Varicose veins (varicose veins)

Varicose veins are a disease that leads to varicose veins, thinning of its walls, formation of venous nodules and disruption of blood flow in them.

With varicose veins in the lower part of the legs - varicose veins of the legs - the saphenous veins on the legs thicken, become clearly visible, winding, acquiring a blue or dark purple color, and forming convex knots. Varicose veins can also affect other organs where similar changes occur.

There are several types of varicose veins:

  • Superficial varicose veins, in which veins close to the surface of the skin become thick and nodular. As a rule, they are clearly visible, they are quite long, winding and cause significant cosmetic discomfort.
  • Reticular varicose veins are small veins that form a thin blue tissue under the skin.
  • Telangiectasia - "star" or "spider" on the skin, which often appears on the face and décolleté, as well as on the legs. They are harmless and, unlike superficial veins, do not stand out above the surface of the skin.
Scheme of varicose vein development

Varicose veins are a common condition that affects about three out of ten adults. Women are more susceptible to disease than men.

Varicose veins can form in any part of the body, but most often they develop in the veins in the legs and feet, especially in the ankles, because a lot of pressure is placed on the lower part of the body when standing and walking.

For most people, varicose veins do not pose a major threat to health, only have cosmetic defects and do not require treatment. If varicose veins cause you pain, discomfort, or increase the risk of complications, they need to be treated.

Unfortunately, free surgical treatment for varicose veins is not always available (this depends on the provincial health insurance program), so you may have to pay for the treatment yourself.

If you need treatment, you may need to print out a description of the treatment for varicose veins and discuss it with your doctor.

Prevention of varicose veins

So far, there is no evidence that varicose veins can be prevented with certainty. However, there are ways to slow the progression of the disease, for example:

  • do not stand or sit for too long, try to move every half hour;
  • rest during the day, lifting the legs on a pillow, this helps relieve discomfort;
  • exercising regularly can improve blood circulation and help maintain a healthy weight.

Symptoms of varicose veins

As a rule, varicose veins are dark purple or blue in color, they twist or protrude from the surface of the skin.The appearance of varicose veinsIn addition to the special features, the symptoms of varicose veins include:

  • pain, heaviness and discomfort in the legs;
  • swelling of the feet and ankles;
  • burning or throbbing in the legs;
  • muscle spasms in the legs, especially at night;
  • dryness, itching, and thinning of the skin over the affected veins.

These symptoms tend to get worse in hot weather or if you have been standing for a long time. You may feel better if you walk or sit with your legs raised higher. Comfortably place your feet on the pillow.

Varicose veins usually form in the legs, either on the back of the ankles or on the inside of the legs. But varicose veins can develop in other parts of your body, for example:

  • in the esophagus;
  • uterus;
  • vagina;
  • pelvic area;
  • rectum (anus).

If you are worried about the appearance of your veins, call a vascular surgeon or, if there is no way to contact a specialist, a general practitioner.

Causes of varicose veins

The most common causes of varicose veins are thinning of the venous wall and weakness of the valves.

Inside the vein there is a small valve that opens to one side to allow blood to enter and then closes again to prevent blood from flowing in the opposite direction. Sometimes the vein wall can stretch and lose its elasticity, which causes valve weakness. If the valve is not working properly, it can cause blood to flow or flow in the opposite direction. In this case, blood will stagnate in the veins, which will cause their swelling and stretching.

It is still unclear what causes venous wall stretching and valve weakness. Some people develop varicose veins for no apparent reason.

