Varicose veins (varicose veins).

10 August 2018

Varicose veins (varicose veins) is one of the most common and oldest diseases of the vascular system, which has been opened since the time of ancient Egypt. With the help of the Egyptian papyri and the excavation was found a mummy with signs of varicose veins. The disease interested the famous and ancient doctors: Hippocrates, Galen, and Avicenna, and later Troyanova, Trendelenburg. IDO although the disease has not lost its importance in modern medicine. Definition of "Varicose" comes from the Latin word "varix", which means "extension", therefore, the disease is called "Varicose veins." This disease is characterized by the expansion and increase of the length of the peripheral veins in serpentine tortuosity (deformations), as well as a violation of the exit of the blood, resulting in insufficiency of the valve and the weakening of its walls. The disease most often affects the veins of the lower extremities, as the main burden of the exit of the blood (large volume) falls on them, therefore, preferred to this section. Varicose veins occurs in about 17 - 25% of the population. At an early age of the disease occurs equally in boys and girls. At the ripe old age of women will be sick 2 to 3 times more often than men, due to hormonal changes of the female body (menstruation, pregnancy, menopause).

Causes and risk factors in the development of varicose veins

The exact cause of the disease is not known, we only know that under the influence of some factors in the development of the weakening of the valves, the pressure increase and the loss of elasticity of the walls of the superficial and connecting veins. Risk Factors:

The genetic predisposition: the transfer of the varicose veins by inheritance is caused by mutation of the gene responsible for the structure of the vessel wall, the result of the mutation, children are born with weak congenital of the connective or muscular tissue of the vessel wall, or the lack of it of the valve (negative number), and as a result there is a weakness of the vessel wall and increased pressure in the veins.
Hormonal changes (pregnancy, menopause): pregnancy, hormonal changes make-up of an organism (increasing the level of progesterone and decrease of estrogen) that affect the formation of clotting factors (to increase them) to reduce the tone of the wall vein (as a result of the destruction of collagen and elastic fibers of the vessel wall) all of this leads to the formation of blood clots, obstruction of blood vessels and their deformation.
Obesity : excess weight involves a sedentary lifestyle, which is a slowing down of the circulation, in addition to the excess of fat increases intra-abdominal pressure, which violates the exit of blood through the veins, resulting in the development of the stagnation in the veins and the possible development of the disease.
Diabetes :chronic high levels of blood sugar over time damages blood vessels, which is a favourable environment for the development of the formation of blood clots.
Alcohol abuse : excessive alcohol consumption leads to dehydration and thickening of the blood, which are formed as a result of the formation of blood clots that clog veins and compromises flow of blood.
Weight lifting (engines),always on foot or long foot job (salesmen, drivers): associated with a decrease of muscle tone, increased intra-abdominal pressure and as a result reduce the speed and the obstruction of the flow of blood to the heart and the development of its stagnation in the lower extremities.
Congenital coagulation defects: congenital hypercoagulation (excessive production of clotting factors in the blood) leads to the formation of blood clots and disruption of the blood through the blood vessels.
Poor nutrition: the lack of certain vitamins in the diet (Vit.C, E, R, plant fibers play an important role in the strengthening of the wall of the vessel and improve the circulation of the blood).
Wear tight clothing: brings constant leads to the mechanical compression of the veins, causing obstruction of the venous outflow from the lower extremities.
Chronic constipation : frequent increase in the pressure on the abdomen (during effort) leads to the difficulty of the exit of the blood from the lower extremities.
Frequent walking high heel: the lack of movement of the muscles of the legs and the development of stagnation.
Hot season: frequent thirst leads to dehydration of the body occurs blood clots and blood clots.
At the same time, diseases of the cardiovascular system or diseases of the kidneys: deterioration of the exit of venous blood (heart valve insufficiency, congenital defects).
Overdose of drugs increase of blood coagulation: risk of blood clots and blockage of blood vessels.
Surgery of the loss of some volume of blood is not a comfortable position in the table of operations (the compression of certain blood vessels), leading to the risk of blood clots.

Complications of varicose veins

The formation of blood clots, as a result of the stagnation of the blood in the veins;
detachment of thrombus and occlusion of the vessel coincides with its diameter;
thrombophlebitis (clot formation in the light of the line is the inflammation of the walls);
pulmonary embolism (detached blood clot in the blood enters the pulmonary artery, which participates in the circulation of the blood in a small circle. If the clot diameter coincides with the diameter of the trunk of this artery, which can cause sudden death. If the clot is of a smaller diameter that goes to the branches of the pulmonary artery, causing pulmonary infarction or edema).
sores or eczema of the legs caused eating disorders (poor blood circulation leads to lack of oxygen in the tissues, which is the main food of the tissues of the body);
swelling different areas of the body as a result of the stagnation in the veins (which are soft, elastic, bluish in color, his education, does not depend on the time of day, often form on the affected area);
dermatitis (skin inflammation of the affected area) because of the malnutrition of the web;
change the color of the skin of the affected area;
sealing subcutaneous fatty tissue in the affected area due to swelling.

