The team of qualified cardiothoracic surgeons/phlebologists at the medical clinic diagnoses and treats all types of varicose veins at any stage of the disease as well as associated pathologies. The asset we are proud of is treatment according to the Israeli protocol, which shows maximum effectiveness in clinical practice.
Varicose veins – the causative agent of varicose veins is considered a disruption of the normal functioning of venous valves with the appearance of reverse blood flow (reflux).
As a rule, the valves that are subjected to maximum mechanical stress are affected first. In this case, pathological bleeding occurs through the mouths of the large and small saphenous veins, sometimes through large perforating veins. The excessive amount of blood that arises in the superficial veins gradually leads to excessive distension of the vein walls. The total volume of blood contained in the superficial venous bed of the lower extremities increases. This increased blood volume continues to flow into the deep system through the perforating veins, causing them to become overstretched. As a result, dilation and valvular insufficiency occur in the perforating veins.
Symptoms and signs of the disease
Signs of illness do not necessarily come with pain. On the contrary, most patients said that when they first got the disease they were more concerned about aesthetics than pain.
The clinical picture depends on the location of the pathological process, as well as the stage of the disease.
Varicose veins of the lower limbs manifest as follows:
- Feeling of heaviness in the legs, feeling of heaviness in the legs.
- Cramps appear in the calf muscles, spasms in the feet and fingers.
- Feeling tired after walking for a long time.
- Swollen ankles in the evening.
- Pattern of veins on the skin, spider veins, spider veins.
- Signs that accompany the disease are cellulite, itchy feet, dry ankles and calves, thin and sagging skin, slow-healing ulcers, uneven pigmentation - from dark spots to colorless areas, formation of spotsdistinctly rough with a color ranging from bluish to dark purple or burgundy. , trophic ulcers.
Progressive vein disease is accompanied by a decline in overall health:
- Unstable blood pressure, hypertension, hypotension.
- A feeling of chronic fatigue, apathy develops.
- Arrhythmia, tachycardia.
- Difficulty breathing, common diseases of the respiratory system.
Obvious symptoms of lower limb varicose veins in women may appear stronger before menstruation and gradually decrease after menstruation.
Symptoms of venous disease in the upper extremities are characterized by numbness in the hands, spasticity of the fingers, goosebumps, tingling and cold sensations.
Esophageal varices are manifested by belching, burning sensation, pain behind the sternum, inflammation of the esophagus and stomach, difficulty swallowing and signs of reflux esophagitis and anemia.
Diagnostic
Effective treatment of varicose veins cannot be carried out without a preliminary comprehensive diagnosis. The diagnosis is clarified by clinical pictures and data analysis after hardware studies.
The following methods are commonly used for diagnosis:
- duplex or triple ultrasonic pulse scanning;
- phlebography with contrast;
- MRI with venography;
- Contrast angiography.
To determine the presence of reflux in the affected veins and evaluate blood flow, several tests are performed:
- Check the vein by compressing on different segments.
- Valsalva maneuver, or stress testing.
- Parana test with imbalance to evaluate veins in the calf area.
- Test walking at different intensities.
Additional methods to clarify the diagnosis:
- Plethysmography to identify venous reflux and obstruction.
- CT, MRI to visualize tissues and structures in the affected area.
- Infrared thermography to assess temperature balance in the affected area of the body.
- Intravascular ultrasound uses a catheter to look at the vessel walls from the inside.
The results of any diagnostic studies performed are evaluated comprehensively. Any diagnosis is of great help in determining further treatment tactics.
Clinical tests of blood and urine complement the picture of the disease and can indicate accompanying pathologies.
How are varicose veins treated?
If worrying symptoms of varicose veins appear, you should consult your doctor to get a diagnosis and start treatment promptly. In regional medical institutions, this problem is solved by general surgeons, in clinics - by phlebotomists and vascular surgeons.
The polyclinic has a well-equipped vein department, with a team of surgeons with extensive practical experience. The center provides superior service and quality of treatment, which is demonstrated by the excellent clinical outcomes of which we are proud.
Varicose veins of the lower limbs and other types of pathologies can be treated in the early stages of development. As the process progresses, it becomes increasingly less effective, partly retaining only symptomatic significance.
The therapeutic effect 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 must be done by all available means.
Conservative treatment
- At the beginning of treatment for varicose veins, medication is limited to anti-vein agents.
- To reduce the risk of thrombosis and obstruction, anticoagulants and low molecular weight heparin-fragmin are used.
- New oral anticoagulants.
- For inflammation in blood vessels and surrounding tissues, the use of topical nonsteroidal anti-inflammatory drugs such as diclofenac and indomethacin is indicated.
How to further treat varicose veins?
In parallel with therapeutic treatment, patients should perform some exercises to help strengthen the muscles in the lower limbs and improve overall health. For example, the best exercise in a lying position is "bicycle", alternately pulling your toes towards you and stretching them, as in ballet.
