Vein diseases and their symptoms. Vein Diseases You Should Know

The danger of such pathologies is that in the absence of specific treatment, their course is aggravated and leads to the development of complications that affect not only the general condition of the body, but also threaten the patient's life. It is possible to prevent this if the patient, knowing the main signs of the disease of veins in the legs, promptly contact a medical institution for medical help.

Types of diseases of the veins of the lower extremities

There are few disease-causing processes related to the field of phlebology in comparison with other nosological forms.

The classification of diseases of the veins of the lower extremities includes only 5 items and is as follows:

Varicose veins of the lower extremities.
Post-thrombotic syndrome.
Thrombosis of deep veins in the legs.
Anomalies in the development of blood vessels on the legs, both congenital and acquired.
(acute or chronic).

The initial stages of development of these pathologies have similar symptoms, therefore, if warning signs appear, it is necessary to undergo a detailed examination as soon as possible to differentiate the disease.

What can lead to the development of pathology

One of the main provoking factors, as a result of which diseases of the legs, veins, vessels on the lower extremities develop, is a genetically determined weakness of the structure of the vascular walls in the body.

Other reasons for the formation of a pathological condition include:

Excessive weight gain. With obesity of any degree, the load on the lower extremities increases several times, which creates the prerequisites for the expansion of the weakened sections of the venous lines.
Increased concentration of estrogens and progestogens in the body. They are among the female hormones, which explains the increased vulnerability of the beautiful half of humanity to this category of diseases.
Excessive physical activity as a result of heavy physical work or strength training.
An increase in psycho-emotional stress, a patient's stay in a stressful state for a long time leads to the activation of the synthesis of biologically active substances and a decrease in the body's resistance to unfavorable external factors.
Violation of the balance of the diet. Eating excessively fatty, spicy, spicy foods provokes a violation of metabolic processes and an increase in the concentration in the bloodstream of compounds that have a damaging effect on the walls of blood vessels.
The period of gestation. In this case, in women, the development of diseases of the veins of the lower extremities can be provoked both by a change in the hormonal background, an increase in the load on the vessels of the legs due to an increase in the weight of the fetus, and by the compression of the increasing uterus of the blood lines in the small pelvis, which leads to a violation of blood circulation through them. ...

Investigating the causes of pathological disorders in the venous lines of the lower extremities, specialists in most cases determine the presence of several factors in the patient that triggered the launch of pathological mechanisms.

What underlies the development of diseases of the veins in the legs

The pathogenesis of varicose veins of the lower extremities, as well as other diseases of this category, is the defeat of the vascular valve apparatus. Normally, the valves of the venous lines prevent the retrograde movement of blood in the vascular bed.

Under the influence of unfavorable factors that provoke deformation of the walls of the veins, their valves are weakened and cannot withstand the pressure exerted on them by the blood. This leads to a reverse flow of blood and the formation of its stagnation in the peripheral parts of the lower extremities.

As the disease worsens, the intensity of pathological disorders increases, up to complete damage to the valve apparatus of the venous vessels. This entails a violation of metabolic and gas exchange processes in the lower parts of the legs, as a result of which the structure of tissues in the affected area is disrupted.

How do diseases manifest?

In most clinical cases of lesions of the venous lines of the lower extremities, the initial pathology is varicose veins. Therefore, answering the question, what is the name of the disease of the veins in the legs, we can confidently indicate precisely varicose veins.

Regardless of the type of leg vein disease, the symptoms of pathological disorders are identical.

In the initial stages the formation of the pathogenic process, patients note increased fatigue of the legs, the formation of edema of the feet. Such violations are short-lived and go away on their own after the person rests.

As the disease progresses, prolonged standing in an upright state can provoke the appearance of pain in the lower parts of the legs, swelling and veins become more pronounced and are formed not only on the feet, but also on a part of the lower leg.

To eliminate the feeling of discomfort in the lower extremities, a person needs more time and effort - giving an elevated position to the legs, cool baths for the feet.

When the pathological condition passes into the subcompensated stage development, the intensity of functional vascular disorders increases - on the skin there are areas of abnormally dilated small blood vessels (venules and arterioles).

Telangiectasias, better known as spider veins or spider veins, are localized mainly on the inner thigh or in the popliteal region.

Quite often, patients do not pay due attention to this symptom, perceiving the appearance of telangiectasias not as the initial signs of varicose veins of the lower extremities, but purely as a cosmetic defect.

In the subcompensation stage development of the pathogenic process, specific symptoms are complemented by the occurrence of cramps of the calf muscles at night.

If at this stage, when the disease of the veins in the legs is clearly manifested, there is no treatment, there is a violation of the trophism of the tissues of the peripheral parts of the lower extremities (the lower third of the leg) - the skin becomes excessively dry, flabby.

In the future, on their surface, first, eczema forms, and subsequently ulcerations form. Depending on the degree of tissue trophism disturbance, ulcers are able to heal or not heal.

In the subcompensated stage the development of venous diseases, a violation of the rheological properties of blood occurs - it becomes more viscous, which causes a tendency to increased thrombus formation. Changes in laboratory blood counts are also defined as symptoms of varicose veins of the lower extremities.

If a patient at this stage of development has varicose veins of the lower extremities, but treatment is not carried out, this ends with the transition of the pathological state to the stage of decompensation, when extremely severe complications are formed - thrombophlebitis, thrombosis, damage to the tissues of the lower extremities up to necrosis. They can be eliminated only through surgical methods of treatment.

The success of the treatment of diseases of the veins in the legs is in direct proportion to the stage at which the development of the disease-causing process the patient turned to a medical institution for specialized help.

Diagnostic measures

When treating a person with signs indicating varicose veins of the lower extremities, the medical history (anamnesis) is of paramount importance.

After conducting an external examination, collecting anamnesis and determining characteristic complaints, the phlebologist prescribes a detailed examination:

clinical and biochemical blood tests;
ultrasound examination of the venous lines of the legs using Doppler ultrasound;
angiography is an X-ray method for examining the vascular bed with the preliminary introduction of a contrast agent into it. This examination method is used for the differentiated diagnosis of diseases of the internal veins of the legs.

In some clinical cases, the attending physician may prescribe additional consultations of related specialists. Having at his disposal all the necessary diagnostic data, the phlebologist can decide on the organization of adequate treatment for varicose veins of the lower extremities.

This principle also applies to other diseases leading to structural disorders of the venous lines and formed as complications of varicose veins of the lower extremities - thrombophlebitis, thrombosis, chronic venous insufficiency.

