Varicose veins: treatment and symptoms

7 June 2024

The name of this disease is based onvaricose veins of the lower extremities, lies the Latin word "varicis". It is translated as "swelling", which fully reflects the main symptom of this pathology, which is characterized by the abnormal expansion of the veins. It is accompanied by other, no less unpleasant manifestations, in the form of impaired blood flow and valve dysfunction.
The medical statistics are inexorable: the disease has affected the majority of the world's population! Thus, clinical manifestations of varicose veins, expressed in varying degrees, are found in almost 90% of women and more than 65% of men. Unfortunately, the disease is getting younger and younger – and today there are reports that it is even being detected in school-age children!

If you experience more than 80% of the listed symptoms, we strongly recommend that you consult a doctor for advice.

Varicose veinsis a disease of the veins, the clinical manifestations of which are the expansion and pathological tortuosity of the veins, with the formation of venous nodules, and the subsequent progression of symptoms of chronic venous insufficiency of varying degrees of severity (ranging from a feeling of heaviness, fatigue in the legs, varying degrees of swelling, the development of compactions of subcutaneous adipose tissue and skin, the appearance of dermatitis, eczema and the eventual formation of venous trophic ulcers).

Doctors classify this pathological condition as polyetiological, as it occurs under the influence of several factors. The main ones include:

Congenital predisposition;
Pregnancy in women;
Hormonal imbalances;
Overweight;
Passive lifestyle.

A professional team of phlebologists from the network of family clinics "Médico Próximo" is always ready to help anyone who wants to be cured of this disease. The selection of a course of treatment is made individually, taking into account all factors. Together with the use of modern and effective techniques, this allows you to achieve the desired results.

Causes and signs of developing varicose veins

The main pathogenetic mechanisms that lead to varicose veins are:

Increased intravenous pressure, which is mainly determined by the hydrostatic pressure in the vein, resulting from the action of gravity, measured by the height of the fluid column, that is, the distance from the heart to the point on the leg where the measurement is made. And the pressure within the body cavities - abdominal or pleural, when increased (pregnancy, excess weight, lifting and carrying heavy objects, etc. ) worsens the return of venous blood to the heart.
Relative weakness of the venous wall, which is genetically determined, but can sometimes change under the influence of inflammatory processes in the vein.

The interaction of these factors leads to progressive stretching of the vein, the development of insufficiency of the venous valves, the appearance of reverse blood flow and the occurrence of stagnation in the venous bed.

With prolonged exposure to provoking factors, inflammatory processes develop, which, as they develop, affect and weaken the resistance of the venous wall of the venous valves.

As a result of all these processes, a pathological reverse flow of blood through the vein occurs, which is called reflux and venous stagnation develops, which leads to the development of inflammation of the subcutaneous fat and skin, which, with further progression, leads to o appearance of a trophic ulcer

Symptoms of varicose veins:

Visually noticeable expansion and tortuosity of the saphenous veins, in advanced cases - formation of venous nodules;
Feeling of heaviness, tiredness, fullness in the calves of the lower extremities;
Formation of telangiectasias ("stars", vascular "webs");
Cramps in the calf muscles at night;
Swelling of the feet and legs;
Itching, dryness, hyperpigmentation and blueness of the skin
The appearance of trophic, weeping and difficult-to-heal ulcers.

Risks of varicose veins

Varicose veins in the legs are more of a cosmetic problem, but they can lead to unpleasant complications: chronic venous insufficiency and inflammation of the vein, called acute varicothrombophlebitis. Acute varicothrombophlebitis is a pathological condition that occurs as a result of inflammation of the venous wall and the appearance of a blood clot in the lumen. A dangerous complication of varicthrombophlebitis is the continuous growth of the blood clot and its spread into the deep veins. Therefore, this condition requires mandatory medical supervision and treatment and sometimes leads to emergency surgery. Modern medicine offers a number of effective techniques that can help eliminate the risk of developing such conditions, but treatment must be started in a timely manner.

Classification of varicose veins

There are different classifications of varicose veins, which are presented in the table below.

Type/stage/class of varicose veins according to CEAP	Signals
The form of the pathology, its degree and the complications it led to
C1	Damage to intradermal vessels: telangiectasia (colloquially - "spiders", "nets", "asterisks") and dilated reticular veins.
C2	Dilation, pathological tortuosity Damage to the saphenous veins.
C3	Damage to the saphenous veins, accompanied by edema
C4a C4b	The appearance of hyperpigmentation (dark brown color) on the lower leg or eczema (inflammation of the skin, dermatitis) The development of lipodermatosclerosis (inflammation and thickening of subcutaneous adipose tissue).
C5	Healed trophic ulcer
C6	"Open" trophic ulcer
Stages of development of a pathological condition according to Savelyev
Compensation	There are no symptoms or complaints. Examination reveals dilated veins in one or both lower extremities.
Subcompensation	The patient feels discomfort, which is expressed in swelling and "pins and needles" in the legs, as well as cramps in the calf muscles at night. The condition is accompanied by swelling at night, which disappears in the morning. On examination, varicose veins of the lower extremities are revealed.
Decompensation	The discomfort listed above complements inflammatory skin lesions and eczema. The skin becomes dry and shiny and hyperpigmentation appears.

Dynamics of development of varicose veins

Clinical picture of the diseasedepends on the stage of disease progression. At the same time, doctors identify the main clinical sign that determined the name of the disease - dilation of the saphenous veins of the lower limbs.

Beginning of disease development

Initially, patients feel heaviness in the legs, tiredness and pain in the legs. During this period, visual signs of pathology are not visible. There are often cases when the above symptoms are also absent, which is why patients do not seek professional medical help. During the examination by the phlebologist, he identifies dilated soft veins, the skin of which has not undergone pathological changes.

Subcompensation stage

As the disease progresses, patients notice pain, swelling appears when standing or sitting for long periods of time, which disappears at night. During the examination, the phlebologist notices slight swelling in the ankle area.

Decompensation stage

The progression of pathology is expressed in a constant feeling of heaviness in the lower extremities, rapid fatigue and cramps in the calf muscles at night. Additionally, severe itching occurs at night.

When examined by a doctor, a pronounced dilation of the veins of the lower extremities and impaired blood flow are revealed. Tension of the veins, adhesion of their walls to the skin, hyperpigmentation, cyanosis, roughness and dryness of the skin are noted.

Skin changes appear on the lower third of the leg. First of all, they represent the appearance of a brown color of the skin, the development of inflammation - dermatitis or eczema, the appearance of compaction of subcutaneous adipose tissue, against which trophic ulcers subsequently begin to form and progress.

Diagnosis of varicose veins

Varicose veins treatmentprescribed after the patient has undergone a comprehensive diagnostic study, which makes it possible to accurately determine the stage of development of the disease and the pathological changes to which it has led. Depending on the situation, this may include the following studies of the inferior veins:

Inspection;
Duplex/triplex scanning.
Studies of some coagulation indicators, thrombophilia markers

Main methodvaricose veins diagnosisis an ultrasound examination, in addition to which they also perform a full range of examinations and functional tests.