Varicose veins (varicose veins).

10 August 2018

Varicose veins (varicose veins) is one of the most common and oldest diseases of the cardiovascular system, which is open 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 still the disease has not lost its importance in modern medicine. Definition of "Varicose" comes from the Latin word "varix", which means "expansion", therefore, the disease is called "Varicose veins." This disease is characterized by the enlargement and increase of the length of the peripheral veins in the serpentine tortuosity (deformations), as well as the violation of the outflow of blood on them, the resulting valve at the club, and the weakening of their walls. The disease often affects the veins of the lower limbs, as well as the main cargo of the expiry of the blood (large volume) falls on them, therefore, preferred this section. Varicose veins occur in about 17 - 25% of the population. At a young age the disease occurs in respect of boys and girls. At the ripe age of women will be sick 2 - 3 times more often than men, due to hormonal changes in 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 is developing of the weakening of the valves, the pressure increase and loss of elasticity of the walls of the superficial and connecting veins. Risk factors:

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 a mutation, children are born with the innate weakness of the connective or muscular tissue of the vessel wall, or the lack of it, of the valve (a negative number), and as a consequence, it is not a weakness of the vessel wall and increased pressure in the veins.
Hormonal changes (pregnancy, menopause): pregnancy changes the hormonal makeup of the organism (increasing the level of progesterone and decrease of estrogen) that influence the formation of factors of the blood (increase them) to reduce the tone of the venous wall (as a result of the destruction of collagen and elastic fibers of the vessel wall) all this leads to the formation of blood clots, blockage of blood vessels and their deformation.
Obesity : excess weight leads to a sedentary way of life, which represents a slowdown in circulation, plus excess fat increases the intra-abdominal pressure, which violates the outflow of blood through the veins, resulting in the development of stagnation in the veins and the possible development of the disease.
Diabetes :chronic elevated levels of blood sugar over time damages blood vessels, which is a favourable environment for the development of the blood.
Alcohol abuse : excessive alcohol leads to dehydration and thickening of the blood, formed as a result of blood clots that veins and compromises flow of blood.
Weight lifting (movers),long walk or lengthy work (sellers, conductors): is connected with the decrease of muscle tone, increased intra-abdominal pressure, and as a consequence slowing down and obstruction of blood flow to the heart and the development of its stagnation in the lower limbs.
Congenital coagulation defects: congenital hypercoagulation (excessive production of blood factors in the blood) leads to the formation of blood clots and disruption of the blood through the vessels.
Poor nutrition: a lack of certain vitamins in the diet (Vit.C, E, R, plant fibers play a role in strengthening the vessel wall and improve blood circulation).
Wearing tight underwear: wearing it constantly leads to mechanical compression of the veins, causing obstruction of the venous outflow from the lower limbs.
Chronic constipation : frequent increase in abdominal pressure (during effort) leads to difficulty of outflow of blood from the lower limbs.
Frequent walking high heel: the lack of movement of the leg muscles and the development of stagnation.
Hot season: frequent thirst leads to dehydration of the body occurs blood clots and blood clots.
Concomitant diseases of the cardiovascular system or diseases of the kidneys: impaired outflow of venous blood (heart valve insufficiency, congenital defects).
Overdose of the drugs increasing blood coagulation: risk of blood clots and blockage of blood vessels.
Surgery the loss of some volume of blood is not a comfortable position of working table (the compression of certain blood vessels), which leads to the risk of a blood clot.

Complications of varicose veins

The formation of blood clots, as a result of stagnation of blood in the veins;
detachment of the thrombus and occlusion of the vessel coincides with its diameter;
thrombophlebitis (clot formation in the lumen of the vein is the inflammation of its walls);
pulmonary embolism (detached blood or blood gets into the pulmonary artery, which participates in blood circulation in a small circle. If the clot diameter coincides with the diameter of the trunk of this artery, it can cause sudden death. If the clot is smaller in diameter, which passes to the branches of the pulmonary artery, due to pulmonary infarction or edema).
wounds or eczema on legs cause eating disorders (poor blood circulation leads to lack of oxygen in the tissue, which is the main food of the tissues of the body);
swelling of the different parts of the body, as a result of stagnation in the veins (they are soft, elastic, in blue color, their education does not depend on the time of day, often form in the affected area);
dermatitis (inflammation of the skin in the affected area) due to malnutrition of the web site;
change the color of the skin in the affected area;
sealing subcutaneous fatty tissue in the affected area due to swelling.