Treatment activities

In solving the problems of eliminating pathological disorders of the veins, manifested in the deformation of their walls, damage to the valve apparatus and the formation of stagnation in the peripheral parts of the lower extremities, an integrated approach is used. The standards for the treatment of varicose veins of the lower extremities include the following measures:

To increase the elasticity of the walls of venous vessels at the site of the lesion, eliminating pain, providing anti-inflammatory effects and eliminating edema, local use of drugs belonging to the pharmaceutical group of venotonics is shown. They are available in the form of gels, liniment and can be of both synthetic and vegetable origin. Regardless of the type of drug chosen (Lioton gel, Troxevasin or Heparin ointment and others), the result obtained is the same in all cases.
To enhance the therapeutic effect of local application of venotonic , drugs of this group are also prescribed for internal administration in the form of tablet forms or syrups, drops (Detralex, Doppelgerz, Venoruton and others). The choice of the drug, the regimen and duration of treatment is determined by the doctor.
To correct the rheological properties of blood phlebologists prescribe medication, the active ingredient of which is aspirin (Aspirin Cardio, Cardiomagnyl and others).
The use of exercise therapy methods for the correction of pathological disorders in the legs allows you to increase the tone of both the vascular walls and muscle fibers surrounding the venous lines in the affected areas of the lower extremities.
Daily hardening of the vessels of the legs in the form of a contrast shower or contrast baths allows you to enhance the therapeutic effect of drug therapy.
To consolidate the result and to prevent the aggravation of pathological disorders of the venous walls, the use of compression hosiery is shown, which exerts the necessary pressure on various parts of the lower extremities, thereby relieving some of the load experienced by the weakened veins of the legs.
To eliminate the affected areas of the venous lines of the lower extremities in the subcompensated stage of the development of the pathological process, such methods of treatment as sclerotherapy and laser correction are successfully applied.
With the development of severe complications (thrombophlebitis, thrombosis) it is possible to correct the pathological condition only by promptly removing the entire affected vein.

On condition of early treatment of the patient, the duration of treatment of vascular deformities is significantly reduced.

Preventive actions

Prevention of varicose veins of the lower extremities, as well as other pathological disorders belonging to this category, consists in observing the following recommendations:

Making maximum efforts to reduce body weight with a history of obesity.
Balancing work and rest regimes, allocating sufficient time for sleep at night.
Implementation of health-improving physical activity into practice (cycling, walking, visiting gyms or gyms). The main condition for this is that physical exercises must be carried out, at least at the initial stages, under the guidance of an experienced trainer, in order to prevent overloading of the vascular bed.
The use of medical compression underwear. A qualified specialist helps to choose the right jersey.
Development of a balanced diet, maximum limitation of the use of harmful products.
Getting rid of addictions, alcohol abuse, smoking.
Reducing stress levels in everyday life.

An attentive attitude to any manifestations of incipient pathological disorders in the body and timely referral to medical specialists allow avoiding serious complications that can lead to the patient's disability.

A set of exercises for diseases of the veins of the legs

All diseases of the veins are accompanied by functional changes in the vascular system, such as impaired outflow and flow of blood to organs and limbs, venous hypertension, defects in the valve apparatus, trophic changes, etc. The lower extremities are more often affected, since they have the greatest stress during life. Vein problems can cause serious complications and lead to disability.

Causes of venous diseases

Factors causing lower limb disease:

genetic dysfunction (weakness of the connective tissue in the blood vessels);
gender (women are more likely to get sick);
pregnancy (hormonal changes lead to a weakening of the tone of the vascular walls);
age (people over 50 are more susceptible to the development of varicose veins);
a profession that requires prolonged standing on its feet, which leads to stagnation of blood;
hard physical labor;
obesity;
limb injuries;
flat feet;
constipation.

Types and symptoms

Vascular diseases progress gradually and are chronic.
Cramps and muscle pain can be a sign of vascular pathology.
Depending on the severity, symptoms of leg vein disease include:
muscle pain or cramps;
discoloration of the skin;
white atrophy of the skin;
swelling;
heaviness in the legs;
dermatoliposclerosis;
dermatitis;
dry or weeping eczema.

Thrombosis and thromboembolism
A pathological condition characterized by impaired circulation due to the formation of blood clots (thrombi) that block the bloodstream is called thrombosis. A common complication of the disease is hypoxia, resulting from obstruction of the veins and arteries. The blood clot may break off and begin to travel through the body (thromboembolism). A thrombus prevents blood flow to the main organs, which is fraught with serious consequences for a person's life, for example, clogging of blood vessels in the lungs (), brain (stroke), gastrointestinal tract, kidneys, etc. suddenly. Thromboembolism is the leading cause of disability and death in patients.
With varicose veins, the veins look swollen.
The disease develops due to thinning of the venous walls and vasodilation. This causes the valves preventing the backflow of blood to stop closing. The circulation process slows down, blood accumulates, causing the veins to expand even more. The blood vessels in the legs usually appear swollen, bluish purple or red in color, and are sometimes painful to touch.
Trophic ulcer
A long-lasting wound caused by poor circulation is most often localized on the foot or lower leg. It appears when the tissues stop receiving the necessary nutrients, which leads to the extravasation of inflammatory mediators into the subcutaneous tissues, which then begin to break down, capturing the skin. The wound gradually enlarges, causes severe pain, itching, fever, and is often complicated by a wound infection. Healing is difficult, with an unfavorable outcome, an infected trophic ulcer leads to a general infection of the body with a threat to life.

Chronic venous insufficiency
The disease is associated with dysfunction of valves and venous hypertension, as a result of which the contents of the vessels penetrate into the surrounding tissues. There is a breakdown of blood cells, inflammation develops, accompanied by tissue edema, microcirculation disorders, trophic changes. Signs of the disease are hyperpigmentation, persistent dilatation of small vessels (telangiectasia), varicose veins, which increases in the evening and decreases in the morning puffiness.

Such a pathology in a man can lead to serious consequences.
The disease is similar to varicose veins of the lower extremities, but is detected in the vessels that deliver blood to the reproductive glands in men. Such an anomaly occurs in the scrotum and is accompanied by the expansion of the veins in the uviform plexus of the spermatic cord. Varicocele can lead to a decrease in the production and quality of sperm, in some cases to infertility. Pathology is detected more often in men aged 15-25 years. The disease is signaled by pulling and bursting pains, a feeling of heaviness and discomfort in the scrotum, a noticeable expansion of the veins.

Phlebitis and thrombophlebitis
Acute or chronic inflammation of the vascular walls is called phlebitis. Most often, the disease develops with varicose veins. Superficial phlebitis is an inflammation of blood vessels near the surface of the skin, it is not dangerous and can be the result of small blood clots or some irritating factors. Deep phlebitis refers to inflammation of deeper, larger veins and often turns into thrombophlebitis - inflammation of the wall, accompanied by the formation of blood clots, which is facilitated by increased blood viscosity. The disease can have serious, life-threatening consequences.
Hemorrhoidal disease

The disease often proceeds in parallel with the defeat of the veins in the legs.
Disease of the veins in the legs contributes to the occurrence of hemorrhoids - varicose veins of the rectum. Hemorrhoids are one of the varieties of venous disease, with the only difference in localization. The causes of the disease are identical - constipation, inactivity and any effects that put pressure on the organs in the pelvic region. If identified, the likelihood of developing hemorrhoids increases. This is due to the fact that impaired blood flow in the legs is interconnected with blood circulation in the vessels located near the anus.

