically useless. They cannot penetrate further than the skin and accordingly affect the condition of the blood vessels. Ointments and gels are prescribed in the early stages of the disease, when it is not yet known what can eliminate swelling and heaviness in the legs: drugs or postural drainage and the end of physical activity. Sometimes ointment manufacturers are cunning and recommend using the product in combination with tablets.
ointment based on the flavonoid rutin.
an ointment containing horse chestnut extract is applied twice a day.
gel, the active substance of which is an extract of grape leaves. There are also capsules of the drug that are taken on an empty stomach twice a day.
Venotonics in tablets
For varicose veins, tablet venotonics are used.
Saponin derivatives of the drug are obtained on the basis of horse chestnut, which contains the plant bioflavonoid aescin. These include the drug, which exists in the form of drops and tablets.
The most effective preparations are made on the basis of a plant flavonoid obtained from citrus fruits - a powerful venotonic. The course of treatment with these drugs can last up to six months.
Rutosides were the first venotonics. Their effect is improvement of microcirculation and anti-inflammatory effect.
Natural rutoside, which is available in the form of tablets and capsules.
Semi-synthetic rutosides.
Combined rutoside. It combines a semi-synthetic derivative of rutin and ginkgo biloba extract. The medicine in the form of capsules is taken twice a day for one month.
Phlebosclerosing drugs
It allows you to cut off the veins from the blood flow without surgery. The action is achieved by the growth of connective tissue, which gradually closes the lumen of the vessel. Connective tissue is stimulated by increased coagulation of endothelial proteins, as well as irritation of vascular smooth muscle.
The simplest option is an acid sulfur-based ointment containing glycosaminoglycan, glucocorticoid, and a nonionic surfactant. However, the effect is so weak that injection solutions are used.
Synthetic phlebosclerotics.
Products containing iodine or based on animal proteins. Medicines are used to selectively close small vessels in the affected areas of the veins. Drugs that do not cause vascular thrombosis are popular among doctors,
They only burn the walls at the endothelial level.
Phlebosclerotic therapy involves the injection of drugs or an elastic bandage. This is a fairly simple, painless technique that does not affect the patient's well-being and is quite popular among doctors.
However, isolated sclerotherapy does not provide lasting results and cannot stop the progression of the disease. Therefore, it is better to use it in combination with surgical treatment. Before therapy, it is necessary to undergo ultrasound of the lower extremities to exclude extensive lesions of the saphenous and deep veins.
Contraindications for phlebosclerosis are: allergies to drugs, atherosclerosis of large vessels and the presence of ischemia, obliterating endarteritis, diabetic angiopathy, damage to the blood coagulation system, pregnancy, acute thrombophlebitis of the legs.
Additional medications
Agents that improve blood microcirculation: low molecular weight dextran, purine derivatives. These drugs stimulate the breakdown of platelets, reduce blood viscosity and increase the elasticity of red blood cells. These processes improve blood supply to tissues and oxidative reactions in them.
Anticoagulants with direct or indirect action. Reduce the risk of thrombosis. Popular products in the form of ointments and gels have anti-edematous, anti-inflammatory and anti-thrombotic effects.
Nonsteroidal anti-inflammatory drugs - suppress inflammatory processes and relieve pain.
Options for phlebosclerosis therapy
Venous sclerosis is performed before the operation to reduce the risk of thrombosis and bleeding in the postoperative period.
During surgery as an alternative to vein removal.
After surgery to close unoperated veins.
The puncture method of drug administration is used at any time, and the catheter method is used exclusively during surgery.
Puncture method
In addition to the operating room, it can only be performed in a specialized surgical room in compliance with all aseptic rules. The large veins are closed first, then the small ones. Medicines are administered from top to bottom. The venipuncture is performed with the patient in an upright position, and the drugs are administered in a horizontal position. If sclerosis of an enlarged vessel is necessary, the procedure is performed in several sessions. After the sessions, the patient registers with a phlebologist for three years for monitoring.
