A team of certified cardiovascular surgeons/phlebologists at the medical clinic diagnoses and treats all types of varicose veins at any stage of the disease, as well as related pathologies. Our asset, which we are proud of, is the treatment according to the Israeli protocol, which shows maximum effectiveness in clinical practice.
Varicose veins - the trigger for the development of varicose veins is considered to be a disruption of the normal function of the venous valve with the occurrence of backflow (reflux) of blood.
As a rule, the valve subjected to maximum mechanical stress is the first to be affected. In this case, the discharge of pathological blood occurs through the mouth of the great and small saphenous veins, sometimes through the large perforated vein. The excessive amount of blood that arises in the superficial veins gradually leads to excessive stretching of the vein walls. The total volume of blood contained in the superficial venous bed of the lower leg increases. This increased volume of blood continues to flow into the deep system through the perforated veins, stretching them excessively. As a result, dilatation and valve insufficiency occur in the vena cava.
Symptoms and signs of the disease
Signs of disease are not necessarily associated with pain. On the other hand, most patients claim that at the beginning of the disease they care more 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 on the lower legs show themselves as follows:
- Heaviness in the legs, fullness in the legs.
- The appearance of cramps in the calf muscles, leg and finger cramps.
- Feeling tired after a long walk.
- Ankle swelling in the evening.
- Venous discharge patterns on the skin, spider veins, spider veins.
- The signs that accompany this disease are cellulite, itching in the legs, dry ankles and calves, thinning and sagging skin, long-healing ulcers, uneven pigmentation - from dark spots to colorless areas, clear nodular formationswith 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 sense of chronic fatigue, apathy develops.
- Arrhythmia, tachycardia.
- Shortness of breath, frequent diseases of the respiratory system.
The obvious symptoms of lower leg varicose veins in women may appear stronger before menstruation and decrease after.
Symptoms of venous pathology in the upper part of the leg are characterized by numbness of the hands, spastic condition of the fingers, goosebumps, tingling, and coldness.
Esophageal varicose veins are manifested by belching, burning sensation, pain behind the sternum, inflammation in the esophagus and stomach, difficulty swallowing and signs of reflux esophagitis, anemia.
Disease diagnosis
Effective treatment of varicose veins cannot be done without early comprehensive diagnostics. Diagnosis is explained by clinical picture and data analysis after hardware study.
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 vein and assess blood flow, several test manipulations are performed:
- Vein examination with compression on different segments.
- Valsalva maneuver, or strain test.
- Parana test with disequilibrium to assess the veins in the calf area.
- Tests run at varying intensities.
Additional methods to clarify the diagnosis:
- Plethysmography to determine venous reflux, obstruction.
- CT, MRI for visualization of tissues and structures in the affected area.
- Infrared thermography to assess the temperature balance in the affected body area.
- Intravascular ultrasound uses a catheter to visualize the vascular wall from the inside.
The results of any diagnostic study performed are evaluated comprehensively. Any diagnosis is very helpful in determining further treatment tactics.
Clinical laboratory tests of blood and urine complete the picture of the disease and can show concomitant pathology.
How are varicose veins treated?
If worrying symptoms of varicose veins appear, you should see a doctor to get a diagnosis and start treatment in time. In regional medical institutions, this issue is dealt with by general surgeons, in clinics - by phlebologists and angiosurgeons.
The multidisciplinary medical clinic has a well-equipped phlebology department, staffed by a team of surgeons with extensive practical experience. The center offers a high level of service and quality of treatment, which is reflected in the excellent clinical results we are proud of.
Varicose veins on the lower legs and other types of pathology can be treated at the first stage of development. As the process progresses, it turns out to be increasingly ineffective, some retaining only symptomatic significance.
The therapeutic effect cannot completely eliminate the disease, but as long as it is possible to delay the destruction of blood vessels and the development of complications, this must be done by all available means.
Conservative treatment
- At the beginning of varicose vein treatment, medications are limited to venotonic agents.
- To reduce the risk of thrombosis and occlusion, anticoagulant injections and low molecular weight heparin-fragmin are used.
- A new oral anticoagulant.
- For inflammatory phenomena in blood vessels and surrounding tissues, the use of external non-steroidal anti-inflammatory drugs with diclofenac and indomethacin is indicated.
How to treat extra varicose veins?