Venami called the vessels through which the blood moves towards the heart.

In the lower extremities, superficial, deep veins are distinguished, as well as their connecting - the so-called perforating - veins.

What is phlebology?

Phlebology called a branch of medicine related to the diagnosis and combined treatment of acute and chronic venous diseases. Phlebology, along with arteriology and lymphology, is a section of general angiology.

What are varicose veins?

Varicose veins(in common people - varicose veins) are overstretched, irregularly shaped, tortuous blood vessels that have lost their elasticity. They are increased in length and width and look like thick, convoluted blue ropes that show through under the skin. Veins become such when the venous valves are absent or for some reason cannot perform their functions. If the valves do not work as it should, blood flows in the opposite direction, downward, accumulates in the lower parts of the veins and expands their walls. As a result, the veins lose their natural shape, and a pathological chain of various complications begins.

What do varicose veins look like?

Varicose veins in different patients and even on different legs in the same patient are very different - both in appearance and in quantity. In some patients, varicose veins are generally invisible. In others, they bulge under the skin in ugly writhing cords and knots. But we must not forget that the severity of the disease rarely corresponds to the severity of such external manifestations.

How common is varicose veins?

Varicose veins are one of the most common diseases of the vascular system. According to some statistical calculations, varicose veins up to a third of the total population of Western countries suffers. The number of people who have varicose veins increases with age, with women getting sick much more often than men. According to statistics, in the age group under 25, only 8% of women suffer from varicose veins, and in the older age group - from 55 years and older - 64% of women are affected by varicose veins.

How can you recognize varicose veins in yourself?

The most common symptom of varicose veins is fatigue, dull pain, a feeling of heaviness and fullness in the legs after sitting or standing for a long time. Often these symptoms appear or worsen in the evening. In this case, it is usually impossible to determine exactly where it hurts. And if these unpleasant symptoms - fatigue, heaviness, pain - disappear after resting with raised legs, then they are really caused by varicose veins (unless some other reason has been reliably identified).

Nevertheless, do not rush to blame everything on varicose veins, especially if there are no external signs in the form of dilated veins. Some other painful conditions can also manifest themselves with the same symptoms.

Leg cramps

With varicose veins, painful nocturnal cramps in the muscles of the legs can indeed occur (in other words, "it brings the leg"). Most often, cramps appear in the calf muscles and can sometimes be so painful that the patient wakes up. Moreover, night cramps usually occur after a hard day, when the patient had to stand or sit a lot.

Where do varicose veins usually appear?

Varicose veins most commonly appear on the superficial veins of the legs, just under the skin, and usually involve the large saphenous vein that runs along the inner surface of the leg from the ankle to the groin.

Is varicose veins inherited?

It is now known that varicose veins are hereditary. Scientists even believe that they were able to isolate a separate gene responsible for the development of varicose veins. It is not yet clear whether this gene causes malformations of the venous valves or malformations of the vein walls themselves. But there is no doubt that these studies will help develop a method of gene therapy - perhaps the most promising way to prevent and treat varicose veins. Unfortunately, this is still a matter of a rather distant future, and gene therapy is not yet available to patients with varicose veins.

Varicose veins during pregnancy

Pregnancy does not cause varicose veins, but it often turns out to be a triggering factor for the appearance of varicose veins in those women who are predisposed to it. For example, in people with congenital insufficiency or even the absence of venous valves. This fact has already been established quite definitely, because many pregnant women do not have any varicose veins. Sometimes varicose veins appear only during the fourth, fifth or tenth pregnancy.

And for some women, they, having appeared during pregnancy, disappear immediately after the birth of the child. Pregnancy acts as a triggering factor for varicose veins due to the fact that during pregnancy, the content of sex hormones in a woman's blood sharply increases - estrogen and progesterone. These hormones in high concentration contribute to the softening of the venous walls, the veins are stretched, and the valves cannot close because of this.

Other causes of varicose veins

Such a widespread prevalence of varicose veins in highly developed Western countries is probably associated with the lifestyle of the population. For example, we spend a lot of time sitting on chairs. From kindergarten to graduation from school, a person sits at least 40 hours a week (counting about 5 hours in the afternoon in class, 3 hours in the evening - doing homework, watching TV, and so on - 5 days a week). Now we multiply this clock by 10 months a year, and so on - up to 17 years. Then - work in some institution, where you have to sit even more. When a person sits on a chair, the veins running along the back of the thighs are compressed, and the calf muscles (whose rhythmic contractions help move venous blood to the heart) do not work.

Another important factor is nutrition. In Western countries, people prefer a diet low in coarse fiber. With such a diet, the fecal masses are denser, and constipation often occurs. When straining to move solid feces, the abdominal muscles are strained, and the pressure in the abdominal cavity increases significantly. The high pressure spreads to the veins running along the back of the abdominal cavity and to the veins in the legs, which dilate as a result, causing venous valve failure.

Varicose veins in the elderly

Why varicose veins more common in older people, and especially in women?

1. In short, because their vascular system wears out with age and, sooner or later, fails. Nevertheless, there are still many objective reasons why older women are more likely to suffer from varicose veins than young men and women. First, since women generally live a little longer than men, there are correspondingly more older women than older men, and their veins have worked for a longer period of time.

2. Men don't get pregnant. Even if the varicose veins that appeared in a woman during pregnancy disappear soon after the birth of the child, all the same, within a few months, these veins were abnormally enlarged. And with age, all the muscles of the human body, including the smooth muscles of the vascular walls, become not as elastic as in youth. And the veins that have already dilated at some time during pregnancy, in old age, again become a little wider than normal.

3. Now a lot of women over the age of 30 resort to hormone replacement therapy, which was originally designed to relieve unpleasant symptoms of menopause. There is no doubt that hormone replacement therapy helps women both look younger and feel better, and generally endure the years of menopause more easily. Observations of doctors confirm that hormone replacement therapy to some extent reduces the frequency of angina attacks and prevents the decrease in bone strength due to osteoporosis.

However, hormonal supplements at the same time soften the venous walls in the same way as the increased levels of estrogen and progesterone during pregnancy. This side effect of hormonal pills is all the more dangerous because the walls of the veins are already becoming weaker - due to natural age-related changes in the muscle layer. So, more clinical studies are needed to finally clarify this issue.

Varicose veins

Varicose veins are subdivided into two main groups:

The first group includes primary varicose veins due to a hereditary predisposition to varicose veins.
The second group includes varicose veins that appear after damage to the venous walls as a result of trauma with the formation of blood clots in the veins or thrombosis.

When a clot or thrombus passes through a vein, the integrity of the venous valves is disrupted and secondary varicose veins are formed.

