VERIFIED CONTENTAuthor: lek. Katarzyna Banaszczyk

The problem of varicose veins is quite a common ailment among Poles. Vascular diseases, including chronic venous insufficiency and varicose veins, are typically de alt with by vascular surgeons. What exactly are varicose veins and what are their symptoms? What are the treatment options for this condition? Is it possible to reduce varicose veins at all?

Varicose veinsare elongated and thickened venous vessels (veins), with a typically winding course. Varicose veins most often occur on the lower limbs. On the other hand, veins are those blood vessels that carry deoxygenated blood from tissues and organs to the heart and lungs. On the lower extremities, the veins occur in so-called two systems - as superficial veins and deep veins, hidden between the muscle fibers. Both of these vein systems contact each other by means of perforators, which also belong to the venous vessels.

Types of varicose veins

Varicose veins can occur in several varieties, depending on which venous vessels are dilated. We distinguish mainly:

  • telangiectasias, or so-called vascular spider veins - these changes are known to many of us. These are dilated vessels that are very shallow in the skin and are only an aesthetic defect,
  • reticular varicose veins - they resemble a network of twisted veins, rarely cause clinical symptoms, their typical location is the popliteal fossa or the lateral surface of the calf and thigh,
  • varicose veins of the main venous trunks - this includes the widening of the large veins of the lower limb, i.e. the saphenous and the small saphenous vein. These types of varicose veins most often cause unpleasant ailments reported by patients. If varicose veins are located on the posterior surface of the calf, they are most often due to widening of the saphenous vein, and when visible on the inside of the lower limb, they are typically due to widening of the saphenous vein.

Causes of varicose veins

Why do varicose veins arise? What is the cause of the widening of the venous vessels? There are several reasons for the malfunctioning of the veins in the lower extremities. The most important of them are:

  • genetic susceptibility - varicose veins often occur in related people, which results, among others, from hereditary abnormalities inwithin the venous valves (venous valves are structures inside the veins that prevent blood backflow and blood stagnation) or hereditary disorders in the structure of the vein walls - for example, their increased susceptibility to stretching,
  • taking a standing position for a long time, e.g. at work, lifting heavy objects,
  • abnormally high body weight - i.e. overweight and obesity,
  • multiple pregnancies,
  • older age - it is caused, among others, by decrease in the elasticity of the venous vessels with age and their greater susceptibility to stretching.

Varicose veins - symptoms of vein dilatation

Almost all of us have seen varicose veins - they are bluish, slightly bluish protrusions of the skin, caused by an enlarged and dilated venous vessel. The presence of varicose veins is a clinical component of a disease called chronic venous insufficiency.

The most common clinical symptoms reported by patients with varicose veins are:

  • feeling of heaviness in legs, leg pain and emerging swelling - these symptoms typically intensify at the end of the day,
  • itchy skin within varicose veins,
  • muscle spasms, increasing at night,
  • in advanced cases: dull pain, intensifying during the day,
  • venous insufficiency and varicose veins may also be accompanied by skin changes - for example intense redness and inflammation on one or both limbs.

Varicose veins - treatment

There are different methods of treating varicose veins, and the choice of a particular one depends on the clinical condition and symptoms presented by the patient. The final choice of treatment method depends on the physician and patient preferences. So let's get acquainted with the most commonly used methods of treating this ailment.

Home remedies to alleviate the symptoms of varicose veins

At the very beginning, it is worth getting acquainted with the general rules that should be introduced into your life when you have a problem with dilated venous vessels. First of all, remember about:

  • avoiding long standing and sitting with legs bent at right angles (in the knee and hip joints),
  • avoiding heating of the lower limbs, including tanning them,
  • if you work in a sedentary mode - remember to walk for a few minutes and take breaks from sitting,
  • physical activity (walking, jogging, cycling or swimming is recommended),
  • rest lying down with the lower limbs above the level of the heart - for example on a pillow.

Introduction to the everyday life of these few simple onesrules will certainly help us reduce the unpleasant ailments associated with varicose veins.

