Help with varicose veins in the legs

Healthy legs and leg varicose veins

Varicose veins of the lower extremities are naturally considered to be the most common pathology of peripheral blood vessels, and it is one of the so-called ten civilization diseases. According to epidemiological studies, 80% of people of working age will have venous insufficiency. In most cases, varicose veins in the legs do not cause serious pain, and sometimes they are even ignored and do not require any treatment. However, in some cases, there is no need to delay consulting an expert, and it is worthwhile to receive appropriate treatment. What are the treatments for varicose veins of the lower extremities? What are their advantages and disadvantages?

Ways to get rid of the disease

Every year thousands of people ask themselves a question: How to get rid of the "ugly knot" or "vascular network" on the legs? Media portals are flooded with advertisements for public and private clinics that treat varicose veins of the lower extremities. They provide "unique", "guaranteed", "painless" or "completely safe" methods to get rid of this disease. Sometimes it is difficult to understand this advertisement and answer the question of which treatment plan is most suitable. If a person decides to deal with his dilated blood vessels, but he is not sure about the safety or effectiveness of this or another treatment, the best option for him is to contact several clinics and obtain from at least two professionalsQualified advice.

There are several reasons that force patients with varicose veins to consult a doctor:

  • Beauty considerations;
  • Symptoms of discomfort;
  • Complications of the disease (for example, ulcers, bleeding or thrombophlebitis);
  • Worry about your health (how will the disease behave in the future if it is not treated).

Sometimes it is difficult for doctors to know what the patient wants. Therefore, in the consultation process, it is important to find mutual understanding with the doctor and correctly convey the main reason for contacting him. Many times, patients only need to ensure that their enlarged veins will not harm them in any way, and it is unlikely to do so in the future.

If treatment is needed, doctors usually recommend self-treatment at home within 6 months, which includes:

  • Use compression stockings;
  • Exercise regularly
  • Avoid "long downtime"-exclude sitting or standing for a long time;
  • When resting (horizontal position), raise the "damaged" limb above the level of the heart.

If after the second consultation, the patient is not satisfied with the results, the doctor may recommend conservative or surgical treatment for varicose veins of the lower extremities.

Treatment options for lower extremity pathology

To combat varicose veins in the legs, conservative treatments (compression and medication, lifestyle changes), surgical intervention, external and internal laser irradiation, radiofrequency ablation, and injection sclerotherapy are used. The choice of this or that option depends on the patient's preference. It is also affected by the financial capacity of the patient, the qualifications of the doctor, and the equipment of the medical institution. However, which method of treating varicose veins of the lower extremities is used in each specific case depends to a large extent on the disease itself: what symptoms are present, the degree of venous insufficiency, and other characteristics of vascular disease.

Conservative treatment

Conservative treatment is usually complex and includes several components.

Lifestyle changes, which means a series of measures aimed at preventing venous blood stagnation. As you know, standing or sitting for a long time will increase the activity level of the venous muscle pump (gastrocnemius), which can cause stagnation. Therefore, it is recommended that patients walk regularly and raise their legs in a prone position to above the level of the heart. You should also pay attention to a variety of diets-salt-free, low-calorie. They will allow you to adjust your weight and make up for seasonal vitamin deficiencies. It is necessary to eat foods rich in bioflavonoids (substances that help strengthen blood vessel walls).

Patients with varicose veins should avoid overheating their feet, do not go to bathrooms and saunas, and if possible, do not use heated floors.

Compression stockings improve venous hemodynamics, leading to the disappearance of many manifestations of the disease. Disadvantages of this method:

  • The use time is limited (it is impossible to wear elastic stockings and socks all the time);
  • Discomfort due to continuous compression is especially common in summer, when the symptoms of varicose veins are most "shown".

Usually, the pharmacy only provides compression stockings from one manufacturer. However, there are many different brands, each of which can meet the needs of patients to varying degrees.

Drug therapy can eliminate the symptoms of the disease or reduce its manifestations, aiming to prevent and combat its complications, and can improve the effectiveness of compression therapy. Pharmacology helps cope with side effects after sclerotherapy or phlebectomy.

