Varicose veins are a disease caused by a violation of the structure of the walls of blood vessels, their thinning by stagnant blood flow processes. Although it can be localized in the rest of the body, the disease often affects the lower extremities. According to the International Classification of Diseases of the Tenth Revision of the ICD 10, varicose veins are assigned a code of 183 with four headings describing the various manifestations of the disease.
How did varicose veins appear?
The first mention of varicose veins was found in ancient Greek papyri. History and proven scientific facts suggest that the Egyptian mummy found varicose veins of the lower extremities - it can be claimed that the disease has accompanied humanity throughout its existence.
Prominent doctors - Avicenna, Hippocrates, Galen - tried to treat varicose veins of the lower extremities. In the nineteenth century, painful and traumatic treatment consisting of a bandage after dissecting the tissues of the thigh and lower leg was used to damage the saphenous vessels. In this way, it was understood that stagnant blood flow processes could be prevented and varicose veins would be eliminated. However, the methods left horrible, extensive scars on the patients' bodies, causing damage to nerves, blood vessels, and impaired lymph flow.
Shortly afterwards, the history of the treatment of varicose veins received a positive development - in 1908, for the first time, a metal probe was used as a means of minimally invasive action on the walls of blood vessels. The discovery of radiography has made it possible to perform more accurate and efficient surgeries to remove varicose veins. Duplex and triplex scanning, strong medications, laser therapy, and sclerotherapy are now used when the disease needs to be properly diagnosed and treated. Surgery is used when varicose veins cannot be removed sparingly.
The main causes of the disease
Varicose veins are a great danger, the pathology has "rejuvenated" - in the past, mostly elderly people suffered, now varicose veins are diagnosed in young patients, and very rarely in children.
Causes of the disease:
- Genetic predisposition.
- Overweight, overweight, obesity.
- Sedentary sedentary lifestyle.
- Wrong diet, poor blood quality.
- Accompanying diseases of the cardiovascular system.
- Professional activity.
- Prolonged standing, heavy physical force.
- Pregnancy and hormonal changes.
- Individual features of the structure of the vascular system.
- Pathological congenital diseases.
- Wear high-heeled shoes, tight clothes.
- Thermal treatment.
Any of the above causes can lead to the development of varicose veins, the consequences of which are dangerous, including death.
The structure of venous vessels
To understand what causes varicose veins of the lower extremities, you need to have an idea of the structure and mechanism of action of the vascular system. Represents the sum of the main (deep and superficial) and connecting perforated (communication) vessels.
The small superficial vein begins in the region of the foot, extends along the back of the lower leg, divides the branches below the knee into two branches, and connects with the popliteal vein and the deep femoral vein.
A large superficial saphenous vein forms in the ankle area, extends along the surface of the lower leg and knee joint, and connects to the femoral vein. The deep veins are located along the branches of the arteries and connect the entire venous system with the perforating veins.
With normal blood flow, oxygenated blood flows directly to the heart, and special venous valves prevent backflow. Varicose veins of the lower extremities involve strong pressure, the diameter of the venous lumen increases significantly, the valves do not cope with the task, reflux occurs - reverse blood flow. Improper blood circulation leads to excessive dilation (thinning) of the vessel walls, thinning, venous congestion and blood stasis. As a result - swelling, swelling of blood vessels, the formation of nodules.
Symptoms and clinical manifestations
Varicose veins can progress in a latent form for a long time, then the symptoms appear:
- The formation of spider veins is the accumulation of mesh of dilated small vessels.
- A well-defined model of clogged arteries under the skin.
- Formation of constriction of blood vessels - varicose veins in the form of well-defined tubercles in the legs.
- A change in the normal color of the skin, cyanosis, darkening appears, the top layer (dermis) acquires a loose structure.
- Pain in the legs, heaviness, feeling of stretching and fatigue, decreased mobility, difficulty walking.
- Swelling of the soft tissues with varicose veins of the lower extremities is possible.
Ignoring timely treatment can lead to serious and dangerous consequences when a person recovers only with emergency surgery.
Classification of the disease
According to ICD 10, varicose veins are classified as ulcerative, inflammatory, ulcerative, and inflammatory disease in the absence of these symptoms. According to the International Classification of Chronic Venous Diseases, established in 1994, varicose veins are divided into the following.
- Intradermal, segmental. Pathological venous discharge is not observed.
- It is formed through segmental, superficial and perforated vessels with reverse blood flow.
- Distributed by reverse blood flow through superficial and perforated vessels.