In parallel with the therapeutic treatment, the patient is recommended to perform certain exercises that strengthen the muscle corset of the lower leg and have a general strengthening effect. For example, the best exercise in a lying position is the "bicycle", alternately pulling your toes towards you and stretching them, as in ballet.
- You should be careful with water and thermal procedures, because hot showers and baths, beach holidays in the sun with sunbathing can worsen the condition. Vessels need to 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, take a cold foot bath every day with a decoction of oak bark, chamomile, calendula, birch leaves, St. John's wort, white acacia, and horse chestnut are recommended.
- It is useful to rub freshly squeezed juice from aloe leaves into the skin; it softens the skin and prevents inflammation.
- It is worth it to change your habits and stop smoking. The diet should be dominated by vitamin-rich foods with lots of fiber, fresh vegetables, citrus fruits, and seafood.
- You need to adjust your drinking regime by drinking enough water every day (1. 5 to 2 liters). At the same time, you should reduce the consumption of coffee, strong tea, chocolate, and alcohol.
If the leg veins are enlarged, the doctor may recommend periodic or continuous use of compression stockings.
Cause of disease
Family history allows us to conclude that varicose veins are genetically determined and can be passed down through generations.
In many clinical cases, it is impossible to determine the exact cause of the disease. The researchers concluded that the cause was a combination of several internal and external factors.
Causes of varicose veins:
- congenital defects of the valve system;
- less physical activity, less activity;
- pregnancy;
- working conditions with prolonged pressure on the legs, long periods of standing, 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;
- frequent bowel problems, frequent diarrhea or constipation.
Varicose veins of the lower extremities (varicose veins)- dilatation of the superficial veins of the lower leg, accompanied by valve inefficiency and impaired blood flow. The term "varicose veins" comes from Latin. varix - "swell".
As a result, the veins stop working properly, the entire circulatory system is disrupted, complicated by congestion, disruption of tissue trophism, and blockage of blood vessels with blood clots.
Many complications are life-threatening, therefore, if the onset of varicose veins is suspected, diagnosis and treatment must be carried out immediately and professionally.
Types of diseases
The blood flow in the vessels changes, slows down, and blood clots can form on the uneven walls. Changes in blood vessel function cause blood stagnation, venous insufficiency, and persistent disruption of capillary circulation in the periphery.
According to the WHO, varicose veins occur in 45% of women and 20% of men.
According to the generally accepted CEAP international classification, varicose veins are divided into six disease classes, based on the fact that C0 is the complete absence of subjective, visual and clinical signs.
- C1 – early stage, shown by a network of capillaries and spider veins on the skin.
- C2 – visible thickening of veins under the skin, vein pattern in the lower part of the leg in the form of blue threads.
- C3 – swelling of the legs appears as a result of standing for a long time on the legs or a state of rest (night sleep).
- C4 - skin surface 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 – venous trophic ulcer that does not heal.
The classification of varicose veins on the lower leg differentiates between the pathologies of superficial and/or deep, perforated communicating veins.
According to the origin, venous deformation can be:
- congenital, appearing in babies;
- acquired;
- secondary, arising against the background of other pathologies, injuries;
- idiopathic, with unknown cause.
The full classification of varicose veins of the lower extremities and organs also includes complications - reverse blood flow, reflux, and/or occlusion, lumen blockage.
Varicose veins on the lower legs are not the only manifestation of varicose veins, although they are the most common. There are also esophageal varicose veins, sublingual veins, retina, scrotum (varicose veins in men), stomach, rectal cavernous body (hemorrhoids), pelvic veins, female genital organs - vulva, labia, uterus.
Surgical treatment of varicose veins
RFO (radiofrequency destruction of the saphenous vein)is a modern method of treating varicose veins. Treatment involves the use of radiofrequency radiation on the inner wall of the vein. Using the effect of heat, the vein is "welded", cut off from the general blood flow, and after a few months is replaced by connective tissue.
Advantage
- The procedure is carried out without general anesthesia, local anesthesia is sufficient;
- Maximum safety for patient health
- RFA does not require special preparation;
- During the manipulation, the patient does not feel pain or discomfort;
- Radiofrequency ablation of lower extremity veins is very effective;
- The possibility of complications is low, almost all patients tolerate this procedure well;
- Radiofrequency ablation can be combined with tributary mini-phlebectomy or sclerotherapy;
- After radio frequency ablation no scars or marks remain;
- Literally a few days after the procedure, the patient will be able to return to their normal lifestyle.
