According to statistics, up to 20% of the population suffers from varicose veins of the lower extremities, while the disease occurs twice as often in women. It has been proven that in women there are additional predisposing factors that contribute to a decrease in vascular tone (pregnancy, taking estrogen-progestin contraceptives, imbalance of sex hormones).The type of treatment of leg veins does not differ in men and women, but the frequency of postoperative relapses is higher in women due to the additional hormonal influence (estrogen and progesterone influence).
What causes varicose veins on women's legs?
Venous diseases of the legs must be treated by a phlebologist who specifically deals with this pathology. Various methods of treating varicose veins are not radical, since they are not aimed at eliminating the main pathogenetic cause - failure of the venous valve apparatus. Surgical and conservative treatments delay disease progression over long periods of time. The recurrence rate is high and is between 10 and 50% 5 years after surgery.
Treatment of varicose veins should be comprehensive. There are three groups of methods for eliminating varicose veins:
- phlebosclerotic,
- surgical,
- conservative.
Each type of treatment has its own advantages and disadvantages and a certain relapse rate. The choice of method is conditional, as the phlebologist often has to combine all three methods to achieve the most favorable result.
Characteristic symptoms of varicose veins in women
Symptoms of varicose veins begin with the appearance of functional disorders such as heaviness in the legs and swelling of the ankle joints at the end of the working day. Spider veins initially form on the skin of the legs.
Spider veins are one of the first symptoms of the development of varicose veins on the legs. The main symptoms of the disease - associations of varicose veins - appear several years after the onset of the disease. If the disease remains untreated at this stage, symptoms such as cramps in the calf muscles and itchy skin on the legs occur.
Signs of trophic disorders: skin pigmentation in the lower third of the leg, cyanosis, sclerotic changes in the subcutaneous tissue, eczema, against the background of which a trophic ulcer forms.
Characteristic symptoms of varicose veins in women
- Painful symptoms occur cyclically and intensify before menstruation, which is associated with changes in sex hormone levels;
- During pregnancy, signs of varicose veins may disappear after childbirth;
- In the second half of the menstrual cycle, the diameter of varicose veins increases due to the action of progesterone, so the symptoms of swelling and heaviness in the legs are more pronounced.
- Signs of varicose veins worsen during hormone therapy.
Now let's talk about therapy methods.
Radiofrequency ablation and endovenous laser coagulation
Radiofrequency ablation of veins
The method is based on the introduction of a special disposable catheter into the lumen of the dilated vein under ultrasound control. The catheter is equipped with a special electrode, the working part of which is heated to 120 degrees under the influence of high-frequency radiation. Advancing the catheter along the vein causes the vessel wall to stick together or "weld". Destroyed veins are excluded from the bloodstream of the legs.
Endovenous laser coagulation
The surgical technique consists of puncturing the affected vein and inserting a laser light guide into its lumen under ultrasound control. Under the influence of laser radiation, the proteins of the vessel wall coagulate, causing the vein to collapse and, after a while, become overgrown with connective tissue. Radiofrequency ablation (RFA) and endovenous laser obliteration (EVLO) are relatively new methods for treating varicose veins in the legs. Despite the differences in execution techniques, they have common features.
Advantages and disadvantages of RFA and EVLA
| Does not require hospitalization | High price |
| Execution speed (from 30 minutes to 1 hour) | Relapse rate up to 10% |
| Painless | Impossibility of performing the procedure due to certain anatomical features of the veins (severe tortuosity of blood vessels) |
| Bloodless | |
| Performed under local anesthesia | |
| No postoperative scar (desired cosmetic effect for women) | |
| Short rehabilitation times |
RFA or EVLO is chosen by women who want to treat varicose veins on an outpatient basis with minimal restriction of physical activity in the postoperative period and while maintaining the aesthetic appearance of their legs.
Phlebosclerotherapy
A special drug is injected into the lumen of the affected vein section, which has a sclerosing ("adhesive") effect on the vessel wall. The sclerotherapy agent can be used in liquid or foam form. Due to the larger contact area of the substance with the vein wall, foam sclerotherapy should be usedpreference should be given.
Advantages and disadvantages of phlebosclerotherapy:
| No postoperative scar | Possible long-term pigmentation of the skin at the injection site (up to 2 years) |
| Is carried out on an outpatient basis | In rare cases, postoperative inflammation of the veins (phlebitis) can occur. |
| The operation is carried out without anesthesia | Swelling and redness of the tissue for 2 days after the procedure |
| The manipulation is practically painless (slight burning at the puncture site) | Allergic reaction due to individual intolerance to the drug |
| Spider veins appear on the legs in 20% of cases (telangiectasia). | |
| Relapse rate up to 50% |
The recurrence of varicose veins after sclerotherapy depends on the lumen of the affected vessel - the wider the lumen, the higher the risk of recanalization in it. When treating recurrent varicose veins after surgical phlebectomy, sclerotherapy is chosen.