- Varicose veins with reverse blood flow through deep veins.
It is common to classify the disease according to additional features of the clinical picture:
- There are no symptoms during the examination or palpation.
- Reticular vessels are expressed.
- There are varicose veins.
- There is swelling of the soft tissues.
- Violation of normal skin color.
- Detected lipodermatosclerosis.
- There is a healing ulcer.
- An active ulcer was found.
There are no symptoms or are subjective (the patient's feelings). In addition, varicose veins are classified according to the causes: congenital, primary, secondary, with an unknown factor that causes the development of the disease.
Diagnosis of varicose veins
The main way to identify varicose veins is visual examination and palpation of the patient. In order to carefully determine the severity of the disease and choose the right treatment, when studying the medical history and palpation is applied, the phlebologist prescribes the following:
- Complete blood count is the basic standard for determining red blood cell count and hemoglobin levels. According to blood clotting, conclusions are drawn about the degree of development of the disease and the tendency to thrombosis.
- Doppler ultrasound. The method consists of ultrasound diagnosis of the speed and direction of blood particles. This allows you to determine the direction of blood flow and whether it has enough speed.
- Ultrasonic scanning. Ultrasound monitor is used for real-time visual inspection of vascular walls, structure, direction and speed of blood flow.
- Plethysmography. Diagnosis is based on the detection of electrical resistance of foot tissues. With proper circulation, the parameter should show a normal standard.
- Rheovasographic diagnostics. Tissue is based on the determination of blood filling index. The rheographic index helps to determine the stage of varicose veins - compensation, subcompensation or decompensation.
The history and study of the disease, obtaining comprehensive diagnostic information, allows the doctor to choose the method of treatment.
Conservative drug treatment
This method of treatment involves the appointment of special drugs that have a positive effect on the course of the disease. Conservative treatment of varicose veins is effective in the early stages, it is used as an additional treatment in the formation of nodules, ulcers, eczema.
The main groups of drugs are:
- Phlebotonics and phleboprotectors. Venotonic drugs are the standard for conservative treatment. Restore the structure of blood vessel walls, strengthen and tone blood vessels.
- Effective blood thinners. Helps improve quality composition, faster blood flow through blood vessels, reduce the risk of blood clots, restore normal blood circulation and relieve pain.
- NSAIDs (anti-inflammatory drugs). Eliminate pain, prevent cramps, effectively eliminate inflammation and swelling.
Conservative treatment helps to consult a phlebologist in a timely manner, at the initial stage it is possible to affect the composition of the blood and the condition of the vessel walls. With complex forms of the disease, acute measures are required.
Laser therapy
When varicose veins of the legs need to be classified according to ICD 10 code 183, laser therapy is recognized as a mild and least traumatic method. The idea of the method is to use a laser beam that actively affects the vessel walls and promotes adhesion. . An LED connected to the laser device is inserted into the vein by piercing the skin. Radiation is selective and has no effect on adjacent healthy tissue. Significant advantages of laser treatment in the treatment of varicose veins:
- Rapid positive effect.
- Lack of pain and injury.
- Stable result, long-term remission.
- Restoration of normal blood circulation.
Contraindications will be thick or very thin vascular walls, large venous lumens, pregnancy, oncology and other serious diseases.
Sclerotherapy for varicose veins
The method is based on the introduction of special liquid or foam preparations - sclerosants from varicose veins into the affected vessels. They replace endothelial cells with fibrous tissue. Needles, syringes and sclerosants are used for sclerotherapy.
The treatment technique consists of the following steps:
- perforation of a pathological vessel;
- to remove (remove) all blood from a vein;
- application of sclerosant drug;
- to apply a suitable bandage or knitted compression.
This method gives a lasting result. The procedure is painless, and the combination of vascular tissue with varicose veins is an alternative to surgery.
Implementation of the operation
The most painful and traumatic way to treat varicose veins is surgery. Indications for surgery will be extensive vascular lesions, the presence of varicose veins, dangerous consequences of the disease, such as acute thrombophlebitis.
Phlebectomy is performed under local anesthesia, the pathological vessel is closed, the necessary number of incisions are made and removed. Surgery is known to be an effective treatment, with results in eighty percent of cases. However, phlebectomy has a number of side effects: wound complications, lymph node trauma, and in extreme cases, immobilization and disability with deep nerve damage.
Varicose veins: you should consult a doctor in the early stages of varicose veins to prevent dangerous complications such as nodules, ulcers, bleeding, phlebothrombosis, pulmonary embolism and other serious consequences!