The modern treatment of varicose veins in the lower extremities is incomplete without the use of drugs that can improve symptoms and strengthen the vein walls (vein protectors). They are considered to be basic medical treatments. These include:

  • Horse chestnut extract and thiamine (vitamin B1) are part of the medicine used to treat leg pain and heaviness, and edema observed in chronic venous insufficiency. These funds have shown effectiveness in clinical trials. There are dosage forms: oral solution (10-15 drops, 3 times a day) and tablet form (usually taken after meals, 3 times a day, 1 tablet each time).
  • Butcher's broom is used as a food additive. Helps relieve venous congestion. It is believed to be effective on spider veins. However, clinical data confirming its safety and effectiveness have not yet been conducted.
  • Calf blood deproteinized blood derivative is a popular drug, an excellent vein protectant, and has a good therapeutic effect on varicose veins of the lower extremities.

Usually, Venom is prescribed in the curriculum. The duration of treatment depends on the dynamics of symptom improvement and the duration of remission. Therefore, doctors can vary the intake of drugs from 3 months to 6 months or longer.

Ointments and gels (topical medicines) are also widely used. The treatment plan for varicose veins of the lower extremities is selected by the doctor according to the condition and course of the disease. The therapeutic effects of these topical drugs are achieved through two mechanisms: distraction and actual treatment. First, the alcohol base or essential oil contained in the gel evaporates, which respectively causes a decrease in skin temperature and improves disease symptoms. As a second result, the drug that penetrates directly into the vein through the skin begins to exert its therapeutic effect.

Ointments and gels used for leg varicose veins are classified according to the main active ingredients they contain. They include such medicinal substances:

  • Phleboprotectors (usually rutin, and plant substances that strengthen the walls of blood vessels).
  • Non-steroidal anti-inflammatory drugs are commonly used to relieve pain.
  • Topical corticosteroids are used for allergic dermatitis, which may be a complication of venous insufficiency.
  • When corticosteroids are contraindicated, H1-histamine receptor blockers are prescribed instead of corticosteroids.
  • Proteolytic enzymes can effectively clean trophic ulcers (complications of varicose veins on the legs).
  • Ionized silver is an effective antiseptic, it can perfectly clean and dry wounds, so it is an indispensable medicine for the treatment of infected trophic ulcers.
  • Antibiotics are used locally to infect complications of varicose veins (thrombophlebitis, dermatitis).
  • Moisturizing agents and skin protectants can protect the skin from external influences and improve its elasticity. They are usually used for atrophic skin changes (when using compression stockings for a long time).
  • In addition to its antithrombotic activity (preventing thrombosis), heparin also has anti-inflammatory effects and can relieve pain.

Surgery

The main goal of surgical treatment is to eliminate the pathological mechanism that causes the disease-venous reflex, and eliminate its main manifestation-varicose veins. Surgical treatment: suitable for patients with leg pain and persistent fatigue, with edema, chronic venous insufficiency, cosmetic problems, early hyperpigmentation (hyperpigmentation of the skin), external bleeding, and progression of superficial thrombophlebitis. Nutritional ulcers that cannot be treated conservatively.

Currently, the most popular are three types of operations:

  • Great saphenous vein ligation (ligation and removal of the upper part of the great saphenous vein);
  • Great saphenous vein stripes:
    • Traditional or Bebkokk surgery, in which a special probe is inserted into the cavity of the great saphenous vein (two incisions are initially made: one in the groin area and the second in the upper third of the leg) and extend the entire length along it, and then connect with the veinRemove the varicose together;
    • Freeze peeling, an operation almost similar to the previous one, but the difference is that the probe is cooled to -85°C, so the vein adheres to the probe, which can be removed without trauma;
  • Phlebectomy is a procedure to remove varicose veins through several small 2-3 mm incisions in the skin.