Compression treatment

It should be emphasized here that this is the only method known so far that gives a chance to slow down the development of chronic venous insufficiency. Compression therapy uses properly selected compression stockings or knee-high socks.

Such medical products are selected individually by medical personnel, because the degree of compression depends on the clinical condition of the patient.

There are four classes of oppression:

  • Compression Class I - in this case, the pressure exerted at the ankle is 20-30 mmHg. This level of compression is recommended for patients in clinical situations such as:
    • prevention of venous thrombosis, thrombosis and varicose veins in pregnant women,
    • slight varicose veins during pregnancy,
    • feeling of heaviness and fatigue in the limbs,
    • slight varicose veins without visible swelling,
    • condition after surgery for varicose veins.
  • Compression Class II - in this situation, the pressure exerted at the ankle is 30 - 40 mm Hg. This level of compression is recommended for patients in clinical cases such as:
    • varicose veins with accompanying slight swelling,
    • condition after superficial vein inflammation,
    • condition after sclerotherapy of varicose veins or after healing of minor ulcers,
    • presence of large varicose veins during pregnancy.
  • Class III compression (40-50 mm Hg) - this type of compression is required in the following clinical situations:
    • very large varicose veins accompanied by significant swelling,
    • condition after large ulcers heal,
    • presence of post-traumatic edema,
    • presence of reversible lymphedema.
  • Class IV of compression (50-60 mm Hg) - The highest degree of compression is recommended in the presence of:
    • severe post-thrombotic syndrome,
    • irreversible lymphoedema.

Drug therapy

Drugs are only an auxiliary method in the treatment of this disease. It should be emphasized that the use of pharmacotherapy will not protect us against the development of varicose veins. The basic method of preventing the deterioration of these venous disorders is the above-described compression treatment.

However, let's get acquainted with the most important pharmacological substances that are used in patients with chronic venous insufficiency. It is mainly:

  • rutin and its derivatives, hesperidin, diosmin - these are natural substances obtained from plants or their synthetic derivatives. Diosmin is a flavonoid that reducesthe permeability of venous vessels and increases the tension of their walls, thanks to which it reduces the stagnation of blood in the venous vessels. Interestingly, diosmin also has an anti-inflammatory effect and reduces excessive blood viscosity,
  • saponins (escin) - used not only in venous insufficiency, but also in the prevention and treatment of postoperative hematomas and edema, and in the treatment of hemorrhoids. Escin is contained in horse chestnut seeds and, like diosmin, it reduces the permeability of venous vessels and improves their elasticity, thanks to which it has an anti-swelling effect,
  • calcium dobesylate - this substance improves the activity of the vascular endothelium and increases the resistance of the capillaries, thus reducing their permeability. What's more, calcium dobesylate also improves circulation in lymphatic vessels and peripheral venous circulation, thanks to which it has an anti-oedematous effect,
  • grape seed or citrus extracts.

When is surgery necessary?

In some situations, unfortunately only compression treatment and auxiliary pharmacotherapy are not enough. It is sometimes necessary to perform an operation. The indications for the surgery of varicose veins are:

  • complications of varicose veins, such as inflammation, rupture, bleeding and skin trophic changes (including discoloration),
  • venous ulcers,
  • advanced symptoms of chronic venous insufficiency that impair the daily functioning of the patient.

It should be emphasized that surgery should not be performed on patients with deep vein obstruction. Typically, a procedure is performed to remove dilated veins that run subcutaneously from small, single skin cuts (about 2-3 millimeters long). Such treatments are usually performed by vascular surgeons.

To sum up, the only effective method of inhibiting the development of varicose veins are the compression methods described in this article. In turn, for the permanent removal of varicose veins, it is necessary to undergo surgery. There is no method that allows us to reduce the size of varicose veins, we can only prevent the development and aggravation of changes. If we have varicose veins, it is best to consult a vascular surgeon who will recommend the appropriate course of action.

Category:

Cardiology