Calf muscles - deep vein pumps

However, there are several factors that can increase the risk of varicose veins:

  1. The floor. Women are more susceptible to disease than men. The results of research show that hormones produced by a woman’s body tend to weaken the walls of the veins, which allows the valves to leak blood.
  2. Genetics. The risk of developing varicose veins increases if your closest relatives have the disease. This suggests that part of your varicose veins may be caused by your genes (a unit of genetic material that you inherited from your parents).
  3. With age, the veins begin to lose their elasticity, and the valves in them also do not work.
  4. Being overweight puts extra pressure on the veins, which means they have to work harder to get blood back to the heart. This puts more pressure on the valve, which can cause it to stretch. The influence of excess weight on the development of varicose veins increases in women.
  5. Standing work. Several studies show that long work can increase the risk of varicose veins. This is because people who are standing have increased pressure on the leg veins.
  6. During pregnancy, blood volume increases to help the fetus grow. This adds pressure to the veins. Increased hormone levels during pregnancy also cause relaxation of the muscle walls of blood vessels, which increases the risk of varicose veins. An additional risk factor for varicose veins is the uterus, which grows in size during pregnancy and compresses the blood vessels in the pelvic area. Although pregnancy increases the risk of developing varicose veins, most women find that their veins improve after giving birth.

In rare cases, varicose veins can be caused by other medical conditions, including:

  • previously formed blood clots;
  • swelling or swelling in the pelvic area;
  • blood vessel pathology.

Diagnosis of varicose veins

If you suffer from varicose veins, but this does not give you any difficulty, you do not need to see a doctor. Varicose veins are rarely serious and usually do not require treatment.

However, you should see a doctor if:

  • Varicose veins cause pain or discomfort.
  • The skin over your veins is sore or irritated.
  • Leg pain at night is annoying and disturbs sleep.

Varicose veins are diagnosed by their appearance. The doctor will examine your legs while you are standing. You may also be asked if you are in pain and if there are situations where your varicose veins are getting worse. For example, a number of women report that their menstrual cycle (period) affects the condition of their varicose veins.

To find out how dangerous varicose veins are for you, your doctor should know:

  • do you have a close relative with varicose veins;
  • is there a pregnancy;
  • what is your body mass index (BMI);
  • Have you ever had deep vein thrombosis (a blood clot in one of the veins in your body)?
  • is there an injury to the leg (such as a fracture).

Additional examination for varicose veins

If the doctor decides that you need additional tests, you will be referred to a vascular surgeon who will handle the diagnosis and further treatment.

In most cases, duplex ultrasound of the blood vessels is prescribed. This type of scan is done using high -frequency sound waves that produce a picture of the veins in your legs. The picture shows blood flow and helps the vascular surgeon identify damaged valves that may be causing the veins to dilate.

Varicose Veins Treatment

Treatment of varicose veins is usually required in the following cases:

  • to relieve symptoms if the disease causes pain and discomfort;
  • to treat complications such as foot ulcers, edema, or changes in skin pigmentation;
  • for aesthetic reasons, however, this is rarely covered by insurance, so most likely you will have to pay for the treatment yourself.

Treatment depends on your general health and the size, position, and severity of your varicose veins. A vascular surgeon will recommend the most appropriate treatment for you.

In some cases, varicose veins can be treated at home. There are simple methods to relieve symptoms. To do this, you need:

  • exercise;
  • do not last long;
  • rest, giving the legs a high position.

Endothermic ablation for varicose veins

Endothermic ablation is usually the first treatment you will be offered. This procedure uses high frequency radio waves (radio frequency ablation) or lasers (intravenous laser therapy) to block the affected veins. This operation is described in more detail below.

Radio frequency ablationconsists in heating the walls of the veins using radio frequency energy. The vein is accessed through a small incision above or below the knee. Under ultrasound guidance, a narrow tube called a catheter is delivered to the vein. The probe is inserted into the catheter and releases radio frequency energy. He heated the vein until its wall collapsed, closing and blocking its lumen. Once a vein is clogged, your blood will naturally be diverted to one of your healthy veins.

Radio frequency ablation was performed under local anesthetic. This procedure can cause short -term side effects, such as a tingling sensation (paresthesia). After the procedure, you may need to wear compression stockings for a maximum of one week.

