The medical clinic's team of trained cardiovascular surgeons/phlebologists diagnoses and treats all types of varicose veins at any stage of the disease and related pathologies. We are proud of our treatment according to Israeli protocols, which show maximum effectiveness in clinical practice.
Varicose veins - the root cause of the formation of varicose veins is the disruption of the normal functioning of the venous valves with the occurrence of reverse flow of blood (reflux).
In general, the valves exposed to the greatest mechanical stress are affected first. In this case, the abnormal discharge of blood occurs through the mouths of the great and small saphenous veins, sometimes through large perforating veins. The excessive amount of blood in the superficial veins gradually leads to overstretching of the venous wall. The total volume of blood in the superficial venous bed of the lower extremities increases. This increased blood volume continues to flow through the perforating veins into the deep system, overstretching them. As a result, perforating veins dilate and valvular insufficiency occurs.
Symptoms and signs of the disease
The signs of the disease are not necessarily associated with pain. On the contrary, most patients say that at the beginning of the disease they are more concerned about aesthetic problems than about pain.
The clinical picture depends on the localization of the pathological process and the stage of the disease.
Varicose veins of the lower limbs are manifested as follows:
- Heaviness in the legs, feeling of fullness in the legs.
- The appearance of cramps in the calf muscles, cramps in the legs and fingers.
- Feeling tired after a long walk.
- Swelling of the ankle in the evening.
- Venous relief pattern on the skin, spider veins, spider veins.
- The signs accompanying the disease are cellulite, itching of the legs, dryness of the ankles and calves, thinning and sagging of the skin, long-healing ulcers, uneven pigmentation - from dark spots to colorless areas, pronounced nodular formations from bluish to dark purple or burgundy. , trophic ulcers.
Progressive venous disease is associated with deterioration of the general state of health:
- Unstable blood pressure, hypertension, hypotension.
- A feeling of chronic fatigue, apathy develops.
- Arrhythmia, tachycardia.
- Shortness of breath, frequent respiratory diseases.
Obvious symptoms of varicose veins of the lower extremities in women may be stronger before menstruation, and may decrease afterwards.
The symptoms of venous pathology of the upper limbs are characterized by numbness of the hands, spasms of the fingers, goosebumps, tingling and coldness.
Varicose veins of the esophagus are manifested by belching, burning sensation, pain behind the sternum, inflammation of the esophagus and stomach, difficulty in swallowing and signs of reflux esophagitis and anemia.
Diagnosis of the disease
Effective treatment of varicose veins cannot be carried out without a preliminary comprehensive diagnosis. The diagnosis is clarified by the clinical picture and data analysis after hardware tests.
The following methods are most often used for diagnosis:
- duplex or triplex ultrasound angioscanning;
- phlebography with contrast;
- MRI with venography;
- contrast angiography.
In order to determine the presence of reflux in the affected veins and to evaluate the blood flow, a number of examination manipulations are performed:
- Examination of veins with compression on different segments.
- Valsalva maneuver or strength test.
- Parana test with imbalance to evaluate veins in the calf area.
- Variable intensity walking test.
Additional methods to clarify the diagnosis:
- Plethysmography to determine venous reflux and obstruction.
- CT, MRI to visualize tissues and structures in the affected area.
- Infrared thermography to assess the temperature balance in the affected area of the body.
- Intravascular ultrasound uses a catheter to visualize the inside of the vessel walls.
The results of the performed diagnostic tests are evaluated comprehensively. Any diagnosis is of great help in determining further treatment tactics.
Clinical laboratory tests of blood and urine complement the picture of the disease and may indicate concomitant pathologies.
How are varicose veins treated?
If the alarming symptoms of varicose veins appear, it is necessary to consult a doctor to diagnose and start treatment in time. In regional health care institutions, general surgeons deal with this issue, in clinics - phlebologists and angiosurgeons.
The multidisciplinary medical clinic has a well-equipped phlebology department, where a surgical team with extensive practical experience works. The center offers a high standard of service and quality treatment, which is reflected in the excellent clinical results of which we are proud.
Varicose veins of the lower limbs and other types of pathologies can be treated in the first stage of development. As the process progresses, it proves to be more and more ineffective, partially retaining only its symptomatic significance.
Therapeutic effects cannot completely eliminate the disease, but as long as it is possible to delay the destruction of blood vessels and the development of complications, this should be done with all available means.
Conservative treatment
- At the beginning of the treatment of varicose veins, drugs are limited to venotonic agents.
- Anticoagulant injections and low molecular weight heparin fragment are used to reduce the risk of thrombosis and occlusion.
- New oral anticoagulants.
- In case of inflammatory phenomena occurring in blood vessels and surrounding tissues, the use of external non-steroidal anti-inflammatory drugs with diclofenac and indomethacin is recommended.
How else can varicose veins be treated?
