Varicose veins are not only a cosmetic defect that appears on the thighs, legs and upper part of the leg in the form of a blue net like a tree, accompanied by pain and convulsive tremors in the muscles of the lower part of the leg during walking or exercise, and heaviness. on foot. First of all, there is a high risk of thrombosis of the inferior vena cava system. This is a serious disease, the symptoms of which affect every fourth person on the planet.
Thrombotic complications lead to the appearance of trophic ulcers on the legs, acute blood flow pathologies and tissue necrosis of the lower extremities. Often, a blood clot that breaks free from the wall of a vessel entering the blood flow system of the lower extremities ends its journey through the human circulatory system in the heart or brain. The high risk of stroke or heart attack is the main factor for the initiation of treatment and prevention of varicose veins and not the unsightly appearance of the legs.
Since its onset, the disease has continuously progressed, affecting new areas of the internal and external venous system of the legs. Therefore, it would be logical to start analyzing the issue with the prevention of the disease. Competent preventive measures in most cases determine the rate of development of the pathology, which develops against the background of a hereditary defect in the valve apparatus of the venous blood flow of the legs.
Prevention of varicose veins
The walls of the veins of the lower extremities are very weak, the muscular system is created in such a way that it cannot help push the blood through contractions. To control the directed flow of blood and prevent its stagnation, veins have specialized valves. In some people, the valves cannot work properly due to heredity. However, valve pathology can develop with age due to:
heavy physical activity;
increased intra-abdominal pressure;
constipation;
frequent pregnancies.
Initially, the process develops in the external veins, but as the disease progresses, it affects the deep venous network. The process of developing the disease can last for 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– minimize the increase in intra-abdominal pressure, avoid increased congestion and fight constipation.
The 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 during the day. The essence of the technique is to place the legs on the surface at an angle of 45 degrees compared 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 tight shoes and socks with a narrow elastic band, so as not to complicate the already impaired blood circulation.
Also, when you do sitting work or just sit for a long time, you should try to put your legs in a horizontal position and, if possible, put your feet at a height. Of course, this does not mean that when you work in an office you have to sit with your feet on the table. No. Just try to put something under the table that allows you to rest your legs without obstruction while sitting. You should also avoid the habit of crossing your legs while sitting. At home, you can elevate your legs by placing some pillows.
Conservative treatment
The non-surgical treatment program consists of diet, medication and compression therapy.
diets
One of the risk factors for the development of varicose veins is excess weight. Therefore, diet is one of the treatment factors. Food should be balanced so that the calories taken do not exceed the amount needed to meet daily needs. In addition, the number of calories varies depending on the presence or absence of exercise. You should also remove hot spices, marinade, pepper, excess salt, alcohol, smoked foods from your diet, as well as eat less fried foods.
The menu should consist of a sufficient amount of vegetables and fruits that contain vitamin C, dishes that contain a large amount of fiber, seafood and wholemeal bread. Small frequent 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 an absolute evil. Cholesterol in reasonable amounts helps 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 tars contained in cigarettes block 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, with varicose veins, take hormonal drugs.
Compression underwear (trunks, socks, knee socks)
This prevention and treatment option is suitable in the early stages of the disease. Underwear can be selected according to several parameters of pressure on soft tissues, color scheme and model option. Underwear is worn in the morning, without getting out of bed, until the veins are filled with blood. The main obstacle to using this prevention method is the inflated price. Therefore, the main consumers of hosiery are not those who need prevention, but those who after surgery use underwear for secondary prevention purposes.
Varicose veins: drug treatment
Medicines cannot completely cure or stop the disease.
Venotonics - ointment and gel
Venotonics are aimed at strengthening the vein walls, 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 remove the swelling and heaviness in the legs: drugs or postural drainage and the end of physical activity. Sometimes oil manufacturers are cunning and recommend using the product in combination with tablets.
ointment based on flavonoid rutin.
an ointment containing horse chestnut extract is applied twice a day.
gel, the active substance of which is an extract from grape leaves. There are also capsules of the drug that are taken on an empty stomach twice a day.
Venotonics in tablets
Tablet venotonics are used for varicose veins.
Saponin derivatives of the drug are obtained on the basis of horse chestnut, which contains the bioflavonoid escin. 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 are the first venotonics. Their effect is to improve microcirculation and have an anti-inflammatory effect.
Natural rutoside, which is available in the form of tablets and capsules.
Semi-synthetic rutoside.
Combined rutoside. It combines a semi-synthetic derivative of rutin and ginkgo biloba extract. The medicine in capsule form is taken twice a day for a month.
Phlebosclerosing drugs
It allows you to exclude veins from blood circulation without surgery. The action is achieved through 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 the vessel's smooth muscles.