Intravenous laser therapy.Like radio frequency ablation, with intravenous laser therapy, a catheter is inserted into your vein and monitored by ultrasound. A small laser is inserted through a catheter and placed at the beginning of the varicose vein. The laser emits a short burst of energy that heats the vein, causing it to clog. The laser is slowly pulled along the vein, controlling its movement using ultrasound, until the affected vein is closed throughout.

Intravenous laser therapy is performed under a local anesthetic. After the procedure, you may feel a tightening sensation in your feet, and the affected area may be bruised and sore. Nerve damage may also occur, but this is usually temporary.

Sclerotherapy for the treatment of varicose veins

If endothermic ablation is not an option for you, chances are you will be offered sclerotherapy. The procedure consists of injecting a special foam into a vein. The foam causes scars that clog the vessel. This treatment may not be suitable for you if you have ever had deep vein thrombosis.

The foam is injected into a vein using ultrasound -guided injection. Several veins can be treated in one session. Sclerotherapy is usually done with a local anesthetic, which means you will be given a painkiller to freeze the area to be treated.

After sclerotherapy, the manifestations of varicose veins will disappear in a few weeks, when the healthier veins will take over the damaged work, which are no longer filled with blood. You may need several sessions of sclerotherapy to make the veins pale, and there is a possibility that the varicose veins will reappear.

Although sclerotherapy has been shown to be effective, the long -term effectiveness of foam therapy is unknown. According to the British National Institute of Health and Wellness, this type of treatment is effective in 84 cases out of 100. However, according to the results of another study, in more than half of the cases, varicose veins reappear after treatment.

Sclerotherapy can also cause the following side effects:

  • blood clots in other veins in the legs;
  • Headache;
  • backache;
  • discoloration of the skin, such as brown spots on the veins where the procedure was performed;
  • faint;
  • temporary vision problems.

After the procedure, you will be able to walk and be able to go home immediately. You may need to wear compression stockings for a maximum of one week.

In rare cases, sclerotherapy can cause potentially serious complications such as stroke or transient ischemic attack (TIA).

Surgery for varicose veins: phlebectomy

If endothermic ablation and sclerotherapy are not right for you, chances are you will undergo a surgery called a phlebectomy to remove any affected veins. Varicose vein surgery is usually performed under general anesthesia, which means you will be unconscious during the surgery. Most likely you will be able to go home the same day. However, in some cases it may be necessary to stay in the hospital overnight, especially if surgery is performed on both legs.

A large number of surgeons use an operation called ligation, which involves the ligation of a vein in the affected leg. Two incisions were made with a diameter of about 5 cm. The first incision is made in your groin area, at the beginning of the varicose veins. A second incision is made below, usually in the knee or ankle area. The upper end of the vein (in the groin area) is tied and closed. A thin flexible wire is pulled through the lower end of the vein, which is then pulled slowly through the lower incision in your leg.

With this operation, the blood circulation in the legs is not disturbed, because the veins located far away in the legs will take over the distant work. Such surgery can cause pain, bruising, and bleeding. More serious complications are rare but may include nerve damage or deep vein thrombosis.

Recovery from surgery takes one to three weeks before you can return to work, but this depends on your general health and the nature of your job. You may need to wear compression stockings for a maximum of one week.

Transilumination phlebectomy.During a transillumination phlebectomy, one or two incisions are made in your leg. The surgeon will place a special light bulb called an endoscopic transilluminator under the skin to see which veins need to be removed. Before removal, the affected vein is cut and then removed with a special aspirator through an incision in the skin.

Transilumination phlebectomy can be performed under local or general anesthesia. You may experience bruising or bleeding after the procedure.

This is a relatively new method of treatment, therefore, there are some doubts about its effectiveness, and therefore, transillumination phlebectomy has not been widespread.

Compression stockings for varicose veins

Compression stockings for the treatment of varicose veins on the lower legs

Compression stockings have been specially designed to compress the foot evenly to increase circulation. Pressure often increases especially in the ankle area and decreases higher in the foot. This stimulates blood flow to the heart.