In parallel with the therapeutic treatment, the patient is recommended to perform certain exercises that strengthen the muscle ligaments of the lower limbs and have a general strengthening effect. For example, the best exercise in a lying position is the "bicycle", alternately pulling your toes towards you and stretching them, as in ballet.
- You have to be careful with water and thermal treatments, because hot baths and showers, beach vacations combined with sunbathing can make the situation worse. The dishes need to be strengthened, this is facilitated by hardening with a contrast shower, when hot and cold water are poured alternately on the legs.
- For pain, inflammation, and heaviness in the legs, a daily cool foot bath with a decoction of oak bark, chamomile, calendula, birch leaf, St. John's wort, white acacia flower, and horse chestnut is recommended.
- It is useful to rub freshly squeezed juice of aloe leaves into the skin, it softens the skin and prevents inflammation.
- It is worth changing your habits and quitting smoking. The diet should be dominated by foods rich in vitamins and high in fiber, fresh vegetables, citrus fruits and seafood.
- You should adjust your drinking regime so that you drink a sufficient amount of water (1. 5-2 liters) per day. At the same time, you should reduce the consumption of coffee, strong tea, chocolate and alcohol.
If the veins in the legs are enlarged, the doctor may recommend regular or permanent wearing of compression stockings.
Causes of the disease
From the family history of occurrence, we can conclude that varicose veins are genetically determined and can be inherited.
In many clinical cases, it is impossible to determine the exact cause of the disease. The researchers concluded that the culprit is a combination of several internal and external factors.
Causes of varicose veins:
- congenital defect of the valve system;
- physical inactivity, lack of activity;
- pregnancy;
- working conditions with prolonged stress on the legs, standing for a long time, in a static position;
- treatment with certain hormonal drugs;
- uncomfortable shoes, high heels;
- obesity;
- tight underwear, clothes that constrict the hips and knees (for example, very tight jeans, shapewear);
- regular weight lifting;
- systemic pathology of the kidneys, heart and blood vessels;
- diabetes;
- regular bowel problems, frequent diarrhea or constipation.
Varicose veins of the lower limbs (varicose veins)- expansion of the superficial veins of the lower limbs, accompanied by incompetence of the valves and disturbance of blood flow. The term "varicose veins" comes from Latin. varix - "swelling".
As a result, the veins do not work properly, the entire circulatory system is disturbed, which is complicated by congestion, disruption of tissue trophism, and blockage of blood vessels with blood clots.
Many complications are life-threatening, so if varicose veins are suspected, diagnosis and treatment must be carried out immediately and professionally.
Types of diseases
The blood vessels change, the blood flow slows down, and blood clots can form in the uneven walls. Changes in the functioning of blood vessels cause blood stasis, venous insufficiency, and permanent disorders of capillary circulation in the periphery.
According to the WHO, varicose veins occur in 45% of women and 20% of men.
According to the generally accepted international classification of CEAP, varicose veins are divided into six classes and stages of the disease, based on the fact that C0 is the complete absence of subjective, visual and clinical symptoms.
- C1 - the initial stage, which manifests itself in a capillary network and spider veins on the skin.
- C2 – visible thickening of the subcutaneous veins, venous pattern in the lower limbs in the form of blue threads.
- C3 – swelling of the legs occurs as a result of prolonged standing or rest (sleeping at night).
- C4 – the surface of the skin changes, unevenly pigmented areas appear, venous eczema with itching and ulcers, lipodermatosclerosis.
- C5 – venous ulcers on the surface of the skin that heal after a while.
- C6 – non-healing venous trophic ulcers.
The classification of varicose veins of the lower extremities differentiates between the pathology of superficial and/or deep veins, perforating communicating veins.
According to the origin of the venous deformation, it can be:
- congenital, manifested in infants;
- acquired;
- secondary, against the background of other pathologies, injuries;
- idiopathic, of unknown cause.
The complete classification of varicose veins of the lower limbs and organs includes complications - reverse blood flow, reflux and/or obstruction, lumen obstruction.
Varicose veins of the lower extremities are not the only manifestation of varicose veins, although they are the most common. There are also varicose veins of the esophagus, sublingual veins, retina, scrotum (varicose veins in men), stomach, corpora cavernosa of the rectum (golden vein), pelvic veins, female genital organs - vulva, labia, uterus.
Surgical treatment of varicose veins
RFO (radiofrequency obliteration of the saphenous veins)a modern method of treating varicose veins. During the treatment, radio frequency radiation is applied to the inner wall of the vein. With the help of the thermal effect, the vein is "welded", separated from the general blood flow, and after a few months it is replaced by connective tissue.
Advantages
- The procedure is performed without general anesthesia, local anesthesia is sufficient;
- Maximum safety for the health of patients
- RFA does not require special preparation;
- During the manipulation, the patient does not feel pain or discomfort;
- Radiofrequency ablation of the veins of the lower extremities is highly effective;
- Low probability of complications, almost all patients tolerate this procedure well;
- Radiofrequency ablation can be combined with tributary mini-phlebectomy or sclerotherapy;
- After radiofrequency ablation, there are no scars or marks;
- Literally a few days after the procedure, the patient can return to his normal lifestyle.
