Chronic venous insufficiency is a condition resulting from blood stagnation in the venous system of the lower extremities. It can lead to the formation of venous spider veins, varicose veins, swelling, discoloration, induration and inflammation within the skin, and in the most severe form of venous ulceration. Therefore, any symptoms resulting from vein problems should not be taken lightly. The good news is that there are ways to avoid and treat venous insufficiency.

Chronic venous insufficiency(CVI, chronic venous disease, CVD,chronic venous insufficiency , CVI) is a disease that affects almost half of women in Poland and approx. 37 percent. men. When it comes to young people, up to the age of 35, 6 times more women are ill than men.

The main cause of chronic venous insufficiency is damage to the veins that transport blood from the legs to the heart. In order for the blood to freely overcome gravity as it flows from the feet up, the veins must function efficiently in the venous valves and the muscle pump.

If this is not the case, some of the blood begins to regurgitate (venous reflux) and thus stay in the veins, stretching them and making it difficult for them to function properly. Venous blood stagnates, which hinders the inflow of oxygenated arterial blood and leads to the development of inflammatory conditions with ailments, damage to the walls of the veins with seepage of blood plasma - swelling, discoloration, and ulceration over time.

What are the symptoms of venous insufficiency?

  • leg pain, feeling of heaviness in legs (this disappears after appropriate exercises)
  • swelling of the feet, ankles and calves (in the initial stage of the disease, these are swellings that disappear after "moving in" or exercising, while at night rest - permanent swelling in the advanced stage)
  • pain around the veins
  • paresthesia (tingling, numbness), itching, stinging legs
  • so-called restless legs syndrome
  • night cramps of muscles, mainly of the calves
  • visualization of the subcutaneous veins (often dilated and bluish in color) - the smallest ones that begin to resemble spider veins - and the thicker ones that protrude and soft to the touch
  • brown-reddish subcutaneous discoloration

Causes of venous insufficiency

The development of venous insufficiency is influenced by severalfactors:

  • venous reflux, i.e. reverse blood flow - it results from the lack (destruction), underdevelopment or insufficiency of the venous valves
  • reduced amount of elastic fibers in the venous wall is genetically determined or caused by age in the absence of physical activity
  • failure or weakening of the calf muscle strength, most often as a result of a lack of regular physical activity
  • narrowing of the veins - caused e.g. by venous obstruction (thrombosis) or pressure on the veins from the outside. The pressure may be caused by obesity, sometimes the veins are also pressed by the growing uterus in pregnant women
  • high venous pressure for a long time. Here, the culprit may be some disease of the veins, incorrect lifestyle, e.g. low physical activity, sitting or standing work. Venous hypertension destroys the valves and the walls of the veins - through collagen breakdown and loss of elasticity.

Factors increasing the risk of venous insufficiency:

  • female gender (pregnancy, oral contraception)
  • age
  • obesity
  • sitting or standing work, low physical activity - lack of exercise leads to blood stagnation in the veins
  • high rise
  • frequent constipation
  • genetic factors - the risk of developing varicose veins in a person whose one parent has varicose veins is 42%, if both - the risk increases to 89%
  • smoking
Important

Unusual pipeline

The length of all blood vessels in one leg is as much as 100 km. Some of the veins are hidden deep and form the so-called system of deep veins. Part of it runs close to the surface of the skin and these are called surface veins.

Both systems are connected by crosswise lines called perforators. It is in the surface vessels that varicose veins are formed. Most often on the saphenous vein from the medial (inner) ankle to the groin, and less often on the small saphenous vein from the centrifugal (outer) ankle to the knee.

Diagnosis of venous insufficiency

The diagnosis of chronic venous insufficiency is not difficult even on the basis of the interview with the patient and the examination of the limbs. On the other hand, ultrasound examination of the superficial and deep veins will help to determine the cause of the disease - you can find a segment of the vein with insufficient valves, assess whether there is a thrombus in the veins blocking the outflow of blood, and plan the appropriate treatment of the changes.

Treatment of chronic venous insufficiency

Treatment of chronic venous insufficiency should be divided into 4 parts: treatmentconservative, i.e. pharmacotherapy, compression treatment, lifestyle changes, which should always be implemented first, and surgical treatment.