- You should be careful with water and heat procedures, because hot baths and showers, beach holidays in the sun and sunbathing can worsen the situation. The vessels need to be strengthened, this is facilitated by hardening with a contrasting shower, when warm and cold water are poured alternately onto the legs.
- For pain, inflammation and heaviness in the legs, daily cool foot baths should be made with a decoction of oak bark, chamomile, calendula, birch leaves, St. John's wort, white acacia flower and horse chestnut.
- It is useful to rub fresh juice from aloe vera leaves on the skin, it softens the skin and prevents inflammation.
- It's worth changing your habits and quitting smoking. The diet should consist mainly of vitamin-rich foods with lots of fiber, fresh vegetables, citrus fruits and seafood.
- You need to adjust your water intake by drinking enough water every day (1. 5 to 2 liters). At the same time, you should reduce your consumption of coffee, strong tea, chocolate and alcohol.
If the veins in your legs are swollen, your doctor may recommend that you wear compression stockings periodically or continuously.
Attention! In any case, you should listen to your doctor's recommendations and strictly follow them. Self-medication is unacceptable!
Cause of the disease
The family history of its occurrence allows us to conclude that varicose veins are genetically determined and can be transmitted genetically.
In many clinical cases, the exact cause of the disease cannot be determined. The researchers concluded that the culprit was a combination of several internal and external factors.
Causes of varicose veins:
- congenital defects of the valve system;
- physical inactivity, lack of activity;
- pregnancy;
- Working conditions with prolonged pressure on the legs, standing for long periods of time, in a static position;
- treatment with certain hormonal drugs;
- Uncomfortable shoes, high heels;
- fat;
- tight underwear, clothing that hugs the hips and knees (e. g. , very tight jeans, shapewear);
- Lift weights regularly;
- systemic pathology of the kidneys, heart and blood vessels;
- diabetes;
- Frequent intestinal problems, frequent diarrhea or constipation.
Varicose veins of the lower limbs (varicose veins)- superficial varicose veins of the lower limbs, accompanied by valve insufficiency and impaired blood flow. The term "varicose veins" comes from Latin. varix - "swollen".
As a result, the veins stop working normally, the entire circulatory system is disrupted, complicated by blockages, violations of nutrition in tissues and blockages of blood vessels due to blood clots.
Many complications are life-threatening, therefore, if the onset of varicose veins is suspected, diagnosis and treatment must be carried out immediately and professionally.
Types of diseases
Blood flow in the vessels changes, slows down, and blood clots can form in uneven vessel walls. Changes in blood vessel function cause blood stasis, venous insufficiency and peripheral capillary circulation disorders.
According to WHO, varicose veins occur in 45% of women and 20% of men.
According to the widely accepted international classification CEAP, varicose veins are divided into six disease stages, based on the fact that C0 is the complete absence of subjective, visual and clinical signs.
- C1 – early stage, manifested by a network of capillaries and spider veins on the skin.
- C2 – veins under the skin are thickened, veins in the lower limbs have a blue fibrous appearance.
- C3 – leg swelling appears due to prolonged standing on the leg or due to a state of rest (night sleep).
- C4 – skin surface changes, irregular pigmented areas appear, venous eczema, accompanied by itching and ulceration, liposclerosis.
- C5 – venous ulcers on the skin surface will heal after a while.
- C6 – non-healing venous trophic ulcer.
The classification of varicose veins of the lower extremities distinguishes between superficial and/or deep vessel pathology and perforated veins.
By origin, venous deformities can be:
- congenital, manifests in newborns;
- buy;
- secondary, arising on the basis of other diseases and injuries;
- Idiopathic, cause unknown.
The complete classification of varicose veins of the lower limbs and organs also includes complications - reverse blood flow, reflux and/or occlusion, obstruction of the vessel lumen.
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 (hemorrhoids), pelvic veins, female genital organs- vulva, labia, uterus.
Surgical treatment of varicose veins
RFO (radiofrequency ablation of the saphenous vein)is a modern method of treating varicose veins. Treatment involves applying radiofrequency radiation to the inner wall of the vein. Using the thermal effect, the vein is "sealed", disconnected from the general blood flow and after a few months is replaced by connective tissue.
Favorable
- The procedure is performed without general anesthesia, local anesthesia is enough;
- Maximum safety for patient health
- RFA requires no special preparation;
- During the operation, the patient does not feel pain or discomfort;
- Radiofrequency vein ablation of the lower extremities is highly effective;
- The likelihood of complications is low, most patients tolerate this procedure well;
- Radiofrequency ablation may be combined with small branch phlebectomy or sclerotherapy;
- After radiofrequency ablation there are no scars or marks left;
- Literally a few days after the procedure, the patient will be able to return to his normal lifestyle.