This is how it goes
The intervention is carried out under ultrasound control. Before starting the procedure, local anesthesia is administered so that the patient does not feel pain or discomfort during the treatment.
Let's see how RFA is done step by step:
- Before surgery, the lower limbs are thoroughly treated with antiseptics. The doctor then uses a marker to mark the vein prone to varicose veins. The doctor then inserts a radiofrequency catheter into the vein and uses radiofrequency waves to treat the desired area.
- At the end of the procedure, the catheter is removed, the doctor applies a bandage and helps the patient put on a compression garment.
- The procedure takes 30-50 minutes. To stop the flow of blood through a weakened vessel, it must be destroyed. Then the body itself will redirect the blood through the healthy veins. As a result, after ablation, the walls of the veins stick together and form scar tissue inside (safe and unnoticeable), the varicose veins disappear.
Rehabilitation
Immediately after the operation, the patient must walk (about 30 minutes) to avoid stagnation of blood and lymph. After radiofrequency ablation of the veins of the lower limbs, the recommendations of doctors must be carefully followed:
- During the week, increased physical activity and heavy lifting are prohibited;
- You need to walk more, stay in the same position as little as possible (with the exception of sleeping);
- You need to stop taking hot baths for 3-4 weeks, you can only take a shower;
- You should stop visiting the spa for at least a month;
- It is necessary to drink as much plain water as possible, on average about 2. 5 liters, while minimizing the amount of salt consumed;
- One week after surgery, you should start physical therapy, which the doctor will tell you about;
- It is possible that after radiofrequency ablation of the veins of the lower extremities, the doctor will prescribe certain medications.
Adherence to these rules will help avoid complications and prevent the further development of varicose veins.
A repeat examination is required one week after the operation (ultrasound examination of the veins of the lower limbs). You can learn more about radiofrequency ablation of the veins of the lower limbs during a personal consultation with a specialist.
Laser coagulation of veins
Endovasal (endovenous) laser coagulation (obliteration) of varicose veins (EVLK, EVLO) is a modern method that uses the thermal energy of laser radiation to eliminate blood reflux in superficial and perforating veins. EVLO allows you to perform without incisions and does not require hospitalization from the patient. The international term is EVLA (endovenous laser ablation).
Main Sections
- Venipuncture. It is performed under ultrasound guidance.
- Light guide positioning. The light guide is a thin optical fiber. At the end is laser radiation. The light guide is placed in the patient's vein. Its end is placed at the point where the vein flows into the healthy deep veins, i. e. at the anastomosis.
- Tumescal anesthesia. An anesthetic "pad" is created around the vein to push the vein closer to the light guide and avoid damage to the surrounding tissue.
- Laser vein coagulation. The working part of the light guide receives laser radiation.
- At the same time, the light guide is slowly pulled out of the vein. Thus, the laser heats the vein evenly to 85 °C. Heated vein, like all proteins, contracts when heated. The lumen of the vein disappears, blood flow stops.
Rehabilitation
Immediately after the operation, the patient must walk (about 40 minutes) to avoid stagnation of blood and lymph. After EVLO of the veins of the lower limbs, the recommendations of doctors must be followed:
- During the week, increased physical activity and heavy lifting are prohibited;
- You need to walk more, stay in the same position as little as possible (with the exception of sleeping);
- You need to stop taking hot baths for 3-4 weeks, you can only take a shower;
- You should stop visiting the spa for at least a month;
- It is necessary to drink as much plain water as possible, on average about 2. 5 liters, while minimizing the amount of salt consumed;
- One week after surgery, you should start physical therapy, which the doctor will tell you about;
- Your doctor may prescribe certain medications after surgery.
Sclerotherapymethod of non-surgical (minimally invasive) elimination of varicose and spider veins of the lower limbs.
Advantages of venous sclerotherapy:
- absolute outpatient care that does not require additional preparation,
speed of execution, - no need for anesthesia,
- absence of complications typical of surgical treatment methods, such as nerve damage,
- absence of "thermally induced phlebitis" characteristic of blood coagulation methods, accompanied by shearing pain along the coagulated vein.
Thus, today, sclerotherapy of varicose veins is an effective and safe method, which in some cases can be used as an alternative to other types of surgical interventions.
The sclerotherapy method is based on the destruction of the vein by introducing a chemical substance into its lumen, which "washes away" the inner layer (endothelium) with the subsequent development of endofibrosis. The degree of endothelial damage depends on the concentration and volume of the drug administered.
The modern medical center uses advanced technologies for the treatment of varicose veins, ensuring the maximum effectiveness of all treatment measures. The use of modern equipment by experienced specialists will get rid of varicose veins in the shortest possible time, without complications and long-term rehabilitation.
Treatment in a modern clinic means health and a significant improvement in the quality of life.