The varicose disease is an extension of the veins saphenous with a diameter of more than 3 mm varicose veins develops due to a malfunction of the venous valves and of the weakness of the venous wall; this produces a deceleration of the blood flow of the lower extremities, increasing the pressure in the interior of the vein, which can lead to chronic venous insufficiency.
Sometimes, telangiectasia and reticular vienna the mistake of taking for esophageal varices-advanced.
It is the vein of a diameter of 3 mm or less, do not affect the venous reflux, however, elicit a clear cosmetic defect.
What is the prevalence of varicose veins?
Varicose veins subcutaneous is present in 30 % of women and 15% of middle-aged men. The prevalence of varicose veins of the lower limbs increases markedly with age and is present in most people over the age of 60 years. The proportion of patients with trophic disorders in the adult age is of only 1.8%, while in the old-age percentage reaches 20%. By doing so, one of every five patients in life you are faced with thrombophlebitis. Among the causes that lead to the loss of ability to work, the proportion disabling forms of diseases of the veins more than the arteries.
The main risk factors for the development of varicose veins are:
- the elderly
- the female sex
- hormonal disorders
- positive family history of
For more risk factors:
- the hipertensin arterial
The literature data on risk factors are conflicting. At the same time the risk of developing the disease is low.
As can be seen varicose veins?
The most frequent manifestation protrusion above the uneven surface of the skin varicose veins. In some cases may be barely noticeable or only determined by the touch, and in others they accept winding way with the education of the nodes or in appearance reminiscent of the biggest grape in the bunch.
Often the varicose disease accompanied by the following symptoms:
- a feeling of heaviness and tension in the legs
- the pain, by pulling and/or whining of the nature along the veins
- rapid fatigue of the legs
- the itching of the skin of pimples
Rarely, varicose disease can cause the syndrome of restless legs and night cramps in the legs.
What are the risks of progression of varicose veins?
Without treatment, the progression of the varicose veins can lead to chronic venous insufficiency (CVI). The presence of CVI shows serious violations of limfo venous return (clinical class c3-c6 of the classification CEAP), which include: chronic swelling (lymphedema), the change of color of the skin (hyperpigmentation), venous eczema, the skin seal, trophic venous ulcers.
What are the complications of varicose veins?
Thrombophlebitis – the formation of a blood clot in the venous system superficial is the event with which they face the 20% of patients with esophageal varices-advanced of the veins. Such thrombosis accompanied by intense sensations of pain, redness of the skin, the seal of the motion of the vein in the leg and/or hip. In the absence of treatment it is possible the dissemination of thrombotic masses in the deep venous system.
Deep vein thrombosis (dvt) – in most cases, the start of a process asymptomatic. When the distribution of the thrombosis in the femoral segment and the vein in the pelvis is broken, the primary reflux of the blood from the lower extremities, which is accompanied by a marked edema and pain tolerance of the syndrome and is considered as sustenance in a risk situation.
Thromboembolism pulmonary artery (pd) - 10% of cases, thrombotic mass in the deep veins of the lower limbs are split and the current of the blood migrate to the pulmonary arteries being the cause of the deaths.
What is needed for a correct diagnosis?
Taking into account the diversity of forms of diseases of the veins, for the approach of a correct diagnosis is important every detail of the history of the development of the disease and the life of the patient, the presence of comorbidities, the operations, the results of the medical examination and what is more important, duplex ultrasound scan of the veins. Finally, today, it is the most informative, accurate and non-invasive and the method of study of the veins of the lower extremities.
Varicose veins treatment, the most common forms:
- Pharmacological treatment – veno-tonic drug have demonstrated its efficacy in the reduction of the symptoms of the varicose disease is, however, not possible to remove varicose veins. The pharmacotherapy applied with success for the prevention of complications in high-risk groups post-training and post-operative rehabilitation.
- Compression treatment - ing a special health of the knitted fabric in the form of golf, socks, stockings. In some cases, several coats are applied bands elastic bandages different elasticity and the hardware of pneumo compression ratio. The compression function of treatment is difficult to overstate, which is present in almost all phases of prevention and treatment of chronic diseases of the veins.
- Introduction into the lumen of the vein, of drugs, able to cause its closure. This method is the gold standard solution for larger reticular veins. It is applied with success in the treatment of varicose veins are not of great diameter and has limitations in the solution of the bleeding trunk of the veins saphenous.
- The classic operation – combined phlebectomy, in the current exercise is done on an outpatient basis under spinal anesthesia or local anesthesia. In some cases it is the only feasible way, when the destination of vienna strongly complicated and/or have large extensions. However, the method yields endo-vascular procedures, trauma.
- Endo venous laser obliteration – method of treating varicose veins surgery, in which vienna is not deleted, but closed from the interior of the laser energy, which is conducted directly into the glass of fiber optics. The effectiveness of a procedure comparable with the results of the surgical removal of the vein, however, is characterized by the minimum travmatichnostyu. The rehabilitation time of 1-3 days.
- Radiofrequency obliteration progressive solution to the increased blood flow to the trunk of the veins saphenous. It is a totally outpatient procedure performed under local anesthesia. The effectiveness of the treatment corresponds with the level classic phlebectomy, pain syndrome minimal or does not exist. The rehabilitation period of 1-2 days.