Diagnosis of varicose veins

The flagellum (functional) tests (determination of the patency of the veins and their valves): Troyanova - Trendelenburg,Pratt, Chania, Delbe-pertes and others. One of the most common test Troyanova - Trendelenburg with which the patient is in a horizontal position, raise your leg to 45 ⁰, the doctor makes a delicate, from the foot up (as a result, the veins superficial are emptied), then establishes a tourniquet to the upper part of the thigh and asks the patient to stand normally, the filling of the veins of the leg have to spend more than 15 seconds;
Duplex ultrasound scan of the veins (ultrasound angioscanning) the most informative method to evaluate the blood flow in the vessels and see the boat;
Dopplerhophy - the method to evaluate the flow of blood in the vessels;
Venography is the injection of a contrast agent intravenously, and the study of the x-ray image;
Phleboscintigraphy - intravenous administration of the radiopharmaceutical and observation in a special device.

The treatment of varicose veins

Non-surgical treatment

The traditional methods of treatment (as a complement to medical treatment): using compression hosiery (medium); special exercises (swimming, bike, skis, feet over the head of about 20 ⁰ towards the bed, special exercises ("Bicycle" lying on your back and your breathing, imagine that you pedal the Bike; the same way to bend and unbend the foot at the ankle joint forward and backward) used to improve the output of blood, but only in the complicated cases); contrast shower (under running water to keep the feet and gradually reduces the temperature of the water reaches the cold); a foot bath (not hot) decoction of bark of oak, chestnut, chamomile, St. John's wort; rubbing alcohol tincture of flowers of acacia, the leaves of Kalanchoe, Apple cider vinegar; thrombophlebitis treatment with leeches.
Day: in the morning, slow getting out of bed (about 5-10 minutes), during sleep puts the cushion under the heel so as to lift the leg approximately 15-20 ⁰ relative to bed, the walk must be calm, you can't sit cross leg on the leg, bandaging the legs with bandages, elastic, standing at the top of the thigh, with medical stockings, a good diet, to avoid any tedious movements and any substances or factors that contribute to the thickening of the blood, with the exception of Smoking, the prevention of constipation.
Diet : the body needs food contains vitamins strengthen the blood vessels and improves blood flow: vitamin C (contained with the citruses, tomatoes, rose hips, etc.), vitamin E (vegetables, liver, egg yolk, green onion), vitamin R (grapefruit, walnut, black currant), bioflavonoids (dark sweet cherry, sour cherry), copper (seafood). A sufficient daily amount of fluid at least 1.5 liters. Limited to the use of alcoholic drinks, coffee, products, smoked products.

Surgical treatment

Phlebectomy:Indications for the removal of the veins: extensive varicose veins, saphenous vein pathologically enlarged, trophic disorders of the skin that are not suitable for conservative treatment, acute thrombophlebitis, varicose veins saphenous veins is accompanied by violation of the General condition (severe fatigue, swelling of the legs) of the patient. The contraindications for the removal of the veins: coronary heart disease, a serious infectious processes, the older age of the patient, the pregnancy of the 2nd and 3rd trimesters, swelling in the legs (erysipelas, pyoderma, eczema). The advantages of surgical treatment: the only treatment in severe cases, the only radical method of correction of the valves of the deep veins. Disadvantages of surgical treatment: traumatic (cosmetic defect), requires anesthesia, you need is a few days in the hospital under the supervision of a surgeon. Laser therapy (endovascular microtermocoagulation) :Indications: a Combination of varicose veins with the following diseases: diseases of the cardiovascular system (coronary heart disease, arterial hypertension), peripheral vascular disease (phlebitis, thrombophlebitis), respiratory diseases (asthma, bronchitis, pleurisy), with diseases of the digestive tract (cholecystitis, peptic ulcer and ulcer duodenal), diseases of the nervous system (craniocerebral traumas, neuroinfections), diseases of the genitourinary system (pyelonephritis, endometritis, salpingitis), with skin diseases (dermatitis, Neurodermatitis), peritonitis, boils. Contraindications: people suffering from cancer diseases, diseases of the liver, the kidneys and the heart in the phase of decompensation, cerebral sclerosis, pregnancy. Advantages: eliminates unpleasant vascular pattern, a quick procedure (15-20 min), requires no hospitalization, safe and painless, does not injure the vessels and the tissue surrounding tissue. Disadvantages: not available everywhere method expensive method, the removal of the large vessels possible thermal tissue damage, possible formation of scars and depigmentation (whitening of the skin in the treated area. Radiofrequency coagulation (ablation) of varicose veins: Indications: varicose veins with a lesion of the trunk of great and small saphenous veins, trophic ulcers as a result of the appearance of varicose veins. Contraindications: acute thrombophlebitis of the subcutaneous veins, the impossibility of active walking, pregnancy, mental disorder. Advantages: there is no cosmetic defect, painless, requires no hospitalization, does not violate the capacity. Drawbacks: the only drawback is the price. Sclerotherapy: Indications: small veins, large varicose veins when used duplex dopplerography, varicose veins in the early stages (if the damage is only superficial veins. Contraindications: pregnancy and lactation, allergic to sclerosus, deep venous thrombosis, purulent-inflammatory diseases of the feet. Advantages: lower cost in comparison with surgery, a brief period of the restoration, do not require a stay in the hospital (to go home), the best aesthetic results. Disadvantages:possibility of absorption in the deep veins sclerosus, decreased efficiency due to the mix sclerosus with blood, are effective in advanced cases.