Varicose veins are not only a cosmetic defect that appears on the thighs, legs and upper part of the foot in the form of a tree-like blue mesh, accompanied by pain and convulsive twitching in the lower leg muscles when walking or exercising, and heaviness in the legs. First of all, there is a high risk of thrombosis of the inferior vena cava system. This is a serious disease, the symptoms of which affect every fourth person on the planet.
Thrombotic complications lead to the appearance of trophic ulcers on the legs, acute pathologies of blood flow and necrosis of tissues 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 in starting treatment and preventing varicose veins, and not the unaesthetic appearance of the legs.
Since its onset, the disease has been constantly progressing, affecting new areas of the internal and external venous system of the legs. Therefore, it would be logical to start analyzing the issue with the prevention of the disease. Competent preventive measures in most cases predetermine the rate of development of pathology, which develops against the background of a hereditary defect in the valve apparatus of the venous blood flow of the legs.
Prevention of varicose veins
The walls of the veins of the lower extremities are very weak, the muscular system is designed in such a way that it cannot help push blood through contractions. To control the directional flow of blood and prevent its stagnation, the veins have specialized valves. In some people, the valves cannot function properly due to heredity. However, valve pathology can develop with age due to:
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 process of development of the disease can last for decades, and the speed depends on lifestyle, the strength of the walls of blood vessels 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 passive outflow of venous blood from the legs. To do this, there is a technique that must be performed 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 relative to the horizontal. You need to lie in this position for at least half an hour. For those people who already have varicose veins, it is recommended to sleep with your legs elevated as often as possible.
If you have a disease, you should not use tight shoes and socks with a tight elastic band, so as not to complicate the already impaired blood circulation.
Also, when doing sedentary work or just sitting for a long time, you should try to give your legs a horizontal position, and, if possible, place your legs on an elevation. Naturally, this does not mean that when working in an office you need to sit with your feet on the table. No. Just try to put something under the table that allows you to rest your feet unobstructed while sitting. You should also avoid the habit of crossing your legs while sitting. At home, you can elevate your legs by placing several pillows.
Conservative treatment
The non-surgical treatment program consists of diet, medication and compression therapy.
Diet
One of the risk factors for developing varicose veins is excess weight. Therefore, diet is one of the treatment factors. Nutrition must be balanced so that the calories received do not exceed the required amount to meet daily needs. Moreover, the number of calories varies depending on the presence or absence of exercise. You should also remove hot seasonings, marinade, pepper, excess salt, alcohol, smoked foods from your diet, and also eat less fried foods.
The menu should consist of a sufficient amount of vegetables and fruits containing vitamin C, dishes containing a large amount of fiber, seafood, and wholemeal bread. Frequent small meals are recommended. It is important to note that animal fats should be present in moderation. You should not listen to those who say that cholesterol is an absolute evil. Cholesterol in reasonable quantities helps strengthen vascular walls, reducing the risk of vein ruptures and recurrent thrombotic deposits.
To give up smoking
Tobacco smoking is the most harmful habit for varicose veins. The fact is that the tars contained in cigarettes clog blood vessels, and carbon dioxide causes vascular spasms. Smoking increases the risk of blood clots and, as a result, secondary complications such as heart attacks and strokes. Smoking is especially dangerous for those who, having varicose veins, take hormonal medications.
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 pressure on soft tissues, color scheme and model option. The underwear is put on in the morning, without getting out of bed, until the veins are overflowing with blood. The main obstacle to the use of this method of prevention is the inflated price. Therefore, the main consumers of knitwear are not those who need prevention, but those who, after surgery, use underwear for the purpose of secondary prevention.
Varicose veins: treatment with medications
Medicines cannot completely cure or stop the disease.
Venotonics – ointments and gels
Venotonics are aimed at strengthening the walls of the veins, stimulating blood outflow and slightly improving microcirculation. These medications, when taken as a course, can reduce pain and swelling. The course of using the drug is carried out twice a year and lasts at least two months.
Ointments and gels, while 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 remove swelling and heaviness in the legs: drugs or postural drainage and the end of physical activity. Sometimes ointment manufacturers are cunning and recommend using the product in combination with tablets.
ointment based on the flavonoid rutin.
an ointment containing horse chestnut extract is applied twice a day.
gel, the active substance of which is an extract from grape leaves. There are also capsules of the drug that are taken on an empty stomach twice a day.
Venotonics in tablets
Tablet venotonics are used for varicose veins.
Saponin derivatives of the drug are obtained on the basis of horse chestnut, which contains the plant bioflavonoid escin. These include the drug, which exists in the form of drops and tablets.
The most effective preparations are made on the basis of a plant flavonoid obtained from citrus fruits - a powerful venotonic. The course of treatment with these drugs 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, which is 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 you to exclude veins from the bloodstream without surgery. The action is achieved through the growth of connective tissue, which gradually closes the lumen of the vessel. Connective tissue is stimulated by increased coagulation of endothelial proteins, as well as irritation of the smooth muscles of the vessel.
An ointment based on acidic sulfur-containing glycosaminoglycan, glucocorticoid and nonionic surfactant is the simplest option. However, the effect is so weak that injection solutions are used.
Synthetic phlebosclerotics.
Products containing iodine or based on animal proteins. The drugs are used to selectively close small vessels in the affected areas of the veins. Among doctors, drugs that do not cause vessel thrombosis are popular,
They only burn the walls at the endothelial level.