Surgical phlebectomy
Surgery is a more radical method of eliminating varicose veins. The principles of surgical treatment are to eliminate the pathological outflow of blood from the deep to the superficial leg veins and to remove the dilated vessels themselves. Stages of combined phlebectomy:
- Crossing and ligating the mouth of the great saphenous vein (incision in the groin area) or the small saphenous vein (incision in the popliteal fossa);
- Removal of varicose vein trunks. It is done using a special metal probe that pulls the vein into the skin incision.
| Radicality | Hospital stay of 5 to 7 days |
| Possibility of performing surgery at any stage of the disease | Scar on legs |
| Spinal anesthesia or general anesthesia | |
| Injury to surrounding tissue when pulling a vein | |
| Possible complications: bleeding, wound infection | |
| Relapse rate up to 20% |
It is preferable to treat the trunk-type lesion surgically when varicose deformation of the large or small saphenous vein occurs to a significant extent. And also with signs of trophic disorders of soft tissues and symptoms of decompensation of venous insufficiency.
Miniphlebectomy
Miniphlebectomy is a separate surgical option for treating varicose veins of the legs in the initial stages. It is most commonly used for single varicose veins on the legs. A puncture is made in the skin over the pathological formation and the vein is pulled out and crossed with a hook. The operation does not require general anesthesia or skin sutures.
Conservative therapy
It is necessary to start treating varicose veins in the legs with medication and compression therapy.Prescribing medications that improve blood circulation and wearing medical compression stockings are the main conditions that determine the outcome of surgical intervention on the leg veins.
Compression therapy
Elastic compression of the legs is the leading method of treatment in cases where surgery is contraindicated. Elastic bandages and special medical knitwear can be used as compression products: stockings, knee-highs, tights. Medical products are characterized by high durability, maintain the original compression for a long period of time and provide comfortable wearing, which is important for women.
Depending on the degree of compression, there are 4 classes of elastic knitwear. It is recommended to treat varicose veins with Class 2 products if the disease does not progress for up to 6 months and with continued use during physical activity or prolonged standing. If there are signs of damage to the valves of the deep veins or severe symptoms of impaired lymphatic drainage, class 3 jerseys are prescribed until the progression of varicose veins stops.
The therapeutic effect of compression stockings is based on:
- a reduction in venous volume, which leads to less blood outflow into the varicose veins;
- increased absorption of tissue fluid into the bloodstream, as a result of which swelling and heaviness in the legs disappear;
- Improving blood circulation, preventing the formation of blood clots.
Varicose veins are one of the oldest diseases known to mankind. Mentions of it can be found in the works of Avicenna, Hippocrates, Paracelsus and other legendary healers, and the Italian scientist Marcello Malpighi devoted many years to its research. The pathology can affect any organs in which there are large veins (stomach, esophagus, male testicles), but the most common are varicose veins of the lower extremities. Let's talk about the causes of varicose veins in the legs, methods of diagnosing and eliminating them.
About varicose veins of the lower extremities
Varicose veins are an irreversible expansion of the veins due to disruption of the valves involved in the blood circulation mechanism of the veins of the lower extremities. When the muscle contracts and relaxes normally, it moves vigorously upward from valve to valve, but when the vein dilatesThe valves no longer close and blood flow slows, resulting in a range of clinical symptoms.
According to statistics, people today suffer from the symptoms of varicose veins in the legs: every tenth man and every third woman aged 30-40. The leading countries in terms of the prevalence of the pathology include the developed countries of Europe, where it is diagnosed in 30-40% of the population; Varicose veins are rarest in Africa and Asia (approx. 0. 1%).
Why it occurs, risk factors
Most experts do not know the exact causes of the diseaseleans towards heredity theory: People who have a family history of varicose veins are at risk. The factors provoking the development of pathology also include:
- Gender. Women are more prone to varicose veins than men - this is due to the increasing stress on the veins during pregnancy and childbirth, as well as the use of hormonal medications;
- bad habits and excess weight. Smoking, abuse of fatty foods and alcohol have a negative effect on blood circulation in the body, increasing the load on the veins and can cause corresponding disorders;
- working conditions. People whose jobs require them to stand or sit motionless for long periods of time (hairdressers, salespeople, waiters, office workers) suffer from this disease more often than others;
- excessive physical activity. Another group of people at risk of developing varicose veins are those who perform heavy physical work or engage in certain strength sports (e. g. weightlifting);
- uncomfortable clothing or shoes. Tight, restrictive clothing and high-heeled shoes also contribute to worsening venous blood flow.
classification
Most often (in 75-80% of cases) the disease affects the trunk and branches of the great saphenous vein, in 5-10% the small saphenous vein, and in 7-10% of patients both veins are involved in the process. In the clinical course of varicose veins of the lower extremities, experts distinguish two forms and four groups.
