Varicose veins in legs: treatment, symptoms, surgery

Varicose veins are not just a cosmetic blemish, they appear as tree-like blue meshes on the upper thighs, calves, and feet, and are accompanied by pain and twitching in the calf muscles and a feeling of heaviness when walking or exercising. on the legs. First, the risk of thrombosis in the inferior vena cava system is high. It is a serious disease whose symptoms affect one in four people on the planet.Thrombotic complications lead to trophic ulcers in the legs, acute blood flow lesions, and tissue necrosis of the lower extremities. Typically, a blood clot that breaks away from a blood vessel wall and enters the lower extremity bloodstream ends its journey through the heart or brain's circulatory system. A high risk of stroke or heart attack is the primary factor in initiating treatment and prevention of varicose veins, not the unsightly appearance of the legs.Since its onset, the disease has continued to progress, affecting new areas of the leg's internal and external venous systems. Therefore, it is logical to start analyzing the problem from disease prevention. In most cases, effective preventive measures can predetermine the rate of development of pathology that occurs against the background of hereditary defects in the valve apparatus of the venous blood flow in the legs.

Prevent varicose veins

The walls of the veins in the lower extremities are very weak and the muscular system is not designed in a way to help push the blood through contraction. To control the directional flow of blood and prevent it from becoming stagnant, veins have specialized valves. In some people, due to genetics, the valve does not work properly. However, valvular disease can develop with age for the following reasons:

• strenuous physical activity;
• increased intra-abdominal pressure;
• constipate;
• Frequent pregnancies.

Initially, the process occurs in the external veins, but as the disease progresses, it affects the deep vein network. The progression of the disease can last for decades, and its rate depends on lifestyle, the strength of the blood vessel walls and the intensity of physical activity.The first priority is prevention– Minimize the increase in intra-abdominal pressure, avoid increased load and combat constipation.second task– Promote the passive outflow of venous blood in the legs. To do this, a technique must 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 outstretched leg on the surface at a 45-degree angle to the horizontal. You need to lie in this position for at least half an hour. For those who already suffer from varicose veins, it is recommended to sleep with your legs elevated as often as possible.If you have a disease, you should not wear shoes and socks with too tight elastic bands to avoid complicating the already damaged blood circulation.Also, when doing sedentary work or sitting for long periods of time, try to keep your legs in a horizontal position or, if possible, place your legs on a high ground. Of course, this doesn't mean you need to put your feet up on the table while working in the office. No. Just try placing something under your desk that allows you to rest unhindered while you sit. You should also avoid the habit of crossing your legs when sitting. At home, you can elevate your legs by placing a few pillows.

Conservative treatment

Non-surgical treatment options include diet, medication, and compression therapy.

diet

One of the risk factors for developing varicose veins is being overweight. Therefore, diet is one of the therapeutic factors. Nutrition must be balanced so that the caloric intake does not exceed the amount required to meet daily needs. Additionally, the number of calories varies depending on whether you exercise or not. You should also eliminate spicy seasonings, marinades, pepper, excess salt, alcohol, smoked foods from your diet and eat less fried foods. The menu should include adequate amounts of vegetables and fruits containing vitamin C, dishes rich in fiber, seafood and whole-grain breads. It is recommended to eat small and frequent meals. It is worth noting that animal fat intake should be moderate. You shouldn't listen to those who say cholesterol is absolutely evil. Appropriate amounts of cholesterol help strengthen blood vessel walls and reduce the risk of vein rupture and recurrent blood clot deposits.

quit smoking

Smoking is the habit most harmful to varicose veins. The fact is that the tar contained in cigarettes can clog blood vessels, and the carbon dioxide can cause vasospasm. Smoking increases the risk of blood clots, which increases the risk of secondary complications such as heart disease and stroke. Smoking is especially dangerous for people who have varicose veins and take hormone medications.