Varicose nodules

Varicose nodules- These are bundles of thin crimson or red thread vessels that appear around the knees or ankles. (Sometimes such vascular "cobwebs" can appear on the face, near the nose.) These vessels cannot be called varicose veins, because, by definition, varicose veins- these are veins increased in length and diameter. In fact, these are slightly dilated venules (vessels that connect the capillaries to the veins proper), which are located close to the surface of the skin.

Such expanded venules appear due to the increased content of female sex hormones in the blood and are often found in women taking oral contraceptives. But venules can also expand in the presence of externally not manifested varicose veins of larger veins. However, women with varicose nodules often have symptoms that are very similar to the manifestations of varicose veins.

Treatment of varicose veins

Treatment depends on the severity of the disease. If the disease does not manifest itself too much, then conservative treatment is best suited:

regular rest with my legs raised,
elastic bandage (siltand special elastic stockings),
exercise for the muscles of the legs.

If these measures are not enough, the veins affected by varicose veins must be surgically removed at the Phlebology Center. Or, using new, experimental techniques - elastic strengthening of the venous walls is performed surgically. That is, a special elastic plastic cover is put on the outer surface of the affected veins in the places of varicose enlargements, where the incompetent venous valves are located. And, finally, for the treatment of dilated venules or varicose veins of small veins left after surgery, it is used sclerotherapy- that is, the introduction of sclerosing substances into the places of enlargement, from which there is a clogging of the pathological vein. Blood returns to the heart through normal venous vessels.

Complications during treatment

The main danger with conservative treatment (elastic stockings, exercise and rest with raised legs) is its possible ineffectiveness.

Surgical treatment of varicose veins of the lower extremities should now be performed by experienced vascular surgeons and phlebologists... Often complications and relapses after surgical treatment are caused by the fact that the operation was not performed by a specialist at the phlebology center.

With sclerotherapy, the main problem is small dark spots, which can remain at the injection sites for several months, in some cases forever.

Dilated veins after surgical treatment

If varicose veins have been removed, varicose veins in their place will no longer appear. However, sometimes varicose veins are found after the operation - in the veins that were not previously affected, or in small veins that were not detected during the preoperative examination. Varicose veins after surgery appear because the blood is forced to find new outflow pathways. At the same time, a larger volume of blood is redistributed to the remaining veins than before, and if there were any defects in the valves or walls in them, then new problems arise. New varicose veins, as a rule, bring cosmetic inconveniences and are easily eliminated by a phlebologist using modern sclerotherapy techniques.

Complications of varicose veins

The most common complications are thrombophlebitis. With the ascending nature of thrombophlebitis, when the inflammation spreads to the thigh. There is a danger of a life-threatening condition of pulmonary embolism. With pronounced stagnation (chronic venous insufficiency), the skin of the limb becomes dense, pigmented at the slightest injury, non-healing trophic ulcers open.

Prevention of the manifestation of varicose veins

If you have a hereditary predisposition to varicose veins, then sooner or later it will still manifest itself. However, it is still possible to delay the onset of the disease, you can smooth out its manifestations and even avoid the development of complications.

To do this, you need to follow a few rules.

1. You can not sit on a chair or stand for a long time. If you can choose between work, where you have to sit a lot, and work associated with constant movement, do not hesitate, choose the second. If you have to travel for a long time in a train or fly in an airplane, be sure to get up from the chair at least every hour. If you have to travel for a long time by car, stop at least every two hours and stretch your legs, walking for several minutes. If you definitely need to sit or stand for a long time, be sure to rest your veins at least once a day, lifting your legs up, above the level of your heart.

2. Do not wear tight clothing that squeezes the veins in the groin and hips. Do not wear tight stockings (other than medical elastic stockings that fit your leg), tight-fitting jeans, old-fashioned stockings, and long socks with elastic.

3. Take good care of your body. Don't overeat. Eat more high-fiber foods. Avoid obesity. In obese people, varicose veins are more severe and various complications develop much more often. Some surgeons refuse to operate on obese patients until they lose weight. Since obesity complicates the operation.

4. Keep your feet clean. It's no secret that a variety of infections often affect the elderly (and anyone!) Just because of insufficient hygienic care of the skin of the feet.

5. Try to move more only not on heels, but in comfortable shoes with low soles - this is how the calf muscles have a big load. Rather than taking the elevator, walk a few flights of stairs. Jog. Ride your bike. Dance. Swim. Do anything, just do not stand still for a long time and do not sit!

Varicose veins of the lower extremities is extremely common, and if earlier people of older age became patients more often, now people 25-45 years old often suffer from it. Its signs, according to various statistics, are observed in 66% of men and 90% of women from the population of developed countries and in 50% of men and 67% of women among residents of the Moscow region. This disease is progressive and can be combined with venous insufficiency.

Varicose veins of the lower extremities are accompanied by pathological expansion of the superficial veins, which is caused by insufficiency of the venous valves and is accompanied by a significant violation of hemodynamics. In the future, this pathology can be aggravated by thrombophlebitis, leading to an increased risk of developing phlebothrombosis and (PE).

The first trigger in the development of this pathology of the veins of the lower extremities is a malfunction of the venous valves, which leads to blood reflux. As a result, endothelial cells react to slowing down the blood flow, and leukocytes are fixed on them, which activate the inflammatory process in the vessel wall, spreading along the venous bed. In parallel with inflammation, the functions of the endothelial layer of the veins, and then all layers of the venous wall, are disrupted.

First of all and especially acutely from the above-described pathological processes suffers. First, the zone of maximum load is usually affected: in the mouth of the great and small saphenous veins or in large perforating vessels. Subsequently, due to the overflow of the venous bed, the venous walls are overstretched and the volume of venous blood in the superficial venous vessels of the lower extremities increases. Further, this excess volume enters through the perforating system into the deep veins and stretches them. In the future, they develop dilatation and insufficiency of the venous valves.

Such pathological changes lead to horizontal reflux (the throwing of part of the blood into the subcutaneous venous network) and the work of the venous pump completely loses its effectiveness. In the future, venous hypertension develops, leading to venous insufficiency. First, the patient develops edema, and then from the bloodstream into the soft tissues, blood cells also penetrate, which lead to hyperpigmentation and lipodermosclerosis of the skin. As the disease progresses, it appears on the surface of the skin, which can be complicated by a secondary infection.

Causes

Phlebologists point out several reasons that can lead to pathological disorders in the functioning of the venous system. They are divided into two main groups:

I - genetic predisposition;
II - a number of reasons due to the influence of unfavorable factors or their combination.

A hereditary predisposition to varicose veins can be determined in both women and men, despite the fact that in most cases this pathology is observed in women. The disease may not manifest itself for a long time, but under certain circumstances (for example, with intense physical activity), a malfunction of the valves of the veins is triggered.