To form:
- descending– The process spreads from top to bottom starting from the opening of the large femoral vein.
- ascending– The disease begins in the foot and is caused by a malfunction of the valve apparatus of the deep veins.
Groups:
- subcutaneous or intradermal pathology, not burdened by venous discharge;
- segmental with reflux through perforating and superficial veins;
- widespread with venous reflux (through superficial and perforating veins);
- Expansion with reflux through the deep veins.
Depending on the degree of venous insufficiency, there are four main stages of varicose veins:
- – Symptoms of the disease may be present, but these are not detected by diagnostic methods;
- I - This stage is characterized by temporary swelling, "heavy legs" syndrome and the appearance of "spider veins";
- II - the appearance of persistent swelling that occurs in the evening, discoloration of the skin, eczema;
- III – the presence of trophic ulcers, including non-healing ones.
Dangers and complications
The risk to the patient's health and life lies not in the disease itself, but in the complications it causes. This includes a disturbed nutrition of the skin, which leads to thisTrophic ulcers and erysipelas may form, as well as the most dangerous complication – thrombophlebitis. Increased thrombus formation occurs, as a result of which blood clots that detach from the vein walls disrupt the function of internal organs and, in the worst case, can lead to the patient's death.
In addition, dilated vessels with thinner walls are at risk of mechanical damage, which can lead to serious bleeding.
Symptoms
The first symptoms of the disease are a feeling of heaviness and tiredness in the legs, which usually occur in the evening and subside when lying down.Veins acquire a bluish hue and protrude on the surface of the skin, creating "spider veins".(a network of dilated capillaries visible through the skin) and a characteristic sign is that the vein pattern disappears when the limbs are raised higher (e. g. when placed on a chair).
Over time, varicose veins become more pronounced and appearAppearance of small nodules or large conglomerates.
Unpleasant symptoms intensify and bother the patient even at nightSwelling of soft tissuesmost commonly in the area of the feet, legs and ankles, as well as a feeling of fullness in the legs and cramps in the calf muscles.
Without proper treatment, varicose veins progressThe skin becomes dry, lumps and dark spots formand subsequently trophic ulcers. With the development of thrombophlebitis, the veins become bright red, cord-like and painfully compacted when palpated.
When should you see a doctor?
Many people ignore the early signs of varicose veins and attribute them to normal fatigue. This makes it much more difficult to treat the disease and can therefore have serious consequencesImmediately after the symptoms of the disease appear, you should contact a phlebologist.Constant feeling of tiredness and heaviness in the legs, changes in vein and skin color, swelling, spider veins, etc.
diagnosis
The diagnosis of "varicose veins of the lower extremities" is made after a comprehensive examination, which includes:
- general blood analysis– Based on the number of red blood cells, platelets, leukocytes and the hemoglobin level, one can assess a blood clotting disorder and the presence of inflammation;
- Ultrasonicrepresents the most effective method for identifying affected vessels and vein sections;
- Rheovasographycarried out to determine the lack of tissue nutrition with blood (the so-called rheographic index), by which the stage of the disease can be determined;
- PhlebographyA contrast agent is injected into the veins and the condition of the venous system is then assessed using an X-ray machine.
- physiological tests(Troyanov-Trendelenburg test, Hackenbruch test) allow assessing the function of the valve apparatus of the superficial veins.
Treatment
In the initial stages, varicose veins can be combated with conservative methods: taking medications, using ointments and gels, wearing compression clothing and moderate physical activity. To correct cosmetic defects, patients may be recommended minimally invasive surgery or laser treatment. In more advanced cases, varicose veins can be eliminated exclusively through surgery, although the type of varicose veins is selected individually for each case.
Varicose veins of the legs are a disease whose occurrence is best prevented, as it is quite difficult to cure. Therefore, every woman needs to know the causes and signs of such a problem.
What are the dangers of varicose veins on the legs?
Given the early development of the disease, many believe that its worst manifestation is the appearance of a swollen limb. Unfortunately it isn't. The worst case scenario for the development of varicose veins on the legs in women is death. In addition, the complications of the disease can be very different.
