A team of qualified cardiovascular surgeons/phlebologists at the clinic diagnoses and treats all types of varicose veins at any stage of the disease, as well as accompanying pathologies. Our proudest asset is the treatment according to Israeli protocols, which show maximum effectiveness in clinical practice.
Varicose veins - the triggering factor for the development of varicose veins is considered to be a violation of the normal functioning of the venous valves with the occurrence of a reverse flow (reflux) of blood.
As a rule, the valves that are subjected to the maximum mechanical load are the first to be affected. In this case, the pathological discharge of blood takes place through the mouth of the great and small saphenous vein, sometimes through large perforating veins. The excessive blood volume occurring in the superficial veins gradually leads to overstretching of the venous wall. The total volume of blood contained in the superficial venous bed of the lower extremities increases. This increased blood volume continues to drain into the deep system through the perforating veins, overstretching them. As a result, dilatation and valvular insufficiency of the perforating veins occurs.
Symptoms and signs of the disease
Signs of disease are not necessarily associated with pain. On the contrary, most patients claim that at the beginning of the disease they are more concerned about aesthetic problems than pain.
The clinical picture depends on the localization of the pathological process, as well as on the stage of the disease.
Varicose veins of the lower extremities are manifested as follows:
- Heaviness in the legs, feeling of fullness in the legs.
- The appearance of cramps in the calf muscles, leg and toe cramps.
- Feeling tired after a long walk.
- Swelling of the ankle in the evening.
- Venous relief pattern on the skin, cobwebs, cobwebs.
- The signs accompanying the disease are cellulite, itching of the legs, dry ankles and calves, thin and loose skin, long-healing ulcers, uneven pigmentation - from dark spots to colorless areas, pronounced nodular formations with a color from bluish to dark purple or burgundy. , trophic ulcers.
Progressive venous disease is accompanied by deterioration of general health:
- Unstable blood pressure, hypertension, hypotension.
- A feeling of chronic fatigue, apathy develops.
- Arrhythmia, tachycardia.
- Shortness of breath, frequent diseases of the respiratory system.
The obvious symptoms of varicose veins of the lower extremities in women may appear more strongly before menstruation and decrease after it.
Symptoms of venous pathology of the upper extremities are characterized by numbness of the hands, spastic conditions of the fingers, a sensation of goosebumps, numbness and coldness.
Varicose veins of the esophagus are manifested by belching, burning sensation, pain behind the sternum, inflammation of the esophagus and stomach, difficulty swallowing and signs of reflux esophagitis, 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 studies.
The following methods are most often used for diagnosis:
- duplex or triplex ultrasound angioscanning;
- phlebography with contrast;
- MRI with venography;
- contrast angiography.
To determine the presence of reflux in the affected veins and to assess the blood flow, several test manipulations are performed:
- Checking veins with compression of different segments.
- Valsalva maneuver or tension test.
- Parana imbalance test to evaluate veins in the calf area.
- Walking test with different intensities.
Additional methods to clarify the diagnosis:
- Plethysmography to determine venous reflux, obstruction.
- CT, MRI to visualize the 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 vessel walls from the inside.
The results of the performed diagnostic tests are evaluated comprehensively. Each diagnosis is of great help in determining further treatment tactics.
Clinical laboratory tests of blood and urine complete the picture of the disease and may show concomitant pathologies.
How are varicose veins treated?
If alarming symptoms of varicose veins appear, you should consult a doctor to diagnose and start timely treatment. In regional medical institutions, general surgeons deal with this problem, in clinics - phlebologists and angiosurgeons.
The multidisciplinary medical clinic has a well-equipped department of phlebology, in which a team of surgeons with extensive practical experience works. The center offers a high level of service and quality of treatment, which is expressed in the excellent clinical results of which we are proud.
Varicose veins of the lower extremities and other types of pathology can be treated in the first stages of development. As the process progresses, it turns out to be increasingly ineffective, partially retaining only symptomatic value.
Therapeutic effects cannot completely eliminate the disease, but as long as it is possible to slow down the destruction of blood vessels and the development of complications, this should be done by all available means.
Conservative treatment
- At the beginning of the treatment of varicose veins, drugs are limited to venotonic agents.
- To reduce the risk of thrombosis and occlusion, injections with anticoagulants and low molecular weight heparin-fragmin are used.
- New oral anticoagulants.
- For inflammatory phenomena in the blood vessels and surrounding tissues, the use of non-steroidal anti-inflammatory external agents with diclofenac and indomethacin is indicated.