Phlebologists also identify a number of adverse factors that can provoke varicose veins:

hormonal imbalance;
age;
diabetes;
frequent constipation;
previous surgery or injury;
hypercoagulation;
obesity;
addiction to alcohol and tobacco smoking;
professional risks (increased load, long forced standing position);
wearing underwear that squeezes the body;
long-term wearing of high-heeled shoes;
pregnancy and childbirth;
constitutional features and congenital anomalies of the circulatory system;
living in unfavorable climatic conditions.

Signs and symptoms

In the initial stages of the disease, patients are worried about the heaviness and fatigue of the legs at the end of the day.

In most cases, varicose veins develop slowly and gradually. At an early stage, it manifests itself in a few and nonspecific signs that can be combined into the "heavy legs syndrome":

feeling of heaviness in the legs;
rapid fatigue of the legs;
burning sensations and distention in the veins;
aching pains;
recurrent dorsum of the foot and ankles, increasing in the evening and disappearing after a night's sleep.

The main and first sign of the onset of varicose veins are the appeared saccular or cylindrical areas of dilated superficial veins. This symptom is accompanied by rapid fatigue of the lower extremities, burning and a feeling of fullness in the area of veins and a constant feeling of heaviness in the legs. The dilated vessels become convoluted and begin to protrude above the surface of the skin in the area of the feet and lower legs, and after a long walk or intense physical activity, they become more noticeable. Also, the patient may be disturbed by edema, which is especially pronounced in the evening in the area of the ankles, lower leg and back of the foot. At night, the patient may have convulsions. And in the later stages of the disease, due to insufficient blood circulation, the skin on the legs can become hyperpigmented and hardened.

In some cases, the first signs of varicose veins are manifested only by the so-called "spider veins" (a spider web of dilated veins no more than 0.1 mm thick), and the patient does not know about the onset of the disease for a long time. Some women perceive this symptom as just a cosmetic defect, and men simply do not notice it. Despite the absence of any other signs of varicose veins, it is "spider veins" that are the first and, in some cases, the only symptom of varicose veins, and a visit to a doctor at this stage of the disease can help the patient to significantly slow down the progression of pathological varicose veins.

Classification

Most often, Russian phlebologists use the form of classification of varicose veins, proposed in 2000, which takes into account the form of the disease and the degree of chronic venous insufficiency:

I - intradermal or segmental varicose veins without veno-venous discharge;
II - segmental varicose veins with reflux in perforating and / or superficial veins;
III - widespread varicose veins with reflux in the perforating or superficial veins;
IV - varicose veins with deep vein reflux.

Varicose veins can be:

ascending - veins begin to pathologically change from the foot;
descending - the development of varicose veins begins from the mouth of the great saphenous vein.

Also, when detecting varicose veins of the legs, to determine the tactics of treatment, it is important to take into account the degree of chronic venous insufficiency:

0 - CVI is absent;
1 - the patient has only “heavy legs” syndrome;
2 - the patient has transient edema;
3 - the patient has persistent edema, lipodermatosclerosis, eczema, hypo- or hyperpigmentation;
4 - a trophic ulcer forms on the surface of the legs.

Complications

Trophic ulcers

At the first stages of its development, varicose veins significantly worsens the patient's quality of life and gives him unpleasant moments in the form of a noticeable cosmetic problem. In the future, with the progression of the pathology, limbs can form, which are often complicated by a secondary infection. Initially, areas with a thinned, dry, tense and shiny surface appear on the surface of the skin (usually in the lower third of the lower leg). Subsequently, zones of hyperpigmentation appear on them and a small ulcer develops, increasing in size and giving painful sensations. In the future, its edges become denser, and the bottom is covered with a bloom of a dirty color and periodically bleeds. With minimal trauma, its borders increase significantly and the ulcer becomes infected.

Thrombophlebitis and thrombosis

With untimely or unqualified treatment, varicose veins of the lower extremities may be complicated by the development of thrombosis or. These diseases occur suddenly and are not associated with the influence of external adverse factors (for example, with intense physical activity). The patient develops significant and rapidly spreading edema throughout the leg, which is accompanied by severe bursting pains. In some areas of the skin, local soreness, redness, or cyanosis may appear. With the migration of a detached thrombus into the vessels of the lungs, such a severe complication of thrombosis of the lower extremities as PE can develop.

Diagnostics

Usually the diagnosis of "varicose veins" becomes obvious to the phlebologist already at the first examination of the patient. After examining the patient's complaints, examining the lower extremities and conducting a series of physical tests, the doctor will prescribe a number of studies to clarify the diagnosis and determine the tactics of further treatment:

clinical and biochemical blood test;
Ultrasound dopplerography;
duplex scanning;
occlusive plethysmography;
rheovasography;
X-ray contrast phlebography (prescribed only if the indicator of non-invasive techniques is questionable).

Treatment

The main goals of the treatment of varicose veins of the lower extremities are aimed at stabilizing and restoring the normal outflow of venous blood, improving the patient's quality of life and preventing the development of complications caused by venous insufficiency. Treatments can include:

Conservative therapy

Conservative methods of treating varicose veins involve a set of measures:

Reducing risk factors for disease progression. Patients with varicose veins and those in the group at increased risk of developing varicose veins are recommended constant dispensary observation by a phlebologist.
Fight against adynamia. Patients who do not have signs of thrombophlebitis or thrombosis are shown regular exercise therapy and some sports aimed at strengthening and training the veins of the lower extremities. The intensity of the load should be discussed with the attending phlebologist or physiotherapist. A beneficial effect on the state of the vessels of the legs is exerted by: walking, cycling, jogging, swimming. Such patients are advised to perform exercises (except for those performed in water) under conditions of additional compression created by special underwear or elastic bandages. Before training, the patient is advised to lie down for a few minutes with raised legs. Patients with varicose veins are contraindicated to engage in sports that are traumatic for the legs: various power martial arts and sports associated with weight lifting, skiing, tennis, basketball, volleyball, football.
Compression therapy. For dosed muscle squeezing, which helps to eliminate blood stasis and normalizes venous circulation, elastic bandages and compression hosiery of various compression classes are used. At 0 and 1 degrees of chronic venous insufficiency, knitwear of I-II class is recommended, at 2 - II class, at 3 and 4 - II or III (and in severe cases IV) class. Depending on the degree of venous damage, compression therapy for varicose veins of the lower extremities can be prescribed both for a limited and long term.
Drug therapy. Patients with varicose veins of the lower extremities, accompanied by 1-4 degrees of venous insufficiency, are shown a course of medication. It should be remembered that the appointment of drug therapy can only be performed by a doctor, since thoughtless use of drugs will not be able to relieve the patient of venous insufficiency and will only aggravate the disease. With adequate and well-chosen drug treatment and the implementation of the doctor's recommendations for compression and physiotherapy, the patient will be able to eliminate clinical symptoms, complications and compensation of venous insufficiency within 3-4 weeks. The following drugs can be included in the therapy regimen: and phlebotonics (Detralex, Troxevasin, Rutin, Cyclo 3 Fort, Ginkor-Fort, Aescin, Doxium), antiplatelet agents (Curantil, Trental, Aspirin), (Fraxiparin, Heparin), non-steroidal anti-inflammatory drugs (Dicloberl, Ibuprofen, Reopirin). With a complicated course of the disease and venous thrombosis, the therapy regimen can be supplemented with topical agents for local use (Curiosin, Lyoton, Troxevasin, Venoruton, Heparin ointment, etc.), and with the development of trophic ulcers and their infection - with antibiotics and wound healing agents.
Physiotherapy. The complex of medical procedures for varicose veins of the lower extremities can include a variety of procedures that contribute to the normalization of the tone of the walls of the veins, microcirculation and lymph drainage. For this, the patient can be prescribed: local darsonvalization, magnetotherapy, laser therapy, amplipulse therapy, intermittent pneumocompression, hyperbaric oxygenation and hydro- and balneotherapy (general and local baths from mineral waters, contrast, pearl and oxygen baths). Also, in the absence of contraindications, the patient may be shown courses of light massage, which must be performed by a specialist or independently (after learning a simple technique from an experienced massage therapist). Many patients with varicose veins may be recommended such insufficiently widespread methods of treatment as hirudotherapy and apitherapy.