Compression underwear (tights, stockings, knee socks)

This preventive and treatment regimen is ideal for the early stages of the disease. Underwear can be chosen based on several parameters of soft tissue pressure, color schemes and style options. Put on your underwear in the morning without getting out of bed until your veins are filled with blood. The main barrier to using this preventive method is its high price. Therefore, the main consumers of knitwear are not those who need prevention, but those who use underwear for secondary prevention after surgery.

Varicose veins: drug treatment

Medications cannot completely cure or stop disease.

Venotonics – ointments and gels

Venotonics are designed to strengthen vein walls, stimulate blood flow and slightly improve microcirculation. Taken as a course, these medications can reduce pain and swelling. The course of using this drug is carried out twice a year and lasts for at least two months.Ointments and gels, while safe, are virtually useless. They cannot penetrate beyond the skin and therefore affect the condition of blood vessels. In the early stages of the disease, it is not known what will eliminate swelling and heaviness in the legs: medications or postural drainage, and at the end of physical activity, ointments and gels are prescribed. Occasionally, ointment manufacturers are cunning and recommend combining the product with tablets.

• Ointment based on the flavonoid rutin.
• Use an ointment containing horse chestnut extract twice daily.
• Gel whose active substance is an extract of grape leaves. There is also a drug capsule that can be taken twice a day on an empty stomach.

Venotonics Tablets

Intravenous refill tablets are used to treat varicose veins.

1. The saponin derivative of the drug is obtained on the basis of the horse chestnut tree, which contains the plant bioflavonoid aescin. These include medications that come in the form of drops and tablets.
2. The most effective preparations are based on phytoflavonoids extracted from citrus fruits - a powerful intravenous supplement. Courses of these medications can last up to six months.
3. Rutin was the first intravenous supplement. They work by improving microcirculation and have anti-inflammatory properties.
   • Natural rutin, available in tablet and capsule form.
   • Semi-synthetic rutin.
   • Combined rutin. It combines a semi-synthetic derivative of rutin and ginkgo leaf extract. The drug in capsule form is taken twice daily for one month.

venous sclerosis drugs

The vein can be excluded from the blood flow without surgery. This effect is achieved by the growth of connective tissue, which gradually seals the lumen of blood vessels. Increased endothelial protein coagulation and stimulation of vascular smooth muscle irritate connective tissue.

• Ointments based on acidic sulfur-containing glycosaminoglycans, glucocorticoids, and nonionic surfactants are the simplest options. However, the effect is weak and injection is required.
• Synthetic venous sclerosing agents.
• Products containing iodine or based on animal protein. These drugs are used to selectively close the small blood vessels in the area of the affected vein. Among doctors, drugs that do not cause blood clots are popular,They only burn the wall at the level of the endothelium.

Venous sclerotherapy includes injections of medication or elastic bandages. It's a fairly simple, painless technique that doesn't affect the patient's health and is very popular with doctors.However, sclerotherapy in isolation does not provide long-lasting results or halt the progression of the disease. Therefore, it is best used in conjunction with surgical treatment. Ultrasound examination of the lower extremities is required before treatment to exclude extensive lesions of the saphenous and deep veins.Contraindications to phlebosclerosis are: drug allergy, large vessel atherosclerosis and ischemia, obliterative endarteritis, diabetic vasculopathy, damage to the coagulation system, pregnancy, acute thrombophlebitis of the legs.

additional medications

• Agents for improving 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 the blood supply to the tissue and oxidative reactions in the tissue.
• Anticoagulants acting directly or indirectly. Reduce the risk of thrombosis. Popular products in ointment and gel form have anti-edematous, anti-inflammatory and anti-thrombotic effects.
• Nonsteroidal anti-inflammatory drugs – inhibit the inflammatory process and relieve pain.

Venous Sclerosis Treatment Options

• Venous sclerosis is performed before surgery to reduce the risk of postoperative thrombosis and bleeding.
• As an alternative to phlebotomy during surgery.
• The unoperated vein is closed after surgery.