How to further treat varicose veins?
In parallel with the therapeutic treatment, the patient is recommended to perform certain exercises that strengthen the muscle corset of the lower limbs and have a general strengthening effect. For example, the best exercises in a lying position are the "bicycle", alternately pulling the toes towards you and stretching them, as in ballet.
- You need to be careful with water and heat procedures, as hot baths and showers, beach holidays in the sun with sunbathing can worsen the situation. The vessels must be strengthened, this is facilitated by hardening with a contrast shower, when warm and cold water is poured alternately on the legs.
- For pain, inflammation and heaviness in the legs, daily cool foot baths with decoctions of oak bark, chamomile, calendula, birch leaves, St. John's wort, white acacia flower and horse chestnut are 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 giving up smoking. The diet should be dominated by vitamin-rich foods with a lot of fiber, fresh vegetables, citrus fruits and seafood.
- You should adjust your drinking regime by drinking enough water daily (1. 5 to 2 liters). 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 intermittent or permanent wearing of compression stockings.
Causes of the disease
The family history of occurrence allows us to conclude that varicose veins are genetically determined and can be inherited.
In many clinical cases, it is impossible to establish the exact cause of the disease. The researchers concluded that the culprit was a combination of several internal and external factors.
Causes of varicose veins:
- congenital defect of the valve system;
- lack of physical activity, lack of activity;
- pregnancy;
- working conditions with prolonged load on the legs, long standing periods, in a static position;
- treatment with certain hormonal drugs;
- uncomfortable shoes, high heels;
- obesity;
- tight underwear, clothes that tighten the hips, knees (for example, very tight jeans, shapewear);
- lifting weights regularly;
- systemic pathology of the kidneys, heart and blood vessels;
- diabetes;
- regular bowel problems, frequent diarrhea or constipation.
Varicose veins of the lower extremities (varicose veins)- expansion of the superficial veins of the lower limbs, accompanied by valvular insufficiency and impaired blood flow. The term "varicose veins" comes from the Latin varix - "swelling".
As a result, the veins stop working properly, the entire circulatory system is disturbed, it is complicated by congestion, disruption of tissue trophism and clogging of blood vessels with blood clots.
Many complications are life-threatening, therefore, if varicose veins are suspected, diagnosis and treatment should be carried out immediately and professionally.
Types of diseases
The blood flow in the vessels changes, slows down, and blood clots can form in uneven walls. Changes in the functionality of blood vessels cause blood stagnation, venous insufficiency and permanent disturbances of capillary blood 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 CEAP, varicose veins are divided into six classes-stages of the disease, based on the fact that C0 is the complete absence of subjective, visual and clinical signs.
- C1 – initial stage, manifested by a capillary network and cobwebs on the skin.
- C2 – visible thickening of the veins under the skin, venous pattern of the lower extremities in the form of blue threads.
- C3 - swelling of the legs occurs as a result of prolonged standing or a state of rest (night sleep).
- C4 – the surface of the skin changes, unevenly pigmented areas appear, venous eczema accompanied by itching and ulcers, lipodermatosclerosis.
- C5 – venous ulcers on the surface of the skin that heal after some time.
- C6 – non-healing venous trophic ulcers.
The classification of varicose veins of the lower extremities distinguishes pathology of superficial and / or deep vessels perforating communicating veins.
By origin, the venous deformity can be:
- congenital, manifested in infants;
- acquired;
- secondary, occurring against the background of other pathologies, injuries;
- idiopathic, of unknown cause.
The complete classification of varicose veins of the lower limbs and organs also includes complications - reverse blood flow, reflux and/or occlusion, blockage of the lumen.
Varicose veins of the lower extremities are not the only manifestation of varicose veins, but the most common. There are also varicose veins of the esophagus, sublingual veins, retina, scrotum (varicose veins in men), stomach, cavernous bodies of the rectum (hemorrhoids), pelvic veins, female genital organs - vulva, labia, uterus.
Surgical treatment of varicose veins
RFO (radiofrequency saphenous vein obliteration)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 "welded", disconnected from the general blood flow and after a few months is replaced by connective tissue.
Advantages
- The procedure is performed without general anesthesia, local anesthesia is sufficient;
- Maximum safety for the patient's health
- RFA requires no special training;
- During the manipulation, the patient does not feel pain and 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 miniphlebectomy of tributaries or sclerotherapy;
- After radiofrequency ablation, no scars or traces remain;
- Literally a few days after the procedure, the patient will be able to return to his normal lifestyle.