Minimally invasive methods and surgical treatment

In the later stages of varicose veins, the patient may be shown minimally invasive methods of treatment or surgery. Indications for one or another type of surgery are determined individually for each patient, depending on the severity of symptoms and concomitant diseases.

Among minimally invasive interventions, currently the following can be used:

: the doctor injects a sclerosing substance into the pathologically altered vein, which promotes adhesion of the vascular walls, later they grow together, stop changing and transform into cicatricial cords, such drugs can be used as sclerosants: Thrombovar, Fibro-Wayne, Ethoxysclerol, Polydonacol, Sclerovein;
microsclerotherapy: one of the types of sclerotherapy, which involves the introduction of sclerosants into the veins of the "spider veins";
Foam-form sclerotherapy: one of the types of sclerotherapy, which is performed by injecting a sclerosant whipped into a foam into a vein;
microthermocoagulation: performed using a thin electrode, which is inserted into the thinnest veins of multiple "spider veins", under the influence of the current, the vessels coagulate and disappear;
endovasal laser coagulation: a laser beam is applied to the inner surface of a varicose vein, which has a thermal effect on it, and the vein grows together;
radiofrequency ablation of varicose veins: the affected vein is exposed to high-power radiofrequency radiation, which has an effect on it, similar to the effect of a laser.

Some of the minimally invasive treatments for varicose veins - sclerotherapy, endovasal laser coagulation and radiofrequency ablation - can be used as additional techniques during radical vein surgeries. Currently, the view on the surgical treatment of varicose veins has changed significantly. It is this type of treatment that is the main one, since it allows for a long time to eliminate all the symptoms of varicose veins and prevents its recurrence.

The classic phlebectomy, which was quite traumatic for the patient, was replaced by more gentle techniques that allow avoiding large incisions and performing the most accurate excision of the affected vessels. Depending on the severity of the disease, the following techniques can be used:

Stripping (varieties: cryostripping, invagination stripping, with the Babcock probe, PIN stripping). During the intervention, the surgeon makes only two small incisions, at the beginning and at the end of the vein to be removed. The transected vessel is squeezed, and a special probe is inserted into its lumen, to which the affected vein is fixed. Then the vein is removed, tied up and cut off. If necessary, a short stripping can be performed to remove only a portion of the varicose vein and to preserve the intact vein.
Miniflebectomy. This technique allows you to remove varicose vein segments through small skin punctures.
Crossectomy. During the operation, the surgeon performs bandaging and transection of the small or large saphenous veins at the level of their anastomoses with deep veins. This type of intervention is used independently only in emergency cases, and with planned treatment it is used as an additional technique.

The indication for combined phlebectomy is varicose veins with reflux in the area of the trunks or anastomosis of the small and large saphenous veins. As a rule, modern angiosurgeons for the treatment of varicose veins always use a different combination of surgical and / or minimally invasive methods of treatment.

Contraindications for combined phlebectomy:

period of pregnancy and lactation;
suffered repeated thrombosis;
acute thrombosis and thrombophlebitis;
pronounced atherosclerosis of the vessels of the legs;
infectious and inflammatory processes of the skin of the legs;
severe obesity;
the inability to independent and full-fledged movement;
severe general diseases that are contraindications to surgery and anesthesia.

Since the 90s, a separate direction in the surgical treatment of venous diseases has appeared - endoscopic video surgery. Today, the following techniques can be used to remove varicose veins:

endoscopic dissection: during the operation, the ligation of the perforating veins is performed under the control of endoscopic instruments;
transluminal phlebectomy: a thin probe is inserted into the lumen of the affected vein, which emits light and allows the doctor to control the entire operation process visually, then a special solution is injected under the skin, providing anesthesia and separation of the vein from adjacent tissues, after which the surgeon performs their destruction and removal by aspiration.

Also, angiosurgeons have developed methods of venous-sparing operations, the essence of which is to preserve and restore the functions of the affected venous valves. For this, various designs of special cuffs are fixed around them and varicose vein segments, preventing the progression of pathological changes. In some cases, to save veins, hemodynamic operations can be performed, aimed at providing unloading of pathologically altered veins by switching the direction of venous flows. Unfortunately, after all vein-saving operations, relapses of varicose veins often develop, and the patient has to re-perform the surgical intervention.

In the postoperative period, patients with varicose veins of the legs are recommended to wear elastic bandages or compression hosiery. Also, depending on the volume of surgical intervention, the patient must comply with some restrictions (visits to saunas and baths, long walking, lifting weights, etc. are limited).

Phlebological center "Antireflux", video heading "Question-answer" on the topic "What is the benefit of walking with varicose veins (varicose veins) of the lower extremities?":

When diseases of the veins of the lower extremities are mentioned, they most often mean varicose veins. However, the list of pathological processes associated with leg veins is much wider. It includes many, even more dangerous, diseases, such as, for example, thrombophlebitis. We will talk about the causes of diseases of the venous system and the most common pathologies in this article.

Varicose veins

Varicose veins are a pathology of the venous walls. With varicose veins, the walls of the veins become thinner and wider due to impaired blood flow. The disease is associated with a decreased tone of the venous walls and valve insufficiency. Venous outflow is hampered, the lumen in the veins increases. Valves, on the other hand, undergo deformation, their walls become thicker and shorter. Most often, varicose veins affect the lower extremities.

Causes of the disease:

genetic factor;
excess body weight;
constant overstrain of the legs during prolonged stay in an upright position;
insufficient physical activity, a sedentary lifestyle;
pregnancy;
hormonal disorders;
bad habits (alcohol, smoking, drugs);
taking hormonal drugs.

The first manifestations of the disease include the following symptoms:

swelling of the legs, worse in the evening;
heaviness in the lower limbs;
bursting sensation in calves.