Phlebosclerotic therapy involves injections of drugs or elastic bandaging. This is a fairly simple, painless technique that does not affect the patient’s well-being and is quite popular among doctors.
However, isolated sclerotherapy does not provide lasting results and cannot stop the progression of the disease. Therefore, it is better to use it in combination with surgical treatment. Before therapy, it is necessary to undergo an ultrasound of the lower extremities to exclude extensive lesions of the saphenous and deep veins.
Contraindications to phlebosclerosis are: allergies to drugs, atherosclerosis of the great vessels and the presence of ischemia, obliterating endarteritis, diabetic angiopathy, damage to the blood coagulation system, pregnancy, acute thrombophlebitis of the legs.
Additional medications
Agents that improve blood microcirculation: low molecular weight dextrans, purine derivative. These drugs stimulate the breakdown of platelets, reduce blood viscosity, and increase the elasticity of red blood cells. These processes improve blood supply to tissues and oxidative reactions in them.
Anticoagulants of direct or indirect action. Reduce the risk of thrombosis. Popular products in the form of ointments and gels have anti-edematous, anti-inflammatory and antithrombotic effects.
Non-steroidal anti-inflammatory drugs – suppress inflammatory processes and relieve pain.
Phlebosclerosing therapy options
Before surgery, vein sclerosis is performed to reduce the risk of thrombosis and bleeding in the postoperative period.
During surgery as an alternative to vein removal.
After surgery to close non-operated veins.
The puncture method of administering drugs is used at any time, and the catheter method is used exclusively during surgery.
Puncture method
In addition to the operating room, it can only be performed in a specialized surgical room in compliance with all aseptic rules. Large veins close first, then small ones. Drugs are administered from top to bottom. The vein is punctured with the patient in an upright position, and the drugs are administered in a horizontal position. If sclerosis of an extended vessel is necessary, the procedure is carried out in several sessions. After the sessions, the patient is registered with a phlebologist for three years for observation.
After administering the drug, the limb is subject to elastic bandaging, which is repeated for two weeks. During the first week, the bandage is not removed.
The patient must walk within half an hour from the procedure.
The patient should sleep with his limbs elevated every day and avoid sitting or standing for long periods of time, as well as walking a lot.
Radiofrequency ablation of veins
Vein ablation using a radiofrequency emitter is a recently emerging area of phlebology. This method allows you to get rid of varicose veins painlessly, without complications and with minimal risk of vessel injury. Radiofrequency radiation acts on the inner lining of the vascular wall and destroys it. Thus, the lumen of the vein collapses, and neighboring tissues are practically not affected. This is a very effective method.
The procedure is performed under local anesthesia on an outpatient basis. For accuracy during the procedure, control is carried out using duplex angioscanning.
After the anesthetics have taken effect, a vein puncture is performed. A catheter with an emitter is inserted into the vein. It advances to the point where the saphenous vein joins the deep vein system. With gradual removal of the catheter, sequential irradiation of the vessel occurs from the inside. After the procedure, the puncture site is treated and covered with a bandage. A special elastic stocking is put on the leg. After half an hour of walking 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.
Varicoseextensionveins: operation
The advisability of surgical intervention is considered by a phlebologist or vascular surgeon. For women who need surgery to correct a cosmetic defect, doctors suggest postponing surgery if they are planning a pregnancy. This is due to the fact that during pregnancy, varicose veins progress, and the effect of the operation may be neutralized.
Combined phlebectomy
The most common option for solving the problem of varicose veins using surgery is combined phlebectomy. The surgery is performed under general anesthesia 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 phlebextractor probe with a special tip is inserted into the vein through the incision. After this, the probe is removed along with the vein. Small veins are removed through small ducts, the so-called mini-phlebectomy. After surgery, you should use compression garments.
Endovasal electrocoagulation
Removal of saphenous veins using current. A more dangerous method compared to radiofrequency obliteration and classical surgery.
Cryosurgery
Removal of veins using exposure to low temperatures. The method is relatively safe. True, the depth of freezing is not always accurately calculated, which leads to damage to adjacent tissues or incomplete removal of the vein.
Intraoperative scleroobliteration
The use of catheter injection of a sclerosing agent into the saphenous veins. Before leg surgery, the saphenous veins and altered areas of the veins are marked. During the operation, the anastomosis of the great saphenous vein and femoral vein is exposed. The tributaries of the great saphenous vein are ligated. At a distance of 1 centimeter from the femoral vein, the saphenous vein is crossed and ligated. A catheter is inserted into the severed vein, the vein is sutured, and the wound is bandaged. A gauze roll is placed along the projection of the saphenous vein along the entire length of the leg and pressed. Simultaneously with pulling out the catheter, a sclerosing agent is injected.
Endoscopic dissection
Transillumination phlebectomy of perforating veins makes it possible to ligate and exclude the veins from the bloodstream. These veins connect the subcutaneous network of veins with the deep network. An endoscopic probe is used.
Laser coagulation
The vein is sealed from the inside with a laser and excluded from the bloodstream. Requires a highly qualified doctor and sufficient experience working with lasers.
Home treatment for varicose veins
At home, varicose veins can be treated with tablets, rubbing ointments, using leeches, apple cider vinegar and cabbage leaves. Home treatment can also be carried out by wearing compression garments or elastic bandaging. But if the disease is advanced, none of the methods will help without surgical treatment.
Today, the only high-quality way to get rid of varicose veins is surgical methods, as well as cases of combining surgery with sclerotherapy and compression methods.