When it comes to diseases of the superficial veins of the lower extremities, in most cases their varicose expansion is meant. However, the range of pathological processes that are associated with the veins of the legs is much wider. It includes even more dangerous pathologies, such as, for example, thrombophlebitis. Let's figure out what are the causes of such diseases and what methods of treatment are used to eliminate them.
Varicose veins
Distinguish between superficial and deep veins of the lower limb.
All arteries of the lower extremities are distinguished by thick and elastic walls with smooth muscles. This is explained by the fact that blood is ejected through them under the strongest pressure.
The superficial veins of the lower limb include:
- MVP or small saphenous vein;
- BVP - great saphenous vein;
- skin veins,located under the back of the ankle and plantar zone.
Varicosis is a pathology of the venous walls. With varicose veins, the venous walls expand and become thinner, as a result of which the blood flow through them is disturbed. The disease is associated with reduced tone of the veins and insufficiency of their valves. The outflow of blood through the veins begins to weaken, the lumen of the veins increases. The venous valves also become deformed, becoming shorter, thicker and no longer able to cope with their basic functions. Most often, varicose veins affect the lower extremities.
Reasons
The causes of this disease of the superficial veins of the lower extremities are:
- genetic predisposition;
- overweight;
- constant excessive tension of the limbs during prolonged stay on the legs;
- sedentary lifestyle;
- low physical activity;
- pregnancy;
- hormonal imbalance;
- presence of bad habits (smoking, alcohol, drugs);
- taking hormonal medications.
The initial manifestations of the disease include the following symptoms:
- swelling of the legs, worse in the evening, heaviness in the limbs;
- Feeling of fullness in the calves.
In the morning and when walking, the symptoms become less pronounced. However, the disease progresses, and gradually there are more unpleasant symptoms: convulsions, pain syndrome, fever in the legs appear, telangiectasias form on the skin.
In case of pathology of the superficial veins of the lower extremities, it is necessary to contact a phlebologist who conducts an examination and prescribes diagnostic procedures, including contrast venography and duplex scanning. Therapeutic tactics depend on the patient's condition and the stage of the pathological process. Medicines, physiotherapy exercises, traditional medicine, the use of compression underwear and surgical methods of treatment are used. Drug therapy involves the use of drugs that strengthen the vascular walls and thin the blood (phlebotonics, anticoagulants, venotonics, non-steroidal anti-inflammatory drugs). In addition, local medicines in the form of ointments are used. At the 3rd and 4th stages of the pathology, the only treatment is surgery. Patients are prescribed:
- sclerotherapy (the altered vein is resorbed with a special drug);
- laser therapy (turning off a vein from the bloodstream);
- traditional phlebectomy (vein removal).
Phlebitis
This disease of the superficial veins of the lower extremities is an inflammatory process in the walls of the veins. In most cases, phlebitis is a consequence of varicose veins of the lower extremities. As a result of inflammation in these veins, blood flow is disturbed and blood clots form. Subsequently, phlebitis turns into a more dangerous form - thrombophlebitis. Phlebitis can be caused by the following factors:
- abscess complications;
- complication of varicose veins;
- chemical skin burns;
- streptococcal infection.
The impetus for the development of the disease can also be the human factor (failed sclerotherapy). The symptoms of this disease are:
- pain syndrome;
- skin hyperemia;
- general weakness;
- hyperthermia;
- swelling of the limb.
Chronic form
In the chronic form, the symptoms of pathology are less intense. They periodically subside, then appear again. Treatment of phlebitis consists in the complex application of conservative methods. If the lesion is localized only in the area of superficial veins, hospitalization is not required. In other cases, the patient is subject to hospitalization. His legs should be on some elevation and at rest. The phlebologist prescribes medical remedies, the action of which is aimed at strengthening the walls of the veins and reducing the density of the blood. Also, the treatment of superficial veins of the lower extremities involves the elimination of the inflammatory process. When the exacerbation subsides, the patient is prescribed to wear compression underwear and use elastic bandages. Prevention of the disease consists in the timely treatment of injuries, pustular diseases and all kinds of inflammation.
Thrombophlebitis
This pathology is the main of the possible complications of varicose veins. Thrombophlebitis is characterized by the development of an inflammatoryprocess on the walls of the veins and the formation of blood clots. Doctors believe that every fourth person belongs to the risk group. The most common location of the lesion is the lower extremities (the area is from the lower buttock to the lower part of the calves).