The above-mentioned surgical intervention helps to improve the quality of life of patients; its treatment and economic efficiency have been confirmed in clinical trials. They are usually performed under general anesthesia, but most patients are discharged on the day of surgery. It usually takes 2 to 3 weeks to fully recover and return to normal daily activities. Complications are possible, which are more common in patients with advanced varicose veins. During the operation, the nerves located in the subcutaneous tissue will be damaged. Therefore, after the operation, temporary or permanent numbness in some parts of the leg may sometimes be observed, but this will not cause serious disability.

New therapy

The main goal of using the new treatment method is to minimize the tissue trauma observed during the surgical intervention, so that the patient recovers more quickly. They began to be widely used in the early 2000s.

Vein ablation (radio frequency and laser)

Radiofrequency and laser ablation are methods for treating varicose veins in the legs. The great saphenous vein (or small saphenous vein) is "sealed" by high temperature, causing the dilated blood vessels to recede (their walls stick together). Although these options do not involve surgery, resorting to additional phlebectomy and sclerotherapy is common. Both methods involve:

  • The catheter was inserted into the great saphenous vein through a small incision in the upper third of the leg and advanced to the junction of the saphenous femur under ultrasound guidance. There is no incision in the groin area.
  • Performed under local anesthesia (the anesthetic penetrates extensively into the subcutaneous tissue of the thigh). If a large number of microvascular resections are to be performed at the same time, additional general anesthesia may be required.
  • Bandages or stockings are required two weeks after the operation.
  • Their results are positive for the dependence of the patient's saphenous vein anatomy in the presence of a straight line and suspicious when the blood vessel is curved.

The use of vein ablation, which has been widely used in the past decade, has not shown a significant difference in effectiveness compared to surgery.

The main advantage of this technique is quick recovery after surgery, which is related to the less possibility of wound infection and hematoma.

However, the typical complications of this procedure are: skin burns, temporary paresthesias, and deep vein thrombosis (occurring in less than 1% of patients).

Simple sclerotherapy

This treatment method is currently used by many clinics due to its ease of implementation and low trauma. The essence is to inject sclerosing agent into varicose veins. This substance will stick to the vein wall and blood will flow into healthy blood vessels. Sclerotherapy is usually combined with classic surgery, and it is used as the only treatment in the case of telangiectasia and spider veins.

Contraindications:

  • pregnant,
  • Lactation period,
  • dermatitis,
  • Thrombophlebitis.

Sclerotherapy gives quite acceptable results that satisfy many patients.

Foam sclerotherapy

Unlike simple sclerotherapy, foam is used, and the sclerosing agent is mixed with gas (usually air) and injected into the vein. As a result, foam is obtained, which diffuses through the vein, drains blood from the vein and causes vasospasm. The operation is usually performed under the guidance of duplex ultrasound scanning.

Just like simple foam sclerotherapy, compression stockings need to be worn for 14 days after the operation.

Recovery after surgery is faster than performing classic surgery. However, the mid-term therapeutic effect of foam sclerotherapy (the possibility of recurrence of reflux) is worse than surgery.

Varicose Vein Foam Sclerotherapy

Treatment of "Varicose Veins": telangiectasia, spider veins

The treatment of spider veins is almost always done for cosmetic reasons, although sometimes they can cause burning and throbbing sensations, indicating the presence of reflux. Two types of treatments are commonly used:

  • Micro sclerotherapy-the use of fine needles to introduce sclerosing substances. Often multiple spider veins harden at the same time. Use compression bandages or stockings for 1 to 2 days. If it hardens beyond the blood vessel during the injection, ulcers may appear in the area, which will heal slowly, and then leave scars. This happens rarely, provided that "if the doctor's hands do not tremble during the operation". Hyperpigmentation (darkening of the skin) at the injection site is also possible.
  • Laser ablation. This method is suitable for the treatment of telangiectasia (the growth of blood vessels in the skin that looks like a birthmark).

There are many effective ways to get rid of varicose veins of the lower limbs provided by traditional medicine. The choice of treatment plan depends to a large extent on the patient's own decision. Don't "use the knife" immediately, there are effective options for conservative treatment in the doctor's arsenal. According to doctors, it is impossible to completely cure this disease today, but modern medicine can completely rescue patients from the manifestations of the disease and prevent its further development.