When walking and closer to the morning, the symptoms become less pronounced. However, the disease progresses, and gradually the symptoms become more: pain syndrome, fever in the lower extremities, convulsions appear. Telangiectasias are formed on the skin.

A phlebologist examines the patient and prescribes diagnostic measures, including duplex scanning and contrast venography. Therapeutic tactics depend on the general condition of the patient and the stage of the disease. Medicines, traditional medicine, exercise therapy, compression garments and surgical methods are used.

Drug treatment involves the use of drugs that strengthen the vascular walls and thin the blood (phlebotonics, anticoagulants, venotonics, non-steroidal anti-inflammatory drugs). Local preparations (ointments) are also used.

At 3 and 4 stages of the disease, the only effective treatment is surgery. Patients are assigned:

sclerotherapy (a pathologically altered vein is absorbed with the help of a special drug);
laser therapy (turning off the diseased vein from the bloodstream);
classical phlebectomy (removal of a vein under anesthesia).

Phlebitis

This disease is an inflammatory process of the walls of the veins. Usually phlebitis is a consequence of varicose veins of the lower extremities. Due to inflammation, blood flow is disrupted and blood clots occur. Then phlebitis flows into a more dangerous disease - thrombophlebitis.

Phlebitis can be triggered by the following factors:

complication of varicose veins;
complications of an abscess;
chemical burn of the skin;
streptococcus.

The human factor (unsuccessful sclerotherapy) can also serve as a starting point in the development of the disease. Symptoms of the disease:

pain syndrome;
redness of the skin;
temperature increase;
general weakness;
swelling.

In the chronic form of phlebitis, the symptoms are less intense. The disease then subsides, going into remission, then it sharply aggravates.

Phlebitis therapy consists in the complex use of conservative techniques. If the disease is localized only on the superficial veins, hospitalization is not carried out. In all other cases, the patient is hospitalized.

The patient's legs should be at rest and at some elevation. The doctor prescribes drugs that strengthen the walls of the veins and reduce the thickness of the blood. Also, treatment is aimed at eliminating inflammation. When the exacerbation subsides, the patient begins to wear compression garments and bandage his legs with an elastic bandage. Prevention of phlebitis consists in the timely treatment of pustular diseases, injuries and inflammatory processes.

Note! Treatment of diseases of the veins of the lower extremities should be comprehensive. It is not enough just to take medication. One of the areas of therapy is a strict diet. One of the goals of the diet is to fight excess weight. Also, proper nutrition should help reduce blood cholesterol levels.

Thrombophlebitis

This disease is a complication of superficial varicose veins. Thrombophlebitis is characterized by an inflammatory process on the walls of the veins and the formation of blood clots. It is believed that every fourth person belongs to the risk group with the possibility of developing thrombophlebitis. The most common site of localization of the disease is the lower extremities (from the lower part of the buttocks to the lower part of the lower leg).

Factors that can trigger blood clots and blood clots:

excess body weight;
pregnancy;
trauma;
acute respiratory viral infection;
genetic factor;
low physical activity;
diabetes;
overheat.

Thrombophlebitis is usually preceded by the following pathologies:

inflammatory process on the vein wall (phlebitis);
excessive blood clotting;
impaired blood flow.

Symptoms of the disease:

pain syndrome in the veins (gradually the pain becomes more and more intense and does not stop even at rest);
general malaise;
high body temperature;
redness of the skin;
thickened areas of the skin;
weakness in the lower limbs;
feeling of coldness in the toes;
limping when walking.

The disease is often extremely aggressive, accompanied by a rapid rise in temperature and severe pain in the veins. Puffiness gradually increases, and the skin in the affected areas turns red. The temperature can rise up to 38 degrees. As a rule, the acute phase of thrombophlebitis lasts 10-30 days. After this, the disease is transformed into a chronic form.

Diagnosis begins with examining the patient. The doctor by palpation of the veins determines the painful areas and the nature of pathological changes on the skin. To confirm the preliminary diagnosis, a blood clotting test is prescribed. Also, triplex scanning and radiopaque phlebography are performed.

Therapeutic measures for thrombophlebitis are divided into 2 groups:

conservative;
operational.

Treatment with conservative methods is carried out on an outpatient basis if the thrombus has not gone beyond the leg. If the disease is caused by trauma to the venous wall, anticoagulants or an alcohol compress are used. Anti-inflammatory drugs are used to relieve pain.

In the therapy of thrombophlebitis, the following groups of drugs are used:

phlebotonics (Detralex, Venosmin);
angioprotectors (rutin derivatives);
non-steroidal anti-inflammatory drugs (Sinmeton, Diclofenac, Meloxicam);
anticoagulants (Warfarin, Sinkumar).

Surgical operations are indicated in cases where the disease has spread to deep veins, as well as when there is a risk of complications.

Surgical treatments for thrombophlebitis include:

ligation of pathological vessels;
thrombectomy (removal of a blood clot);
phlebectomy (removal of veins affected by the pathological process).

Thrombosis

This disease develops as a result of a violation of the inner surface of the venous wall of deep veins. Factors that can lead to thrombosis include infection, chemical or mechanical damage, and an allergic reaction.

The risk of thrombosis also increases with high blood clotting and a consequent decrease in blood flow velocity. Another prerequisite for the development of the disease is congestion in the veins of the lower extremities due to low physical activity or prolonged stay on the legs.

Note! Physical inactivity is the main factor leading to thrombosis. There are even unscientific, but common terms such as "television thrombophlebitis" (prolonged sitting near the TV) and "economy class syndrome (long flights in an uncomfortable airplane seat)." When a person is in a sitting position with bent legs for many hours, blood stagnates in the deep veins, which provokes the development of pathology.

The danger of thrombosis is the following:

A blood clot in the lower leg (below the knee) is not as dangerous as in the upper limb. The higher the blood clot rises, the wider the vein, and therefore the risk of separation of this blood clot increases.
If a blood clot enters the heart or lungs, it blocks the blood flow to them. Thromboembolism occurs, which leads to severe shortness of breath, cardiac arrest, and even death.
A blood clot trapped in the arteries of the brain causes a stroke.

Reasons for blockage of blood vessels:

increased blood viscosity due to a lack of fluid in the body, as well as as a result of metabolic disorders or exposure to a malignant tumor;
stagnation of blood in the legs due to physical inactivity, varicose veins or an inflammatory disease;
pathology of the circulatory system (thrombophlebitis, erythremia);
genetic factor;
infectious diseases (sepsis, allergies);
pneumonia;
excessive body weight;
diabetes.

At the initial stage, the symptoms of the disease are usually mild. However, over time, more and more signs of thrombosis appear, including:

swelling of the lower extremities;
spider veins;
convulsions, especially disturbing at night;
pain syndrome in the thigh, lower leg and foot (the pain subsides with the horizontal position of the limb);
venous insufficiency;
high temperature.

