Varicose veins (varicose veins).

10 August 2018

Varicose veins (varices) is one of the most widespread and ancient diseases of the cardiovascular system, which have opened since the times of ancient Egypt. With the help of the egyptian papyri and of the excavation, was found the mummy with signs of varicose veins. This disease affects and famous ancient doctors: Hippocrates, Galen, Avicenna, and later Troyanova, Trendelenburg. Ido still this disease has not lost its meaning and in modern medicine. The definition of "Varicose" comes from the Latin word "varix", which means "extension", for which the disease takes the name of "varicose veins". This disease is characterized by the extension and the increase of the length of the peripheral veins in the form of a serpentine tortuosity (deformations), as well as the violation of the outflow of blood for him, arising from the failure of the valve unit and of the weakening of their wall. The disease usually affects the veins of the lower limbs, as well as the main load of the outflow of the blood (large volume) falls on them, then preference is given to this topic. Varicose veins occur in about 17 - 25% of the population. At a young age, the disease occurs equally as well as boys and girls. At the ripe age of a woman getting 2 - 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 of evolution in the weakening of the valves, the pressure increase and loss of elasticity of the wall surface, and interconnection of the veins. Risk factors:

Genetic predisposition: the transmission of varicose veins, through inheritance, caused by mutation of the gene responsible for the structure of the vessel wall, due to his mutation, children are born with a congenital weakness of the connective or muscular tissue of the vessel wall, or due to lack of its valves (the lack of their number), and as a consequence occurs a weakness of the vessel wall and the increased pressure in the veins.
Hormonal changes (pregnancy, menopause): when the pregnancy changes the hormonal composition (increased levels of progesterone and estrogen) that influence the formation of blood clotting factors (increased them), a reduction of the tone of the venous wall (due to destruction of collagen and elastic fibers of the vessel wall) all of this leads to the formation of blood clots, occlusion of the blood vessels and their deformation.
Obesity : excess weight causes the sedentary style of life, in which occurs a slowing of the circulation, the more the excess fat increases the intra-abdominal pressure, which stops the flow of blood in the veins, causing the evolution stagnant in the veins and the possible development of the disease.
Diabetes mellitus :chronic high levels of sugar in the blood over time causes damage to the walls of the blood vessels, which is an optimal environment for the development of blood clots.
Alcohol abuse : excessive consumption of alcohol causes dehydration and a thickening of the blood, causing the formation of blood clots that block the veins and in breach of the outflow of blood.
Lifting weights (porters),a long walk for years, or courses of work (sellers, conductors): connected with a reduction of muscle tone, increased intra-abdominal pressure and as a result slowing down and obstruction of blood flow to the heart and to the development of its stagnation at the level of the lower limbs.
The defects of the coagulation of the blood: a congenital hypercoagulable (excessive production of factors is unlikely to blood) leads to the formation of blood clots and rupture of the promotion of blood through the vessels.
Poor nutrition: the lack of some vitamins in food (vit.C, E, P, plant fibers play a role in strengthening the vessel wall and improve blood circulation).
Wearing tight underwear: the continuous wearing leads to a mechanical compression of the veins, which causes the obstruction of the venous outflow of the lower limbs.
Chronic constipation : frequent increase of the intra-abdominal pressure (during stress) leads to the obstruction of outflow of blood in the lower limbs.
They often walk with the high heel: the lack of movement of the calf muscles and the development of stagnation.
Hot season: frequent thirst leading to dehydration occurs in the coagulation of blood and the formation of blood clots.
Comorbid cardiovascular or renal disease: is broken the outflow of venous blood (insufficiency of the heart valves, birth defects).
Overdose of medications that increase the clotting of the blood, the risk of blood clot formation, and vasoconstriction.
Surgical interventions:the loss of a certain amount of blood, not a comfortable position on the operating table (the compression of certain blood vessels), leading to a risk of blood clots.

Complications of varicose veins

The formation of blood clots, as a result of stagnation of blood in the veins;
the detachment of a blood clot and occlusion of the vessel coincides with its diameter;
thrombophlebitis (due to the formation of a blood clot in the lumen of the vein occurs the inflammation of the wall);
pulmonary embolism (detached of a blood clot to the current of blood enters the pulmonary artery, which takes part in the movement to a small circle. If the diameter of a blood clot coincides with a diameter of trunk of this artery, may occur sudden death. If a blood clot forms in less in diameter, and then passes into the branch of the pulmonary artery, causing a heart attack or lung oedema).
sores or eczema legs cause of eating disorders (interrupted circulation of the blood leads to a lack of oxygen in the tissue, which is the most important thing is the nutrition of the tissues of the body);
swelling of various parts of the body as a result of stagnation in the veins (they are soft, elastic, cyanotic color, their formation does not depend on the time of day, often formed in the area of the affected area);
dermatitis (inflammation of the skin in the affected area) due to eating disorders of this phase;
the change in color of the skin in the area of the affected area;
the estate of the subcutaneous adipose tissue in the area of the affected area due to swelling.