How it goes
The intervention is performed under ultrasound control. Before the start of the procedure, local anesthesia is applied so that the patient does not feel pain or discomfort during the procedure.
Let's take a look at how RFA is performed step by step:
- Before the operation, the lower limbs are thoroughly treated with antiseptic agents. The doctor then uses a marker to mark the vein that is prone 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 applies a bandage and helps the patient put on a compression garment.
- The procedure lasts from 30 to 50 minutes. To stop blood flow through a weakened vessel, it must be destroyed. Then the body will only redirect the blood through healthy veins. As a result, after ablation, the vein walls stick together and form scar tissue inside (it is safe and not noticeable), and the varicose veins disappear.
Rehabilitation
Immediately after the operation, the patient should walk (about 30 minutes) to avoid stagnation of blood and lymph. After radiofrequency ablation of the veins of the lower extremities, it is necessary to carefully follow the recommendations of doctors:
- During the week, increased physical activity and weight lifting are prohibited;
- It is necessary to walk more, to be in the same position as little as possible (except for sleep);
- For 3-4 weeks you should stop taking a hot bath, you can only take a shower;
- You must stop visiting the bathroom for at least a month;
- It is necessary to drink as much plain water as possible, on average about 2. 5 liters, while you should minimize the amount of salt consumed;
- A week after the operation, you should start physiotherapy, 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 some medications.
Following these rules will help you avoid complications and prevent the further development of varicose veins.
A week after the operation, a re-examination (ultrasound examination of the veins of the lower extremities) is necessary. You can get more detailed information about radiofrequency ablation of the veins of the lower extremities during a personal examination with a specialist.
Laser coagulation of veins
Endovasal (endovenous) laser coagulation (obliteration) of varicose veins (EVLK, EVLO) is a modern method designed to eliminate blood reflux in superficial and perforating veins using thermal energy of laser radiation. EVLO allows you to do without incisions and does not require hospitalization of the patient in a hospital. The international term is EVLA (endovenous laser ablation).
Main stages
- Venous puncture. It is performed under ultrasound guidance.
- Light guide positioning. The light guide is a thin optical fiber. At its end, laser radiation is delivered. The light guide is inserted into the diseased vein. Its end is installed at the place where the varicose vein flows into healthy deep veins, that is, in the anastomosis.
- Tumescent anesthesia. A "cushion" of anesthetic is created around the vein to better press the vein against the light guide and avoid damage to the surrounding tissue.
- Laser venous coagulation. The laser radiation is fed to the working part of the light guide.
- At the same time, the catheter is slowly withdrawn from the vein. Thus, the vein is heated uniformly by the laser to a temperature of 85 °C. Heated vein, like any protein, shrinks when heated. The lumen of the vein disappears, blood flow through it stops.
Rehabilitation
Immediately after the operation, the patient should walk (about 40 minutes) to avoid stagnation of blood and lymph. After EVLO of the veins of the lower extremities, it is necessary to follow the recommendations of doctors:
- During the week, increased physical activity and weight lifting are prohibited;
- It is necessary to walk more, to be in the same position as little as possible (except for sleep);
- For 3-4 weeks you should stop taking a hot bath, you can only take a shower;
- You must stop visiting the bathroom for at least a month;
- It is necessary to drink as much plain water as possible, on average about 2. 5 liters, while you should minimize the amount of salt consumed;
- A week after the operation, you should start physiotherapy, which the doctor will tell you about;
- The doctor may prescribe some medications after the surgery.
Sclerotherapyis a method of non-surgical (minimally invasive) removal of varicose veins and spider veins of the lower limbs.
Advantages of vein sclerotherapy:
- absolute ambulatory care, not requiring additional training,
execution speed, - no need for anesthesia
- lack of complications characteristic of surgical treatment methods, such as nerve damage,
- the absence of "thermally induced phlebitis" characteristic of coagulation methods, accompanied by nagging 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 method of sclerotherapy is based on obliteration of the vein by introducing a chemical into its lumen, which "washes away" the inner layer (endothelium) with the development of subsequent endofibrosis. The degree of damage to the endothelium depends on the concentration and volume of the drug administered.
The modern medical center uses modern technologies for the treatment of varicose veins, ensuring maximum effectiveness of all treatment measures. The use of modern equipment by experienced professionals will save you from varicose veins in the shortest possible time, without complications and the need for long-term rehabilitation.
Treatment in a modern clinic means health and a significant improvement in the quality of life.