How did things go?
The intervention is performed under ultrasound control. Before the procedure begins, local anesthesia is administered so that the patient does not feel pain or discomfort during the treatment.
Let's see how RFA is performed step by step:
- Before surgery, the lower limbs are thoroughly treated with antiseptics. Then, the doctor uses a marker to mark veins that are susceptible to varicose veins. The doctor then inserts a radiofrequency catheter into the vein and treats the desired area with radiofrequency waves.
- At the end of the procedure, the catheter is removed, the doctor bandages and helps the patient wear a compression garment.
- The procedure lasts from 30 to 50 minutes. To stop blood flow through a weakened vessel, it must be destroyed. The body will then redirect blood through healthy veins. As a result, after removal, the walls of the veins stick together and scar tissue forms inside (safe and unnoticeable), varicose veins disappear.
Rehabilitation
Immediately after surgery, the patient must walk (about 30 minutes) to avoid stagnation of blood and lymph. After radiofrequency vein ablation of the lower extremities, the doctor's recommendations should be carefully followed:
- During the week, increased physical activity and heavy lifting are prohibited;
- It is necessary to walk more, stay in the same position as little as possible (except when sleeping);
- For 3-4 weeks you need to stop taking hot baths, you can only take showers;
- You must stop visiting the bathhouse for at least a month;
- Need to drink as much regular water as possible, about 2. 5 liters on average, and at the same time need to minimize salt consumption;
- One week after surgery, you will need to start physical therapy, your doctor will tell you;
- It is possible that after radiofrequency ablation of lower limb veins, the doctor will prescribe some medications.
Following these rules will help you avoid complications and prevent further development of varicose veins.
One week after surgery, a follow-up examination is required (ultrasound of the veins of the lower extremities). You can learn more detailed information about radiofrequency vein ablation of the lower extremities during a direct consultation with a specialist.
Laser venous coagulation
Endoscopic (endovenous) laser coagulation (removal) of varicose veins (EVLK, EVLO) is a modern method designed to eliminate blood reflux in superficial and perforating veins using radiant heat energy. laser. EVLO allows you to perform it without an incision and does not require the patient to be hospitalized. The international term is EVLA (endovenous laser ablation).
Main stages
- Puncture a vein. Done under ultrasound guidance.
- Positioning light guide. The light guide is a thin optical fiber. Laser radiation is delivered to its very tip. The light tube is inserted into the diseased vein. Its end is inserted at the point where the dilated vein flows into healthy deep veins, that is, at the junction.
- Soft tissue anesthesia. An anesthetic "cushion" is created around the vein to better squeeze the vein into the light guide and avoid damage to surrounding tissues.
- Laser venous coagulation. Laser radiation is supplied to the working part of the light guide.
- At the same time, the light guide tube is slowly withdrawn from the vein. The vein is thus uniformly heated by the laser to a temperature of 85°C. Heated veins, like any protein, contract when heated. The lumen of the vein disappears, the flow of blood through it stops.
Rehabilitation
Immediately after surgery, the patient must walk (about 40 minutes) to avoid stagnation of blood and lymph. After lower extremity venous EVLO, you should follow your doctor's recommendations:
- During the week, increased physical activity and heavy lifting are prohibited;
- It is necessary to walk more, stay in the same position as little as possible (except when sleeping);
- For 3-4 weeks you need to stop taking hot baths, you can only take showers;
- You must stop visiting the bathhouse for at least a month;
- Need to drink as much regular water as possible, about 2. 5 liters on average, and at the same time need to minimize salt consumption;
- One week after surgery, you will need to start physical therapy, your doctor will tell you;
- Your doctor may prescribe certain medications after surgery.
Sclerotherapyis a non-surgical (minimally invasive) method of removing varicose veins and spider veins of the lower limbs.
Benefits of venous sclerotherapy:
- Absolute outpatient care, no additional preparation required,
execution speed, - no anesthesia required,
- There are no typical complications of surgical treatment such as nerve damage,
- There is no phenomenon of "thermal phlebitis", characteristic of coagulation methods, accompanied by persistent pain along the coagulation vein.
Therefore, today sclerotherapy for treating varicose veins is a safe and effective method, which in some cases can be used as an alternative to other types of surgical intervention.
Sclerotherapy is based on obliterating the vein by introducing a chemical substance into its lumen, which "washes out" the inner layer (endothelium) with the subsequent development of endothelial disease. The degree of endothelial damage depends on the concentration and volume of the drug administered.
The modern medical center uses advanced technologies in the treatment of varicose veins, ensuring maximum effectiveness for all treatments. The use of modern equipment by experienced specialists will help you get rid of varicose veins in the shortest possible time, without complications and the need for long-term rehabilitation.
Treatment at a modern clinic means health and a significant improvement in quality of life.