Compression stockings can help you relieve the pain, discomfort, and swelling of the legs caused by varicose veins. However, it is not known whether stockings help stop the development of existing varicose veins or whether they prevent new varicose veins from appearing.

Wearing compression stockings as a long -term treatment for varicose veins is only recommended if none of the above treatment methods are suitable for you. If you are pregnant and suffer from varicose veins, you may be advised to wear compression stockings during pregnancy instead of the above treatment.

Compression stockings vary in size and pressure. A large number of people with varicose veins will be given class 1 (light pressure) or class 2 (moderate pressure) stockings. Stockings are also available:

  • Multicolored;
  • the lengths vary: some reach to the knees, and some cover the thighs;
  • with different foot shapes: some cover the foot completely, while others reach the foot.

Compression stockings can be purchased over the counter or directly from the manufacturer.

If you suffer from a lack of deep veins, you may need to wear compression stockings for the rest of your life. Lack of deep veins means you have a valve problem or the deep veins in your legs are clogged. In this case, you will need to wear stockings, even if you have undergone surgery to remove part of your varicose veins.

You should wear compression stockings in the morning, as soon as you wake up and take them off before bed. They are uncomfortable, especially in hot weather, but it is very important to wear them properly in order to get the best results.

Pull them up until the pressure is distributed to the rest of the leg properly. Don’t let the socks slip, otherwise they can bulge into your skin, gather with a tight roller around your feet. See your doctor if stockings are uncomfortable or if they don’t fit you. You may be able to make custom -made socks. To do this, the feet will be measured in several places to make sure the socks fit properly. If your feet are often swollen, your measurements should be done in the morning when the swelling is minimal.

If compression stockings dry out your skin, apply a moisturizer (emollient) on the feet before bed. You should also look for cuts, abrasions, or discoloration of the skin.

As a general rule, new socks should be purchased every three to six months. It is best to buy two pairs of socks so you can wear them, while the rest is washed and dried. Socks should be washed by hand in warm water and dried from direct heat.

Complications of varicose veins

Varicose veins can cause complications because they interfere with normal blood flow. This is rare, usually a few years after the first varicose veins appear under the skin.

Bleeding.Varicose veins that are close to the surface of your skin can sometimes bleed if you cut or hit your leg. The bleeding is hard to stop. You have to lie down, lift your legs and press on the wound. See a doctor immediately if the bleeding has not stopped.

Varicose veins and deep vein thrombosis

Thrombophlebitis- This is an inflammation of the veins caused by the formation of blood clots in them. Blood clots can cause pain, redness, and a rise in skin temperature over damaged veins.

If thrombophlebitis develops in one of the superficial veins of your leg, it is called superficial thrombophlebitis. Like varicose veins, thrombophlebitis can be treated with compression stockings. In some cases, non-steroidal anti-inflammatory drugs may be prescribed. Deep vein thrombosis is more severe and requires immediate medical treatment.

Chronic venous insufficiency.Because the blood flow in the tissues is not correct, the metabolism is disrupted. If metabolic processes are disrupted for a long time, this is called chronic venous insufficiency. Chronic venous insufficiency can sometimes lead to the development of other diseases, including:

  • Varicose eczema is a condition that causes redness of the skin, flaking, blistering and flaking. In many cases, the disease is irreversible.
  • Lipodermatosclerosis causes hardening and thickening of the skin, which can also turn red or brown. Usually the disease attacks the ankle area.
  • Varicose ulcers form when pressure increases in the veins of the lower leg. This causes fluid to leak from the veins and accumulate under the skin. This fluid can cause skin hardening, swelling, and eventually skin damage and ulceration. Often, varicose ulcers form in the ankle area.

If you notice unusual skin changes, as described above, you must see a doctor immediately. This condition tends to respond well to treatment, but it is very important to seek medical attention early.

Which doctor should I call for varicose veins?

You should contact a vascular surgeon or a phlebologist (a more specialized doctor) who can give you competent advice on the treatment of varicose veins.