Varicose veins are not just 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 spasmodic twitching in the lower leg muscles when walking or playing sports, as well as a feeling of heaviness in the legs. First, there is a high risk of thrombosis of the inferior vena cava system. This is a serious disease whose symptoms affect one in four people on the planet.
Thrombotic complications lead to the appearance of trophic ulcers on the legs, acute circulatory disorders and tissue necrosis of the lower extremities. Often, a blood clot that breaks away 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 starting treatment and prevention of varicose veins, and not the unaesthetic appearance of the legs.
Since the beginning, the disease has progressed steadily and affects new areas of the internal and external venous systems of the legs. Therefore, it would be logical to start analyzing the problem of preventing the disease. 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 valve apparatus of venous blood flow of the legs.
Prevention of varicose veins
The walls of the veins of the lower extremities are very weak, the muscles are designed in such a way that they cannot push the blood through contractions. To control the directed flow of blood and prevent its stagnation, the veins have special valves. In some people, the valves cannot function properly due to heredity. However, with age, valve pathology can develop for the following reasons:
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 development process of the disease can take 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 overload and combat constipation.
Second task– promote the passive drainage of venous blood from the legs. There is a technique for this that must be done 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 a 45 degree angle to the horizontal. You need to lie in this position for at least half an hour. For people who already suffer from varicose veins, it is recommended to sleep with their legs elevated as often as possible.
If you suffer from an illness, you should not wear tight shoes and socks with a tight elastic band so as not to complicate the already impaired blood circulation.
Even if you are sedentary or sitting for long periods of time, you should try to bring your legs into a horizontal position and, if possible, place them on an elevated position. Of course, this doesn't mean that you have to sit with your feet on the table when working in the office. No. Just try to put something under the table so that you can freely support your feet while sitting. You should also avoid crossing your legs when sitting. At home, you can elevate your legs by placing several pillows on them.
Conservative treatment
The non-surgical treatment program consists of diet, medication and compression therapy.
diet
One of the risk factors for the development of varicose veins is being overweight. Therefore, diet is one of the treatment factors. The diet must be balanced so that the amount of calories consumed does not exceed the amount required to cover daily needs. In addition, the number of calories varies depending on the presence or absence of physical activity. You should also eliminate hot spices, marinade, pepper, excess salt, alcohol and smoked foods from your diet and also eat less fried foods.
The menu should consist of vegetables and fruits containing sufficient vitamin C, dishes rich in 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 shouldn't listen to those who say that cholesterol is an absolute evil. Cholesterol in appropriate amounts helps to strengthen the vascular walls and reduces the risk of vein rupture and recurrent thrombotic deposits.
Stop smoking
Tobacco smoking is the most harmful habit for varicose veins. The fact is that the tar contained in cigarettes clogs blood vessels, and carbon dioxide causes vascular spasms. Smoking increases the risk of blood clots and subsequent complications such as heart attacks and strokes. Smoking is especially dangerous for those taking hormonal medications due to varicose veins.
Compression underwear (tights, stockings, knee socks)
This prevention and treatment option is well suited in the early stages of the disease. Lingerie can be selected according to several parameters of printing on soft tissues, color scheme and model option. The underwear is put on in the morning without getting up until the veins overflow with blood. The main obstacle to the use of this method of prevention is its excessive price. Therefore, the main consumers of knitwear are not those in need of prevention, but those who use underwear for secondary prevention after surgery.
Varicose veins: treatment with medication
Medication cannot completely cure or stop the disease.
Venotonics – ointments and gels
Venotonics are aimed at strengthening the venous walls, stimulating blood outflow and slightly improving microcirculation. When taken as a regimen, these medications can relieve pain and swelling. The drug is taken 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: medications or postural drainage and the end of physical activity. Sometimes ointment manufacturers are clever and recommend using the product in combination with tablets.
Ointment based on the flavonoid rutin.
An ointment with horse chestnut extract is applied twice a day.
Gel, the active ingredient of which is an extract from grape leaves. There are also capsules of the drug that are taken twice a day on an empty stomach.
Venotonics in tablet form
Venotonics in tablet form are used for varicose veins.
Saponin derivatives of the drug are obtained on the basis of horse chestnut, which contains the plant bioflavonoid escin. This includes the drug, which comes in the form of drops and dragees.
The most effective preparations are made on the basis of a plant flavonoid obtained from citrus fruits - a powerful venotonic. Treatment with these medications 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, 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 drug in capsule form is taken twice a day for a month.
Phlebosclerosing drugs
Allows exclusion of veins from the bloodstream without surgery. The effect is achieved by the growth of connective tissue, which gradually closes the lumen of the vessel. The stimulation of the connective tissue occurs through increased coagulation of the endothelial proteins and through irritation of the vascular smooth muscles.
The simplest option is an ointment based on acidic sulfur-containing glycosaminoglycan, glucocorticoid and non-ionic surfactant. However, the effect is so weak that injection solutions are used.