The most common are:
- trophic ulcers;
- Thrombosis;
- Phlebitis and thrombophlebitis.
Phlebitis is damage to the inner walls of a vein. In this case, the leg swells more and the protruding vessels become hard when palpated. With the further development of phlebitis, the patient's body temperature rises and any movement of the leg causes severe pain. And then phlebitis does not turn into thrombophlebitis. In this case, blood clots form on the walls of the veins - small blood clots.
Thrombosis is the formation of blood clots without inflammation of the veins. This problem is scary because it is almost impossible to diagnose.
Attention! A thrombus detached from the vessel wall is the cause of death in most clinical cases. In addition, this process occurs instantly (sometimes within minutes) and it is almost impossible to detect a dislodged blood clot before it stops blood circulation.
Now you know what the causes of varicose veins on women's legs are. To prevent varicose veins, it is necessary to constantly take preventive measures. This is especially true for women who have a hereditary predisposition to the disease. To reduce the risk of disease, it is necessary to engage in moderate physical activity, wear comfortable shoes and avoid hypotension.
Consequences and complications
There is no uniform course of varicose veins. Different groups of patients have individual characteristics of the course of the disease that are associated with the pathogenesis of varicose veins. Varicose veins can be primary, i. e. associated with congenital insufficiency of the venous valve and weakness of the vessel wall, which is almost always accompanied by reverse blood flow (reflux). And secondary (acquired), when reflux develops several years after the onset of the disease.
What are the dangers of varicose veins on women's legs? Varicose veins tend to progress; if they develop and conservative treatment is not provided, the symptoms of the disease worsen. Feelings of heaviness in the legs are replaced by persistent, persistent swelling, against the background of which tissue damage develops, open trophic ulcers appear, as a result of which the person completely loses the ability to work and requires constant maintenance therapy.
Home treatment
Many women are interested in how to treat varicose veins on women's legs at home? Therapeutic exercises, herbal medicine and some recommendations for a healthy lifestyle for patients with varicose veins will help relieve the symptoms of the disease and prevent its further development.
Therapeutic exercises
Every morning and evening you need to do simple exercises for varicose veins:
- Lie on your back, lift your legs vertically and lean them against the wall at a 90° angle. Hold this position for 3 minutes, breathing slowly through your chest, not your stomach.
- Perform a cycling exercise while lying on your back for 3 – 5 minutes.
- While standing, lift both feet on tiptoes 1 cm above the floor and lower them. Perform 30 times in two approaches.
- While standing, alternately lift one heel and then the other off the floor, at an angle of no more than 45°. Start with 15 minutes daily and increase to 30 minutes.
You should take at least 30 minutes a day for a walk. It makes sense to go to the swimming pool once a week to swim.
home remedies
Take the herbal mixture internally: Mix 1 tablespoon each of birch buds, feverfew, string, calamus roots, coltsfoot leaves and thyme.
Pour boiling water over half a glass of the mixture and heat in a water bath for 40 minutes. Let it steep, strain. Drink 0. 5 cups before each meal for a month.
Make compresses from homemade ointments:
- Mix half a glass of sour milk with freshly chopped wormwood leaves. Apply to diseased veins, secure at the top with gauze and cover with foil. Keep for 30 minutes daily.
- Grate the beets on a fine grater, add 2 tablespoons of melted honey, stir, cool and apply to sore feet.
To avoid evening swelling, apply fresh cabbage leaves to your ankles and first prick them with a fork until the juice comes out. Secure with a bandage.
Forecasts and preventive measures
Because varicose veinsis an irreversible processIn this case there is no need to speak of a complete recovery. But with timely diagnosis, appropriate treatment and prevention, patients can completely eliminate unpleasant symptoms and live a full life.
Preventive measures against varicose veins include:healthy lifestyle, proper nutrition and giving up bad habits. People who are forced by their professional activities to remain in the same position for a long time are recommended to avoid crossing their limbs, from time to time to perform simple exercises, bending and straightening their legs, and performing a light massage in order toto improve blood circulation.
In your free time, you should take walks in the fresh air as often as possible and engage in moderate physical activity.
Ladies who stick to fashion or work attire and go all the timehigh heels, you should swap them out for more comfortable shoes from time to time.
The same appliesuncomfortable clothingEven tight underwear can lead to circulatory problems and the appearance of varicose veins on the legs in women.
Varicose veins of the lower extremities are now considered a widespread disease that is often not given much importance.
It is very important to remember thisInattention to the health of your feet can cost a person not only his ability to work, but also his life, while varicose veins in the early stages can be corrected quite successfully using the simplest methods.