  • Pharmacotherapy - recommended at every stage of venous disease. Safe phlebotropic drugs - synthetic or herbal - are recommended. The latter are, for example, hesperidin, rutin derivatives, escin. The most effective drug, according to specialists, is a combination of butcher's broom, hesperidin and ascorbic acid. Drugs improve the work of the vessels to some extent: they constrict venous and lymphatic vessels, reduce inflammation, seal the walls of the venous vessels, which reduces pain, swelling and the feeling of heaviness in the legs. Lifestyle changes are possible at any stage of chronic venous disease. It includes the increase and regularity of physical activity and weight reduction. Strengthening the calf muscles improves the efficiency of the muscle pump. The venous blood is pumped towards the heart, and in the venous vessels squeezed by the muscles, the petals of the venous valves come closer to each other, which prevents the venous blood from flowing back. Physical activity should be regular, preferably at least 30 minutes each day.
  • Compression therapy - brings much better results. Various types of ready-made compression products or bands of various extensibility are used here. They exert the greatest pressure just above the ankle, and higher, gradually lower, so that the blood can flow freely from the legs to the heart. At the same time, they support the operation of the calf muscle pump. Compression products not only reduce the symptoms of venous insufficiency, but also inhibit the progression of the disease. We have at our disposal: knee-high socks, stockings, tights or unbuttoned compression tights. The products should be selected individually on the basis of the examination and measurements of the lower limb.
  • Surgical treatment - miniphlebectomy, intravascular closure of a venous vessel with the use of a laser (EVLT), classic surgery of varicose veins or sclerotherapy. Miniphlebectomy is the removal of varicose changes from microcuts. EVLT allows the closure of large, inefficient vessels, such as the saphenous or small saphenous vein, in a completely outpatient technique. Classic surgery is fully reimbursed by the National He alth Fund, but it involves incisions and a hospital stay. Sclerotherapy - involves the administration of a drug into the vein that causes chemical irritation, and thus local inflammation, and consequently its fibrosis.
According to an expertGrzegorz Krasowski, MD, PhD, surgeon from the department of general and oncological surgery of the County Hospital in Krapkowice

Diseases of the veins always require propertreatment, and what is the related diagnosis. The Duplex Doppler ultrasound performed in this case is currently the best diagnostic tool for diseases of the venous system.

When experiencing symptoms of chronic venous diseasedo not forget about pharmacological treatment . It is recommended at every stage of the disease development and significantly reduces the feeling of subjective symptoms such as pain, swelling or a feeling of heaviness in the legs.

Remember thatonly a specialist can choose the right drugs, individually for the patient, in accordance with international guidelines.

The use of drugs, not supplements, is strictly recommended. Supplements do not cure, and chronic venous disease should be treated. In addition, due to the lack of control of their composition, they often contribute to the occurrence of various undesirable effects, which, especially in times of difficult access to he alth care, are very undesirable.

Our market includes mainly preparations of plant origin : hesperidin, rutin derivatives, escin, but also synthetic preparations. Medicines containing a combination of Ruszczyk, hesperidin and ascorbic acid remain the best therapeutic option.

Worth knowing

Venous insufficiency: from spider veins to varicose veins

It is unknown why the tendency to widen the veins appears in some early adolescence, and in others later or not at all. It is known, however, that in the walls of the veins of people with hereditary spider veins and varicose veins there are fewer elastic fibers and more (or as many as needed) collagen fibers. The latter are inelastic fibers, so they stretch easily. In places where the veins have widened, mini varicose veins, popularly known as spider veins, form. They can appear singly, form branches resembling a tree crown or merge into large, bluish spots.

But why is this happening? When changing the position from lying to standing, the venous pressure in the vessels of the lower extremities increases. Depending on the condition of the walls of the veins, the efficiency of the venous valves and the efficiency of the calf muscle pump, venous blood is forced upwards, i.e. towards the heart. If the walls of the veins are weakened or slightly stretched, or the valves are inoperative and allow the blood to fall back (fall) downwards or the muscles compress the veins with insufficient force - its excess remains in the veins and presses against their walls with increasing pressure. These stretch more and more and there is a phenomenon called venous hypertension.

Muscle pump and venous valves

In the venous systemthe calf muscles - the muscle pump - play the role of the pump that drives the blood flow from the feet up (as in the arterial system is the heart). During their work, muscles compress the veins, squeezing blood out of them towards the heart. In order for the blood from the veins to flow upwards, he needs support. Let us take an example: if we wanted to remove water from a rubber hose, we can do so by squeezing it with our hands. But as soon as we release the pressure, the water in the hose will drop. The same can happen in the veins if not for … the valves. They are tiny folds of the inner lining of the vessels. They close when the blood flowing up to the heart tries to withdraw. As we walk and run, the muscles contract and compress the veins rhythmically. In this way, they stimulate the action of the so-called muscle pump, which consists of properly functioning calf and foot muscles. If the pump fails, we feel heavy legs, fatigue, and numbness.

How are varicose veins formed?

If our muscles are weak, the valves are damaged and we move little, the blood is still in our veins. The blood pressure increases and it presses against the walls of the veins with increasing force. These expand and, like a stretched spring, they do not return to their original shape. The inefficiency of the veins worsens and varicose veins form in places of their abnormal widening. Over time, the skin above them becomes thinner, taut and shiny. Varicose veins filled with hypoxic blood appear bluish under the skin, sometimes with lumps, and a tortuous line.

What does venous insufficiency lead to?

Untreated chronic venous insufficiency can cause a number of serious consequences, such as: varicose veins, dermatofatal sclerosis, superficial and varicose vein inflammation, deep vein inflammation, congestive dermatitis and, in the final stage, shin ulceration.

  • PPG - venous insufficiency study
  • Pelvic varicose veins, i.e. pelvic venous congestion syndrome

Category:

Cardiology