Synthetic phlebosclerotics.
Products that contain iodine or are based on animal proteins. The medications are used to specifically close small vessels in the affected vein areas. Medicines that do not cause vascular thrombosis are popular among doctors.
They burn the walls only at the endothelial level.
Phlebosclerotic therapy includes injections of medication or elastic bandages. This is a relatively simple, painless technique that does not affect the patient's well-being and is very popular with doctors.
However, isolated sclerotherapy does not produce lasting results and cannot stop the progression of the disease. Therefore, it is better to use it in combination with surgical treatment. Before therapy, an ultrasound examination of the lower extremities is necessary to exclude extensive lesions of the saphenous vein and deep veins.
Contraindications for phlebosclerosis are: drug allergies, arteriosclerosis 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
Active ingredients that improve blood microcirculation: low molecular weight dextrans, 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 the oxidative reactions taking place in it.
Anticoagulants with direct or indirect effects. Reduce the risk of thrombosis. Popular products in the form of ointments and gels have anti-edematous, anti-inflammatory and antithrombotic effects.
Nonsteroidal anti-inflammatory drugs – suppress inflammatory processes and relieve pain.
Possibilities of phlebosclerosing therapy
Venous sclerosis is performed before surgery 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 administering medication is used at any time, the catheter method is used exclusively during surgery.
Puncture method
In addition to the operating room, it can only be carried out in a special operating room in compliance with all aseptic rules. Large veins close first, then small ones. Medications are administered from top to bottom. The venipuncture is carried out with the patient in an upright position, and the medication is administered in a horizontal position. If sclerosis of an enlarged vessel is necessary, the procedure is carried out in several sessions. After the sessions, the patient is registered for observation with a phlebologist for three years.
After administration of the drug, the limb is subjected to an elastic bandage, which is repeated for two weeks. The bandage is not removed for the first week.
The patient must leave within half an hour after the procedure.
The patient should sleep with their limbs elevated every day and avoid sitting or standing for long periods of time or walking a lot.
Radiofrequency ablation of veins
Vein ablation using a radiofrequency transmitter is a newer field of phlebology. This method allows you to remove varicose veins painlessly, without complications and with minimal risk of vascular injury. High-frequency radiation affects the inner lining of the vessel wall and destroys it. As a result, the lumen of the vein collapses and neighboring tissue is practically not affected. This is a very effective method.
The procedure is carried out on an outpatient basis under local anesthesia. To ensure accuracy during the procedure, control is carried out using duplex angioscanning.
After the anesthetic has taken effect, a venipuncture is carried out. A catheter with an emitter is inserted into the vein. It progresses to the point where the saphenous vein flows into the deep venous system. As the catheter is gradually removed, the vessel is irradiated from the inside. After the procedure, the puncture site is treated and covered with a bandage. A special elastic stocking is placed on the leg. After a half-hour walk 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.
Varicose veinsrenewalVeins: surgery
The advisability of surgical intervention is checked by a phlebologist or vascular surgeon. For women who need surgery to correct a cosmetic defect, doctors recommend postponing the operation if they plan to become pregnant. This is because varicose veins progress during pregnancy and the effect of surgery may be neutralized.
Combined phlebectomy
The most common way to solve the problem of varicose veins surgically is combined phlebectomy. The operation is performed under general 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. The probe is then removed along with the vein. Small veins are removed through small channels, called mini-phlebectomy. After the operation you should wear compression clothing.
Endovascular electrocoagulation
Removal of the saphenous veins using electricity. 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. However, the freezing depth is not always accurately calculated, resulting in damage to adjacent tissue or incomplete removal of the vein.
Intraoperative scleroobliteration
The use of a catheter injection of a sclerosing agent into the saphenous veins. Before leg surgery, the saphenous veins and altered vein areas are marked. During the operation, the anastomosis of the great saphenous vein and the femoral vein is exposed. The tributaries of the great saphenous vein are tied off. The saphenous vein is crossed and tied at a distance of 1 centimeter from the femoral vein. 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 protrusion of the saphenous vein along the entire length of the leg and pressed. At the same time as the catheter is pulled out, a sclerotherapy agent is injected.
Endoscopic dissection
Fluoroscopic phlebectomy of perforating veins allows the veins to be tied off and excluded from the bloodstream. These veins connect the subcutaneous venous network with the deep venous network. An endoscopic probe is used.
Laser coagulation
The vein is closed from the inside with a laser and excluded from the blood circulation. Requires a highly qualified physician and sufficient experience in using lasers.
Treatment of varicose veins at home
At home, varicose veins can be treated with tablets, rub ointments, leeches, apple cider vinegar and cabbage leaves. Home treatment can also be done by wearing compression stockings or elastic bandages. However, if the disease has progressed, none of the methods without surgical treatment will help.
Today, surgical methods, as well as the combination of operations with sclerotherapy and compression methods, are the only high-quality way to get rid of varicose veins.