An acidic glycosaminoglycan-based ointment containing sulfur, glucocorticoid, and nonionic surfactant is the simplest option. However, the effect is so weak that injection solutions are used.
Synthetic phlebosclerotics.
Products containing iodine or based on animal protein. Medicines are used to selectively close the small vessels in the affected areas of the veins. Among doctors, drugs that do not cause thrombosis of vessels are known,
They only burn the walls at the endothelial level.
Phlebosclerotic therapy includes drug injections or elastic bandages. 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 an ultrasound of the lower extremities to exclude extensive lesions of the saphenous and deep veins.
Contraindications of phlebosclerosis are: drug allergies, atherosclerosis of large vessels and the presence of ischemia, obliterative 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 dextrans, purine derivative. These drugs stimulate the division 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. Reducing the risk of thrombosis. Known products in the form of ointments and gels have anti-edematous, anti-inflammatory and antithrombotic effects.
Non-steroidal anti-inflammatory drugs - suppress inflammatory processes and relieve pain.
Phlebosclerosis therapy options
Before surgery, vein sclerosis is performed 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 all times, and the catheter method is used exclusively during surgery.
Drilling method
In addition to the operating room, it can only be performed in a specialized surgical room in accordance with all aseptic rules. Large veins are closed first, then small ones. Medicines are administered from top to bottom. The vein is punctured with the patient in a vertical position and drugs are administered in a horizontal position. If sclerosis of an elongated vessel is necessary, the procedure is carried out in several sessions. After the sessions, the patient is registered with the phlebologist for three years for observation.
After the 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 of the procedure.
The patient should sleep with the limbs elevated every day and avoid sitting or standing for a long time, as well as walking a lot.
Radiofrequency ablation of veins
Ablation of veins using a radiofrequency emitter is a recently emerging field of phlebology. This method allows you to get rid of varicose veins painlessly, without complications and with minimal risk of damage to the vessel. Radiofrequency radiation acts on the inner lining of the vascular wall and destroys it. Thus, the lumen of the vein collapses, and the neighboring 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 angioscan.
After the anesthetics have taken effect, a venipuncture is performed. A catheter with an emitter is inserted into the vein. It progresses to the point where the saphenous vein joins the deep venous system. With the gradual removal of the catheter, subsequent irradiation of the vessel occurs from the inside. After the procedure, the puncture site is treated and covered with a bandage. A special elastic sock is put on the leg. After half an hour of walking under supervision, the patient is allowed to go home. If the patient's work does not involve physical labor, he has the right to work the day after the procedure.
varicoseextensionveins: operation
The advisability of surgical intervention is considered by a phlebologist or vascular surgeon. For women who need surgery to correct a cosmetic defect, doctors suggest postponing 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 using surgery is combined phlebectomy. The operation is performed under general anesthesia or local anesthesia. All cuts 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 into the vein through the incision. After that, the probe is removed along with the vein. Small veins are removed through small channels, the so-called mini-phlebectomy. After surgery, you must use compression garments.
Endovasal electrocoagulation
Removal of saphenous veins using current. A more dangerous method compared to radiofrequency ablation and classical surgery.
Cryosurgery
Removal of veins using exposure to low temperatures. The method is relatively safe. True, the depth of freezing is not always accurately calculated, which leads to damage to adjacent tissues or incomplete removal of the vein.
Intraoperative scleroobliteration
Use of catheter injection of a sclerosing agent into the saphenous veins. Before leg surgery, the saphenous veins and altered areas of the veins are marked. During the operation, the anastomosis of the great saphenous vein and the femoral vein is exposed. The branches of the great saphenous vein are ligated. At a distance of 1 centimeter from the femoral vein, the saphenous vein is crossed and ligated. A catheter is inserted into the cut 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. Simultaneously with the withdrawal of the catheter, a sclerosing agent is injected.
Endoscopic dissection
Transillumination phlebectomy of perforating veins makes it possible to connect and exclude the veins from the blood circulation. These veins connect the subcutaneous network of veins with the deep network. An endoscopic probe is used.
Laser coagulation
The vein is sealed from the inside with a laser and excluded from the blood stream. It requires a qualified doctor and sufficient experience to work with the laser.
Home treatment for varicose veins
At home, varicose veins can be treated with tablets, ointments for rubbing, using leeches, apple cider vinegar and cabbage leaves. Home treatment can also be performed by wearing compression garments or elastic bandages. But if the disease is advanced, none of the methods will help without surgical treatment.
Today, the only quality way to get rid of varicose veins is surgical methods, as well as cases of combining surgery with sclerotherapy and compression methods.