The diagnosis of varicose veins

The flagellum (functional) test (definition patency of the veins and their valves): Troyanova - Trendelenburg,Pratt, Shania, Delbe-Bonne, and others. One of the most common test Troyanova - Trendelenburg with which the sick person, while being in a horizontal position, lift the foot on 45 ⁰, the doctor is stroking from the foot to the top (with the resulting empty the superficial veins), then it makes the beam on the upper part of the thigh and asks the patient to stand, a filling rate of the veins of the calf should be for more than 15 seconds;
Duplex ultrasound of the veins (ultrasound angioscanning) the most informative method used to assess the flow of blood in a jar and see if the same vessel;
Dopplerhophy - method with which it is evaluated only the flow of the blood in this vessel;
Phlebography - injection of contrast medium intravenously for the study of x-ray paintings;
Phleboscintigraphy - intravenous radiopharmaceuticals and surveillance on a special device.

The treatment of varicose veins

Non-surgical treatment

The traditional methods of treatment (as an adjunct to medical treatment): wear compression stockings (socks); the particular physical exercises (swimming, cycling, skiing, the legs above the head of about 20 ⁰ with respect to the bed, a special gymnastics ("the bicycle" - lying on his back and breathing evenly, imagine that the pedal of a bicycle; alternately bend and straighten the foot at the ankle in a forward and backward) are used to improve the outflow of blood, but only in complicated cases); douche (jet of water to keep the foot, by gradually reducing the temperature of the water that reaches the cold); anklets bath (not hot) decoction of oak bark, horse chestnut, chamomile, st. john's wort; rubbing alcohol tincture of the flowers of acacia, the leaves of kalanchoe, apple cider vinegar; thrombophlebitis treatment of leech.
Mode day: morning, slow to get up from the bed (about 5-10 minutes), during sleep, place pieces of cushion under the heel to lift the legs approximately 15 to 20 ⁰ with respect to the bed, the foot must be good, it is not possible to keep the crossed foot for foot, wraps around the leg elastic of the indigenous with a bandage from the foot to the upper part of the thigh, wearing stockings health, balanced diet, to avoid tedious movements, and any substances or factors that contribute to a thickening of the blood, removal of smoke, prevention of constipation.
Diet : the body needs foods that contain vitamins strengthen the walls of blood vessels and improve blood circulation: vitamin c (contained with citruses, tomatoes, rose hip, etc), vitamin E (vegetables, liver, egg yolk, chives), vitamin P (grapefruit, walnut, black currant), bioflavonoids (dark cherry, and cherry), copper (seafood). Sufficient daily amount of liquid is not less than 1.5 litres. Limited to the use of alcoholic beverages, coffee, pickles, and cold meats.

The surgical treatment

Flebectomia:Indications for the removal of the veins: a wide varicose veins, subcutaneous veins pathological expanded, trophic disturbances of the skin that are not amenable to conservative treatment, thrombophlebitis, acute, varicose veins of the subcutaneous veins, accompanied by disorders of general condition (severe fatigue, swelling of the legs) of the patient. Contraindications to the removal of the veins: the coronary artery disease, heavy infectious processes, the advanced age of the patient, the pregnancy in 2 and 3 trimester of pregnancy, the inflammatory processes in feet (erysipelas, pyoderma, eczema). The advantages of surgical treatment: the only way to treat in advanced cases, the only way the radical correction of the venous valves deep. The disadvantages of surgical treatment: traumatic (aesthetic defect), requires anesthesia, you need a couple of days in a hospital under the supervision of a surgeon. Laser therapy (endovascular microtermocoagulation) :Indications: Combination of varicose veins with the following diseases: cardiovascular diseases (ischemic heart disease, arterial hypertension), peripheral vascular disease (phlebitis, thrombophlebitis), respiratory diseases (bronchial asthma, bronchitis, pleurisy), with diseases of the digestive tract (cholecystitis, gastric ulcer and duodenal ulcer), diseases of the nervous system (head trauma, cns), diseases of the genitourinary system (pyelonephritis, endometritis, salpingitis), with skin diseases (dermatitis, Neurodermatitis), peritonitis, furuncles. Contraindications: people suffering from oncological diseases, diseases of the liver, kidneys and the heart in the phase of decompensation of the brain, multiple sclerosis, pregnancy. Advantages: allows you to get rid of the bad vascular pattern, the procedure is quick (15-20min), does not require hospitalization, safe and painless, does not damage the vessel tissue and the surrounding tissue. Disadvantages: not always available method expensive method, if you delete by larger vessels possible thermal damage of tissue, is the formation of scars and depigmentation (lightening) of the skin in exposed locations. Radiofrequency coagulation (ablation) of varicose veins: Readings: varicose veins with the defeat of the trunk of the great and small saphenous vein, wounds due to varicose veins. Contraindications: severe thrombophlebitis of the subcutaneous veins, the inability active to walk, pregnancy, mental disorders. Advantages: without the cosmetic defect, painless, requires no hospitalization, does not violate the capacity to work. Disadvantages: the only disadvantage is the cost of the procedure. Sclerotherapy: Readings: small varicose veins, large varicose veins when you are using duplex dopplerography, varicose veins in the initial stages (if the damage is only to the superficial veins. Contraindications: pregnancy and lactation, allergy to the sclerosus of, deep vein thrombosis, pyo-inflammatory diseases feet. Advantages: lower cost compared to the operation, a period of rapid recovery, does not require the presence in the hospital can be a time to go home), the best cosmetic result. Disadvantages:the risk of entering into a deep vein of the sclerosus, decreases due to the mixture sclerosus of the blood, ineffective in advanced cases.