Phlebeurysmis a pathological condition characterized by a change in the structure of the venous system, which leads to an increase in the diameter of the lumen of the superficial veins and disruption of the valvular system, manifested by valve failure, i. e. H. in their incomplete closure of the vein.
Normally, blood flows through the veins against gravity - from bottom to top, which is possible solely through the work of the venous valves. Under the influence of a number of reasons, primary (due to changes in the valve itself) or secondary (due to expansion of the vein) valve failure occurs; this condition is characterized by incomplete closure of the venous valve and reverse blood flow. Reverse blood flow worsens changes in the vein wall and also contributes to blood stasis in the lower extremities, causing swelling of the lower extremities and a feeling of heaviness in the legs.
In addition to blood stagnation in the lower extremities, the above processes lead to disruption of the linear flow of blood through the veins from top to bottom, the appearance of reflux (reverse blood flow) and turbulent blood flows in the area of expansion. Changes in blood flow properties are the main cause of thrombosis.
Possible causes of the development of varicose veins in the lower extremities
- Physical inactivity- the most common cause of varicose veins. A sedentary lifestyle and a prolonged sitting position contribute to persistently high stress on the venous valves. During physical activity - walking, running, swimming - constantly working muscles on the upper and lower legs help to "expel" blood from the venous system of the lower extremities. Static sitting in a sitting position for a long period of time leads to increased stress on the venous valves and withOver time, the venous valves can no longer fully fulfill their function because they can no longer withstand the load.
- obesityshould be considered the second most important reason. Heavy weight also increases the load on the valve system of the veins of the lower extremities and contributes to disruption of their proper functioning.
- pregnancyis the third most common cause. Hormonal changes, increased body weight, compression of the pelvic veins by the fetus are sufficient reasons for dysfunction of the venous valves. However, up to 50% of the changes in the venous wall detected during pregnancy are functional in nature and disappear on their own within the first year after birth.
- Smoke– the fourth most common cause of varicose veins. Changes in the venous wall may be associated with the unfavorable effect of the composition of smoking mixtures on the tone of the venous wall.
- Inheritance– another possible reason for the development of varicose veins. It is generally accepted that heredity plays a leading role in the development of varicose veins. However, genes responsible for the development of varicose veins have not yet been discovered; It is generally accepted that genes responsible for changes in the structure of connective tissue structures are the main cause of varicose veins. However, the influence of heredity can be greatly exaggerated, and lifestyle changes, normalization of body weight and cessation of smoking will help prevent varicose veins even in patients with an unfavorable hereditary history.
Signs of varicose veins
- Presence of dilated saphenous veinsThe nonlinear course of the vein is the most objective, but not the only, manifestation of varicose veins. Even multiple dilated veins are often not visible, especially if the subcutaneous layer is prominent.
- Edema of the lower extremitiesat the end of the working day, especially with asymmetrical swelling, are the earliest and most common sign of varicose veins.
- You should also consider the presence of varicose veinsPresence of heaviness in the legsevening and night, nocturnal leg cramps.
- Spider veins and vein patternsAlthough intradermal veins represent more of an aesthetic problem, they may also indicate the presence of changes in the saphenous veins.
- Persistent redness, skin thickening, lipodermatosclerosis, trophic ulcers on the foot and leg indicate a decompensated course of varicose veins.
Diagnosis of varicose veins
The diagnosis of varicose veins of the lower extremities can only be made on the basis of ultrasound diagnostic data.
During the ultrasound examination of the veins of the lower extremities, the doctor examines in detail the features of the deep and superficial veins from the groin to the ankle, measures the diameter of the veins, analyzes the features of blood flow in the veins and detects the presence of reflux. Based on the data obtained, the doctor draws a conclusion.
Prevention of varicose veins
Prevention of varicose veins is rational motor therapy, normalization of body weight and smoking cessation.
At the first signs of varicose veins, venotonics and wearing compression stockings help slow the progression of the disease.
Compression stockings should be selected by the doctor depending on the severity of varicose veins and the patient's anthropometric data.
Treatment of varicose veins
The treatment of varicose veins is exclusively surgical.
Currently, many different methods of surgical treatment have been developed - from open techniques - combined phlebectomy to minimally invasive methods - laser or radiofrequency coagulation of veins, mechanochemical methods.
- Varicose veins can be removed through a miniphlebectomy, a technique in which the varicose veins are removed from the subcutaneous tissue through separate punctures and bandaged.
- Small varicose veins can be removed using sclerotherapy - the introduction of a special glue-like substance - sclerosant - into the vein lumens.
- Spider veins and intradermal veins can be removed using sclerotherapy.
However, the risk of recurrence of varicose veins in the lower extremities is 10-15%, even after treatment has been completed. Adequate physical activity, sports (running, walking, exercise bike, swimming), normalizing body weight and giving up bad habits help reduce the likelihood of relapse after surgical treatment. Regular use of phlebotonics and wearing properly selected compression stockings will help reduce the speed of spread.
The main thing is not to delay visiting the doctor!