Varicose veins is not just a cosmetic problem. We are talking about a serious threat to the health and even life. In the first manifestation of the disease should consult a doctor and start the treatment.
Let's see, what treatments we can offer medicine.
A modern approach to the treatment of varicose veins
It is difficult to calculate the prevalence of this disease, because, according to statistics affects about 75% of women and 60% men. And it is only among the inhabitants of the developed countries. In order to explain the cause of varicose veins, you should have an idea about the structure of the veins of the lower extremities. Venous blood in our legs constantly moves upwards, overcoming the laws of gravity, for the implementation of this process, the veins are equipped with special valves that prevent the liquid to fall between the jolts of the heart. The interruption of this mechanism causes the reverse current of venous blood, and due to the greater number of the veins dilate, decreases their tone.
The first stage of varicose veins usually passes without special symptoms, except that it is accompanied by mild discomfort in the legs, and "heaviness" in the night. You may notice that the legs were tired even after short walks. For a second sub-compensation stage, these features have been improved and there is pain pain, swelling, tingling in legs, cramps.
Third, compensatory stage is characterized by irreversible changes of the skin of the shins:
- edema that are not fully converge even after sleep;
- hyperpigmentation;
- indurate — seals exposed skin.
Therefore, the skin becomes easily vulnerable, possible varicose veins eczema and, as in the end of disorders trophic, ulcers. Ignoring the disease is also facing such complications as thrombophlebitis and thromboembolism.
The sooner you begin treatment, the more hopeful will be the prognosis. But after the success they should adjust their life-style, leaving time for preventive procedures.
Suspicion of varicose veins should be a reason for early visits to the doctor, which will help to identify the disease and determine its stage.
Diagnosis — the first step to recovery
In particular, the person interviewing the patient it is necessary to collect anamnesis. Continue to be a standard inspection and palpation of the affected areas. For a more detailed and accurate diagnosis using angio ultrasound duplex scanning with color mapping of blood flow. The procedure is so simple ultrasound the only difference is that in addition to two-dimensional images the doctor sees the speed and the direction of movement of the mapping of blood flow in the vessels. Modern ultrasound machines can determine with precision the valve idle vein segments with abnormal direction of blood flow, precisely mark the projection on the skin.
When the diagnosis is clarified, it is time to start taking measures to get rid of varicose veins.
Conservative treatment of varicose veins
With non-surgical methods can prevent, inhibit or alleviate the disease. As the main method of treatment was used only in the case that the operation is not possible.
Conservative methods include:
- Compression therapy, that is to say, the use of special compressive garments or bandages elastic. Its impact constricts the veins, thus facilitating the operation of the valve and improves blood flow. The effectiveness of compression therapy has been demonstrated by numerous studies. There are contraindications between them atherosclerosis, aortoarteritis, inflammatory diseases of the skin and other.
- Drug therapy involves the use of medications such as for oral administration and for local applications (in the form of ointments). The groups of drugs for the treatment of varicose veins in the legs include venotonic and anti-inflammatory drugs, anticoagulants (blood thinners). Necessary medication that the doctor prescribes individually. It is important to remember that everyone has contra-indications. For example, the majority of tablets venotonic cannot be taken at the beginning of the pregnancy and when breastfeeding. And when taking anticoagulants need regular blood tests for clotting.
As the primary treatment, in the absence of obstacles and contraindications to designate one of the options of surgical treatment.
Traditional surgery (venectomy)
It is currently used only in certain cases, related to special structure of the veins or complicated course of the disease, for example, with different forms of acute thrombophlebitis.
The operation consists in the ligation of the confluence of the trunk of the affected saphenous vein in the deep system (crossectomy) and more mechanical removal of the barrel. The manipulation is performed under General anesthesia or with spinal anaesthesia and have a duration of 1-2 hours. Because of the high incidence of postoperative complications — hematomas in places of extraction of the trunk, prolonged pain, skin neuralgia and paresthesias (numbness) in recent years, the traditional surgical intervention gives way to modern methods. These include endo-venous laser photocoagulation.
After the surgery recommend regular physical activity significant loads for a month and a half is shown in the compression of the therapy.
In addition to this method of treatment, there are other, more gentle ways to get rid of varicose veins in the legs.