After administration of the drug, the limb is subjected to an elastic bandage, which is repeated for two weeks. During the first week, the bandage is not removed.
The patient should walk within half an hour after the procedure.
The patient should sleep with the limbs elevated every day and avoid sitting or standing for long periods of time, as well as walking a lot.
Radiofrequency ablation of veins
Venous ablation using a radiofrequency emitter is an emerging field in phlebology. This method allows you to get rid of varicose veins painlessly, without complications and with minimal risk of damage to the vessels. Radiofrequency radiation acts on the inner lining of the vessel wall and destroys it. In this way, the lumen of the vein shrinks and the adjacent tissues are practically not affected. This is a very effective method.
The procedure is performed under local anesthesia on an outpatient basis. For accuracy during the procedure, control is performed using duplex angioscanning.
After the anesthetics have taken effect, the vein is punctured. A catheter with an emitter is inserted into the vein. It progresses to the point where the saphenous vein joins the deep vein system. With gradual removal of the catheter, successive irradiation of the vessel from the inside is carried out. After the procedure, the puncture site is processed and covered with a bandage. A special elastic sock is placed on the leg. After half an hour of supervised walking, the patient can go home. If the patient's work is not related to physical labor, he has the right to work the next day after the procedure.
Varicoseextensionveins: surgery
The expediency of surgical intervention is assessed by a phlebologist or vascular surgeon. For women who need surgery to correct a cosmetic defect, doctors suggest postponing the surgery if they are planning a pregnancy. This is due to the fact that during pregnancy varicose veins progress and the effect of the operation can be neutralized.
Combined phlebectomy
The most common option for solving the problem of varicose veins through surgery is combined phlebectomy. The operation is performed under general anesthesia or local anesthesia. All incisions are made as small as possible. For example, the great saphenous vein is removed through a one and a half centimeter incision in the groin area. A phlebextractor probe with a special tip is inserted through the incision into the vein. The probe is then removed along with the vein. Small veins are removed through small channels, the so-called mini-phlebectomy. You must wear a compression garment after surgery.
Endovasal electrocoagulation
Removal of saphenous veins using current. A more dangerous method compared to radiofrequency obliteration and classical surgery.
Cryosurgery
Removal of veins by exposure to low temperatures. The method is relatively safe. It is true that the depth of freezing is not always calculated accurately, which leads to damage to adjacent tissues or incomplete removal of the vein.
Intraoperative scleroobliteration
The use of catheter injection of a sclerosing agent into the saphenous veins. Before leg surgery, the saphenous veins and the changed areas of the veins are marked. During the operation, the anastomosis of the great saphenous vein and the femoral vein is revealed. The tributaries of the great saphenous vein are ligated. At a distance of 1 centimeter from the femoral vein, the saphenous vein is cut and ligated. A catheter is inserted into the severed vein, the vein is sutured, and the wound is bandaged. A roll of gauze is placed along the projection of the saphenous vein along the entire length of the leg and pressed. A sclerosing agent is injected simultaneously with the withdrawal of the catheter.
Endoscopic dissection
Transillumination phlebectomy of perforating veins makes it possible to ligate and shut off the veins from the blood stream. These veins connect the subcutaneous network of veins to the deep network. An endoscopic probe is used.
Laser coagulation
The vein is sealed from the inside with a laser and cut off from the blood stream. It requires a highly qualified doctor and sufficient experience in working with lasers.
Home treatment for varicose veins
At home, varicose veins can be treated with tablets, rubbing ointments, using leeches, apple cider vinegar and cabbage leaves. Home treatment can also be done by wearing a compression garment or an elastic bandage. But if the disease is advanced, none of the methods will help without surgical treatment.
Today, the only high-quality way to get rid of varicose veins is surgical methods, as well as cases of combining surgery with sclerotherapy and compression methods.