How it goes
The intervention is carried out under ultrasound control. Before the procedure begins, local anesthesia is administered so that the patient does not feel pain or discomfort during the treatment.
Let's see how RFA is done step by step:
- Before the operation, the lower limb is carefully treated with an antiseptic agent. The doctor then uses a marker to mark the veins that are exposed to varicose veins. Then the doctor 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 puts on a bandage and helps the patient put on a compression garment.
- This procedure lasts from 30 to 50 minutes. To stop blood flow through a weakened vessel, it must be destroyed. Then the body itself will divert 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.
Restoration
Immediately after the operation, the patient must walk (about 30 minutes) to avoid stagnation of blood and lymph. After radiofrequency ablation of veins on the lower leg, it is necessary to carefully follow the doctor's recommendations:
- During the week, increased physical activity and heavy lifting are prohibited;
- It needs to walk more, be in the same position as little as possible (with the exception of sleep);
- For 3-4 weeks you need to stop taking hot showers, you can only take a shower;
- You must stop visiting the bathhouse for at least a month;
- It is necessary to drink plain water as much as possible, on average about 2. 5 liters, while you need to minimize the amount of salt used;
- A week after the operation, you need to start physical therapy, which the doctor will tell you;
- It is possible that after radiofrequency ablation of the veins on the lower leg, the doctor will prescribe some medication.
Following these rules will help you avoid complications and prevent the further development of varicose veins.
A week after the operation, it is necessary to re-examine (ultrasound examination of the lower leg veins). You can get more detailed information about radiofrequency ablation of lower leg veins during a personal consultation with a specialist.
Laser vein coagulation
Endovasal (endovenous) laser coagulation (elimination) of varicose veins (EVLK, EVLO) is a modern method designed to eliminate blood reflux in superficial and perforated veins using the thermal energy of laser radiation. EVLO allows you to perform without incisions and does not require hospitalization of the patient in the hospital. The international term is EVLA (endovenous laser ablation).
Main stage
- Venous puncture. Performed under ultrasound guidance.
- Light guide position. The light guide is a thin optical fiber. A laser beam is supplied to the tip. A light guide is inserted into the diseased vein. The end is attached to the point where the varicose vein flows into the healthy deep vein, that is, at the anastomosis.
- Tumescent anesthesia. An anesthetic "cushion" is created around the vein to better press the vein against the light guide and prevent damage to the surrounding tissue.
- Laser vein coagulation. Laser radiation is supplied to the working part of the light guide.
- At the same time, the light guide is slowly pulled out of the vein. Therefore, the vein is heated uniformly by the laser to a temperature of 85 °C. Heated tendons, like any protein, shrink when heated. The venous lumen disappears, blood flow through it stops.
Restoration
Immediately after the operation, the patient must walk (about 40 minutes) to avoid stagnation of blood and lymph. After EVLO of the veins of the lower leg, it is necessary to follow the doctor's recommendations:
- During the week, increased physical activity and heavy lifting are prohibited;
- It needs to walk more, be in the same position as little as possible (with the exception of sleep);
- For 3-4 weeks you need to stop taking hot showers, you can only take a shower;
- You must stop visiting the bathhouse for at least a month;
- It is necessary to drink plain water as much as possible, on average about 2. 5 liters, while you need to minimize the amount of salt used;
- A week after the operation, you need to start physical therapy, which the doctor will tell you;
- The doctor may prescribe some medications after surgery.
Sclerotherapyis a method of non-surgical (minimally invasive) removal of varicose veins and spider veins on the lower leg.
Benefits of vein sclerotherapy:
- absolute outpatient care, requiring no additional preparation,
execution speed, - does not require anesthesia,
- the absence of typical complications for surgical treatment methods such as nerve damage,
- the absence of "heat-induced phlebitis", characteristic of the coagulation method, accompanied by disturbing pain along the accumulated veins.
Therefore, today vein sclerotherapy for varicose veins is a safe and effective method, which in some cases can be used as an alternative to other types of surgical intervention.
The method of sclerotherapy is based on the destruction of the vein by introducing chemicals into its lumen, which "washes" the inner layer (endothelium) with the subsequent development of endofibrosis. The degree of endothelial damage depends on the concentration and volume of the drug administered.
Modern medical centers use advanced technology for the treatment of varicose veins, ensuring the maximum effectiveness of all treatment measures. The use of modern equipment by experienced professionals will relieve you of 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.