In the acute stage, thrombosis proceeds violently:

venous outflow completely or partially stops;
thighs and shins increase in size;
saphenous veins expand significantly;
cyanosis occurs;
the temperature rises to 38 degrees.

If the disease is asymptomatic, the fact that the patient suffers from thrombosis can be guessed by the distinct venous collaterals in the lower abdomen, on the lower leg and thigh.

Based on the results of the examination and tourniquet tests with an elastic bandage, the phlebologist determines the patient's condition. As diagnostic measures, phlebography, duplex scanning, ultrasound examination of the veins, rheovasography of the lower extremities are prescribed.

The choice of treatment tactics depends on the stage of the disease, the general health of the patient, and the localization of the pathology. The main goal is to avoid the spread of thrombosis, as well as to prevent pulmonary embolism (that is, blockage of the arteries of the lungs).

Treatment is carried out only in a hospital setting. The patient is prescribed strict bed rest and taking medications, including anticoagulants, thrombolytic and fibrinolytic drugs, as well as antiplatelet agents. The operation is performed in case of a threat to the patient's life.

Treatment options for deep vein thrombosis:

Drug therapy. Taking medications reduces the activity of symptoms and normalizes blood flow. The action of coagulants (Coumadin, Heparin, Warfarin) is aimed at reducing blood density and preventing thrombosis in the vessels and veins of the legs, as well as reducing edema. Thrombolytic agents (Trypsin, Chymotrypsin) eliminate blood clots. Phlebotonics counteract the stagnation of blood in the extremities and improve vascular tone (Detralex, Venosmin). Non-steroidal anti-inflammatory drugs are aimed at eliminating pain and reducing swelling in the legs (Diclofenac, Indomethacin).
Surgery. The operation is indicated when there is a danger of separation of a blood clot or thrombophlebitis. Such techniques as cava filters, Troyanov-Trendelenburg operation, thrombectomy are used. Surgical intervention is contraindicated at the stage of exacerbation of the disease and in some cardiovascular pathologies.
Traditional medicine. Alternative therapy acts only as an adjunct to alleviate the course of the disease. Herbal tinctures and foot baths are used based on nettle, horse chestnut, chamomile.

Depending on the patient's state of health, the doctor may recommend moderate exercise, including walking and therapeutic exercises. Activities with a high load on the feet, as well as thermal procedures (sauna, steam bath, hot baths) should be completely excluded from the patient's life.

Disruption of blood circulation leads to the formation of trophic ulcers. Stagnation of venous blood provokes the onset of the inflammatory process. The skin is subject to pigmentation, and the subcutaneous tissue is compacted. First, eczema develops, then turns into a trophic ulcer.

Symptoms of a trophic ulcer include the following signs:

powerful pain syndrome;
convulsions that get worse at night;
swelling of the legs;
severe itching;
chills;
an increase in temperature in the ulcerated area;
exfoliation of the epidermis;
bluish-looking skin due to translucent vessels;
increased pigmentation of the skin;
allocation of exudate with ulcers;
scab (in advanced stages of the disease).

Diseases and conditions that provoke the occurrence of ulcers:

diabetes;
skin pathologies;
hypertonic disease;
atherosclerotic processes in the legs;
chemical burns of the skin;
trauma;
improper blood circulation.

Trophic ulcer therapy includes:

decrease in venous pressure;
wearing compression underwear (the degree of compression is determined by the doctor, but usually it is supposed to use the third class of compression);
taking painkillers and antibacterial drugs;
treatment of venous insufficiency, taking antihistamines, antibiotics and phleboprotectors;
surgical operation (up to skin grafting).

Before deciding on the tactics of treatment, the doctor prescribes an examination of the patient. For diagnostic purposes, ultrasound, general examination and clinical studies are carried out. Based on the test results, the doctor can refer you to intravenous, laser or infusion therapy. Electromyostimulation is also used.

A trophic ulcer is not a disease whose treatment can be neglected. The advanced stages of the disease lead to the development of erysipelas, microbial eczema, elephantiasis, sepsis and even death.

Chronic venous insufficiency

The disease is classified into four stages during which chronic venous insufficiency develops:

At the first stage, the disease is almost asymptomatic. The only symptom is minor leg swelling.
The second stage is characterized by varicose veins. However, trophic changes have not yet been observed.
In the third stage, the surface of the skin changes: veins become visible on the surface of the legs. Pronounced age spots appear on the skin of the lower extremities.
The fourth stage is associated with the development of trophic changes on the skin of the legs.

Chronic venous insufficiency is caused by factors such as:

high blood pressure in the veins;
phlebitis;
inflammatory processes.

The disease is treated with conservative methods (medications, therapeutic exercises, draining underwear), as well as with the help of surgical operations.

Drug treatment involves the use of the following groups of drugs:

phlebotonics (Ginkor Fort, Detralex);
antihistamines (Clemastine);
anti-inflammatory drugs (Diclofenac);
antioxidants (Emoxipin).

To prevent the spread of the infectious process throughout the body, patients are prescribed treatment with antibiotics and antibacterial drugs. Such drugs as Lyoton, heparin ointment, Venobene are aimed at eliminating the pain syndrome.

Surgical treatments may include the following:

Sclerotherapy. This method is the least traumatic and has a noticeable cosmetic effect. The operation is carried out under local anesthesia and consists in the introduction into the vein of a special needle-shaped device - a sclerosant, through which the therapeutic solution enters the body. After the injection of the solution, blood flow through the vein is blocked, and the vein itself gradually dissolves. Thus, it is possible to get rid of the pathological vein.
Laser therapy. Also, pathologically dilated veins are removed using a laser. Like the previous method, laser therapy is minimally invasive, does not leave scars on the body and does not require general anesthesia. The method is based on sealing the vein with a laser. As a result, the affected vein is turned off from the general blood flow, which is directed to healthy parts of the leg.
Classical phlebectomy. Traditional surgery is performed under general anesthesia and is quite difficult and traumatic. The essence of the operation is to remove the diseased vein from the leg.

Thromboembolism

This condition is caused by impaired blood flow through veins or arteries due to the formation of clots and excessive blood clotting. The resulting blood clots interfere with the normal functioning of the circulatory system. Blood clots usually occur in the lower extremities.

Thromboembolism symptoms:

pain syndrome;
swelling;
discoloration of the skin on the legs;
swelling of the veins.

Treatment is carried out with thrombolytic drugs, as well as anticoagulants and antispasmodics. To relieve the patient of pain, the doctor may prescribe Papaverine, Novocaine or No-shpu. If drug therapy does not work, thrombectomy or embolectomy is prescribed. One of the dangerous complications of thromboembolism is gangrene. In this case, the leg will have to be amputated.

In no case is it possible to engage in self-diagnosis and treatment of any diseases of the lower extremities. If you find the first suspicions of circulatory problems in the legs, you should immediately seek the advice of a doctor.