The 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, lifts the leg of 45 ⁰, the doctor makes a stroking from the foot up (as a result, the superficial veins are emptied), then establishes a tourniquet on the upper thigh and asks the patient to stand normally, the filling of the veins of the lower leg need to occur more than 15 seconds;
Duplex ultrasound scan of the veins (ultrasound angioscanning) the most informative method for the assessment of blood flow in a blood vessel and to watch the usa;
Dopplerhophy - a method with which to assess the blood flow in a blood vessel;
Venography is the injection of a contrast agent intravenously and the study of the x-ray image;
Phleboscintigraphy - intravenous administration of the radiopharmaceutical and the observation of the special device.

The treatment of varicose veins

Non-surgical treatment

The traditional methods of treatment (as a supplement to medical treatment): the wearing of compression hosiery (socks); special exercises (swimming, bike, skis, feet over head about 20 ⁰ towards the bed, special exercises ("Bike" lie on your back and breathing, imagine that you pedal a Bicycle; alternately bend and unbend the foot of the ankle joint forward and backward) are used to enhance the outflow of blood, but only in complicated cases); contrasting shower (under running water to keep the feet gradually reducing the temperature of the water reaching the cold); a foot bath (not a hot) decoction of oak bark, chestnut, chamomile, st. john's wort; rubbing alcohol tincture from the flowers of acacia, the leaves of Kalanchoe, apple cider vinegar; thrombophlebitis treatment with leeches.
Of the day: in the morning, slowly getting up from the bed (about 5-10 minutes), during sleep put a pillow under the heel, so as to lift the foot about 15-20 ⁰ in terms of bed, the walk must be calm, you may not be able to sit crossed leg on the leg, bandaging the legs with elastic bandages from the foot to the upper part of the thigh, wearing of the medical stockings, a good diet, to avoid any annoying movements and any substances or factors that contribute to thickening of the blood, with the exception of Smoking, the prevention of constipation.
Diet : the body needs foods that contain vitamins, strengthen blood vessels and improves the flow of blood: vitamin C (contained with the citruses, tomatoes, rose hips, etc.), vitamin E (legumes, liver, egg yolk, green onions), vitamin R (grapefruit, walnut, black currant), bioflavonoids (dark sweet cherry, sour cherry), copper (seafood). Enough daily amount of fluid at least 1.5 liters. Limited to the use of alcoholic drinks, coffee, marinades, smoked products.

Surgical treatment

Phlebectomy:Indications for removal veins: big veins, saphenous vein pathologically expanded, trophic disorders of the skin, which are not amenable to conservative treatment, acute thrombophlebitis, varicose saphenous veins is followed by disturbance of the General condition (severe tiredness, swelling of the legs) of the patient. Contraindications for removal veins: coronary heart disease, a serious infectious processes, the older age of the patient, pregnancy in 2nd and 3rd trimesters, inflammation of the legs (erysipelas, pyoderma, eczema). The advantages of the surgical treatment: the only treatment in severe cases, the only radical method of correction of the valves of the deep veins. The disadvantages of surgical treatment: traumatic (cosmetic defect), requires anesthesia, you need several days in hospital under the supervision of the surgeon. Laser therapy (endovascular microtermocoagulation) :Indications: a Combination of varicose veins with the following diseases: diseases of the cardiovascular system (heart disease, high blood pressure), peripheral vascular disease (phlebitis, thrombophlebitis), respiratory diseases (asthma, bronchitis, pleurisy), with diseases of the digestive system (cholecystitis, peptic ulcer and duodenal ulcer), diseases of the nervous system (craniocerebral traumas, neuroinfections), diseases of the genitourinary system (pyelonephritis, endometritis, salpingitis), with diseases of the skin (dermatitis, Neurodermatitis), peritonitis, boils. Contraindications: people who suffer from oncological diseases, diseases of the liver, kidneys and the heart in the stage of decompensation, cerebral sclerosis, pregnancy. Advantages: eliminates the unpleasant vascular pattern, a rapid procedure (15-20 minutes), requires no hospitalization, safe and painless, does not harm the vessel tissue and the surrounding tissue. Disadvantages: not available everywhere method expensive method, the removal of the larger vessels possible thermal damage of tissue, is possible the 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 the large and small saphenous veins, trophic ulcers as a result 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 veins when using the duplex dopplerography, varicose veins in the early stages (if the damage is only superficial veins. Contraindications: pregnancy and breast-feeding, allergic to sclerosus, deep vein thrombosis, purulent-inflammatory diseases of the feet. Advantages: lower cost in comparison with surgery, a quick period of recovery, and does not require a stay in the hospital (to go home), the best cosmetic result. Disadvantages:possible uptake in the deep vein sclerosus, decreased efficiency due to the mixing sclerosus with blood, are ineffective in advanced cases.