The puncture administration method can be used at any time, while the catheter method is specially used during surgery.

puncture method

Except outside the operating room, it can only be performed in specialized operating rooms that comply with all sterile rules. Large veins close first, then small veins. Medication is administered from top to bottom. Venipuncture is performed with the patient in an upright position and administration is administered in a horizontal position. If hardening of an elongated blood vessel is required, the procedure needs to be performed in several sessions. After the course of treatment, the patient will be registered with a phlebologist for three years of observation.

• After administration, the limb is wrapped with an elastic bandage and repeated for two weeks. During the first week, the bandage will not be removed.
• The patient must be walking within half an hour of surgery.
• Patients should elevate their limbs when sleeping every day, avoid sitting or standing for long periods of time, and avoid walking a lot.

intravenous radiofrequency ablation

Venous ablation using radiofrequency transmitters is an emerging field of phlebology. This method allows you to eliminate varicose veins painlessly, without complications and with minimal risk of blood vessel damage. Radiofrequency radiation acts on the inner lining of the blood vessel wall and damages it. As a result, the venous lumen collapses, while adjacent tissue is virtually unaffected. This is a very effective method. The surgery is performed on an outpatient basis under local anesthesia. In order to ensure the accuracy of the surgical process, dual vessel scanning is used for control.After the anesthetic takes effect, a venipuncture is performed. A catheter with a transmitter is inserted into the vein. It proceeds to the junction of the saphenous vein with the deep venous system. As the catheter is gradually removed, the vessel is continuously illuminated from the inside. After surgery, the puncture site is treated and covered with a bandage. Special compression stockings are put on the legs. After half an hour of supervised walking, the patient can go home. If the patient's job does not involve physical labor, the patient is entitled to continue working the day after surgery.

Varicose veinsexpandVeins: Surgery

A phlebologist or vascular surgeon will consider whether surgical intervention is recommended. For women who need surgery to correct cosmetic defects, doctors recommend postponing surgery if they plan to become pregnant. This is because varicose veins progress during pregnancy and the effects of surgery may be offset.

combined phlebectomy

The most common option for surgically resolving varicose vein problems is combined phlebectomy. The surgery is performed under general 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 vein extractor probe with a special tip is inserted into the vein through the incision. Thereafter, the probe is removed along with the vein. Small veins are removed through a small catheter, a so-called microphlebectomy. After surgery, you should wear a compression garment.

intravascular electrocoagulation

Use an electric current to remove the saphenous vein. This is a more risky method compared to radiofrequency ablation and classic surgery.

cryosurgery

The veins are removed by exposing them to cold temperatures. This method is relatively safe. Indeed, freezing depth cannot always be calculated accurately, which can lead to damage to adjacent tissue or incomplete vein resection.

intraoperative scleral closure

A catheter is used to inject sclerosing agent into the saphenous vein. Before leg surgery, mark the saphenous vein and areas of altered veins. During the operation, the anastomosis between the great saphenous vein and the femoral vein was exposed. The tributaries of the great saphenous vein were ligated. The saphenous vein was cross-ligated 1 cm away from the femoral vein. A catheter is inserted into the severed vein, the vein is sutured, and the wound is bandaged. Place the gauze roll along the entire length of the leg along the projection of the saphenous vein and apply pressure. While removing the catheter, inject sclerosing agent.

Endoscopic anatomy

Transillumination phlebectomy of a perforator vein ligates the vein and excludes it from blood flow. These veins connect the subcutaneous venous network to the deep network. Use an endoscopic probe.

laser coagulation

A laser is used to seal the vein from the inside and exclude it from the blood flow. Highly qualified doctors and sufficient experience working with lasers are required.

Home treatments for varicose veins

Varicose veins can be treated at home with tablets, topical ointments, leeches, apple cider vinegar and cabbage leaves. Home treatment can also be done by wearing a compression garment or elastic bandage. But if the disease has progressed to an advanced stage, any method will be useless without surgical treatment.Today, the only quality method for eliminating varicose veins is surgical method, and in cases of surgery combined with sclerotherapy and compression methods.