Causes that can provoke an increase in blood density and, following it, the formation of blood clots:
- pregnancy;
- overweight body;
- injuries;
- genetic factor;
- respiratory viral infection;
- reduced motor activity;
- overheating of the body;
- diabetes.
The disease is usually preceded by the following pathological conditions:
- inflammation process on the venous wall;
- increased blood clotting;
- impaired blood flow.
Symptoms of thrombophlebitis of the superficial veins of the lower extremities are pain in the area of the veins (gradually the pain becomes more intense and does not stop even at rest), high body temperature, general malaise, redness of the skin, hardened areas, weakness in lower extremities, feeling of coldness in the toes, lameness when walking. Often, the pathological process proceeds aggressively, accompanied by a rise in temperature and severe pain in the vein area.
Increase in puffiness
Puffiness gradually increases, and the skin on the affected areas begins to turn red. Body temperature can reach up to 38 degrees. As a rule, on acutestage of thrombophlebitis, such symptoms continue for 10-30 days. Further, the disease is transformed into a chronic form. Diagnosis begins with an examination. The doctor determines the painful areas and the nature of the changes on the skin. To confirm the diagnosis, a blood test for clotting is prescribed. In addition, X-ray contrast phlebography and duplex scanning are performed. Therapeutic measures for this disease are divided into 2 groups: surgical and conservative.
Conservative Therapy
Conservative treatment of thrombophlebitis of the superficial veins of the lower extremities is carried out on an outpatient basis, if the thrombus has not advanced beyond the lower leg. If the pathology is caused by trauma to the venous wall, anticoagulants or alcohol compresses are prescribed. Anti-inflammatory drugs are prescribed to relieve pain. In the treatment of thrombophlebitis, the following groups of drugs are prescribed: phlebotonics ("Venosmin", "Detralex"), angioprotectors (rutin), anti-inflammatory nonsteroidal drugs ("Diclofenac", "Sinmeton", "Meloxicam"), anticoagulants ("Sinkumar", "Warfarin"). Surgical treatment is indicated when there is a risk of complications, as well as in cases where the pathology has spread to deep veins. Surgical treatments include:
- thrombectomy (removal of a blood clot);
- ligation of pathological vessels;
- phlebectomy (vein removal).
What else does the expansion of the superficial veins of the lower extremities lead to?
Thrombosis
This pathology develops as a result of violations of the venous walls of deepveins. The cause of thrombosis is most often infectious, mechanical or chemical damage to the vein, as well as an allergic reaction. The risk of this pathology also increases with increased blood clotting, which leads to a decrease in blood flow velocity. Another prerequisite for the development of this disease is congestion in the veins of the legs as a result of prolonged standing or low physical activity. Thus, physical inactivity is the main cause of varicose veins of the superficial veins of the lower extremities and thrombosis.
In the lower part of the leg, a blood clot is not dangerous, which cannot be said about cases of its localization in its upper part. The higher the thrombus rises, the greater the likelihood of a blood clot detaching from the vessel wall increases. If a clot travels to the lungs or heart, it blocks blood flow and thromboembolism occurs, leading to severe shortness of breath, cardiac arrest, and death. If a blood clot enters the arteries of the brain, it causes a stroke.
Initial stage
At the initial stage, the symptoms of pathology may be mild. Over time, more symptoms of thrombosis occur:
- swelling of limb;
- changing the shade of the skin on the leg affected by a blood clot;
- seizures, more common at night;
- pain in the thigh, foot and lower leg (pain subsides when the leg is horizontal);
- fever;
- venous insufficiency.
At the acute stage, thrombosis proceeds rapidly: blood flow through the vein partially or completely stops, the legs and thighs increase in size, the saphenous veins are noticeably dilated, cyanosis and hyperthermia are noted.
Diagnosis
A phlebologist during the diagnosis conducts an examination and a tourniquet test with an elastic bandage. Duplex scanning, phlebography, rheovasography of the lower extremities and ultrasound of the veins are also prescribed.
Treatment tactics
Treatment tactics depend on the stage of the pathology, the patient's condition, and the localization of the thrombus. The main task in this disease is to avoid the spread of thrombosis and the occurrence of pulmonary embolism. The therapy is carried out in a hospital setting. The patient is prescribed bed rest and medications, including fibrinolytic and thrombolytic drugs, anticoagulants and antiplatelet agents. Surgical treatment is carried out in cases of life-threatening.