Techniques minimally invasive
There are several types of minimally invasive methods for the treatment of varicose veins. On the basis of data about the patient and the characteristics of the disease the treating physician takes the decision of whether to perform one of the procedures.
Endo-venous laser photocoagulation
Operation endo-venous laser treatment has become the treatment method of varicose veins or disease of any severity. Neither the severity of the venous insufficiency or thickness of the light trunks, the venous there are currently limits to the endo-venous laser treatment. This was possible thanks to the use of the following tools:
- two-wave laser with a wavelength of absorption by hemoglobin and the second vascular wall;
- fibres radial, allowing machining on the entire circumference of the interior surface of the vein;
- automatic pump that allows to pump the anaesthetic solution around the vein to provide relief from pain, reducing the diameter of the vein, and protection of adjacent tissues.
Special preparation for endo-venous laser treatment is not necessary. Before the operation is necessarily performed ultrasound duplex scanning. It is also necessary to give blood for the standard set of preoperative tests: General, biochemical, coagulogram.
During the procedure, the doctor puncture of the affected vein, and then insert a thin layer (1 mm thick) catheter with a light guide. Throughout this process, as well as the position of the light guide in Vienna and more "beer" to Vienna is controlled by intraoperative ULTRASOUND device. The operation takes about 40 minutes and requires only local anesthesia.
After surgery spent in the hospital is not necessary, the patient must wear a compression garment for 3-5 days, and within a couple of weeks recommended daily relaxing walks.
The ablation by radiofrequency
The operation is essentially similar to laser coagulation. The only difference is that on the walls of veins for her "closure" and subsequent re-absorption effect of radio frequency radiation. Special training, in addition to standard preoperative procedure, it is not necessary.
At the present time in connection with the improvement of the laser systems no advantages over the endo-venous laser photocoagulation, ablation by radiofrequency is not. However, the procedure is more expensive due to the high price of the waveguides.
Operation can not be done during pregnancy and lactation, atherosclerosis of the arteries of the lower extremities and the inability of subsequent physical activity.
Possible complications and a complex of restorative measures during the rehabilitation period is similar to the previous procedure.
Mini-phlebectomy
The principle of operation is to remove the tributaries and components of the vein through the puncture or incision in the skin using special tools. It is used isolated varicose tributaries or as an additional procedure after laser coagulation, ablation by radiofrequency, and surgical phlebectomy.
The training is similar to the above procedures — a standard set of tests and an ultrasound scan of the veins. Contraindications — pregnancy and breast-feeding, acute infectious diseases, thrombophlebitis, disorders of motor activity, the pathology of the coagulation of the blood.
The duration of the mini-phlebectomy is 20-40 minutes, during rehabilitation it is necessary to wear compression tights.
Sclerotherapy
Non-surgical methods of varicose vein treatment is suitable for advanced varicose veins, and aesthetic purposes — for the destruction of vascular "stars" and "veins".
The contraindications are thrombosis, Allergy, infections, pregnancy and lactation, the inability to perform accurate injection.
Sclerotherapy involves the injection into a vein puncture with a special substance that "glues" of the vessel wall, to subsequently passed its re-absorption. One of the latest innovations — method of froth foam that involves the use of a foam form of the drug. Therefore, it is the least washed out with the blood, which makes it possible to reduce the concentration in amount of substance to be more effective. The operation is done without anesthesia, as well as for puncture, it only requires a thin insulin needle.
The side effects of sclerotherapy include pigmentation, which appears in the course sklerozirovanie of Vienna. In some cases, incomplete union of Vienna, where necessary re-treatments.
After sclerotherapy, you have to wear a compression garment and avoid strenuous activities and high temperatures (for example, when you visit the sauna).
The price of sclerotherapy depending on the volume. For the elimination of large varicose veins trunks sclerotherapy now almost never used. And sclerotherapy of small nodes or venous networks will have a cost of 7,000 and 20,000 rubles.
With the development of medicine in the struggle with varicose veins in the legs have progressed from the category of "one hundred years of war" in the category of "quick wins". Sophisticated surgical techniques have led to minimally invasive procedures that are safer and effective. Today varicose veins is not a phrase, but the only reason to see a specialist.