The disease caused by a violation of the structure of the vascular wall, its thinning, with a pronounced stagnant blood flow process, is called varicose veins. The disease often affects the lower part of the legs, although it can be localized throughout the body. According to the international classification of diseases from the tenth revision of ICD 10, varicose veins are coded 183, which includes four titles describing the various manifestations of the disease.
How do Varicose Veins Appear?
The first mention of varicose veins is found on ancient Greek papyri. History and confirmed scientific facts say that varicose veins in the lower part of the legs were found in Egyptian mummies found - it can be said that the disease accompanied humans throughout its existence.
Incredible doctors - Avicenna, Hippocrates, Galen tried to treat varicose veins on the lower legs. In the nineteenth century, methods of treatment of pain and trauma were used, which consisted of dissecting the tissues of the thighs and lower legs to damage the saphenous veins, followed by bandages. It is understood that in this way it is possible to prevent the process of blocked blood flow and varicose veins will be eliminated. However, the method leaves severe scars on the patient’s body, and causes damage to nerves, arteries and disruption of lymph flow.
Soon, the history of the treatment of varicose veins had positive success - in 1908, for the first time, metal probes were used as a method of minimally invasive effect on the walls of blood vessels. Radiographic findings make it possible to perform more precise and efficient surgical operations to remove varicose veins. Now, when proper diagnosis and treatment of the disease is needed, duplex and triplex scans, powerful drugs, laser therapy and sclerotherapy are used. Surgical intervention is only used in cases where the varicose veins cannot be removed with little.
The main cause of this disease
Varicose veins are a great danger, the pathology has become "younger" - previously, most older people suffered, now varicose veins are diagnosed in young patients, very rarely in children.
Causes of this disease:
- Genetic predisposition.
- Overweight, overweight, obesity.
- Inactive sedentary lifestyle.
- Improper diet, poor blood quality.
- Equivalent diseases of the cardiovascular system.
- Professional activities.
- Prolonged standing, strenuous physical exercise.
- Pregnancy and hormonal changes.
- Individual characteristics of the structure of the vascular system.
- Pathological congenital diseases.
- Wear shoes with heels, tight clothing.
- Thermal treatment.
Any of the above reasons can provoke the development of varicose veins, with dangerous consequences, including death.
The structure of the venous canal
To understand what causes varicose veins in the lower part of the legs, you need to have an idea of the structure of the vascular system and its working mechanism. It represents the entire major vein (deep and superficial) and connects perforations (communicates).
The small superficial veins begin in the leg area, extend along the back of the lower leg, branch below the knee into two branches, connected with the popliteal vein and the deep femoral vein.
A large superficial saphenous vein forms in the ankle area, runs along the surface of the foot and lower knee joints, and connects to the femoral vein. The deep veins are located along the branches of the arteries, and the whole venous system is connected by perforated vessels.
With normal blood flow, oxygenated blood flows directly to the heart, and a special venous valve prevents backflow. Varicose veins in the lower part of the legs show strong pressure, the diameter of the venous lumen increases significantly, the valve does not cope with the task, reflux occurs - blood flow is reversed. Improper blood circulation leads to excessive expansion (stretching) of the vascular walls, thinning, blockage of veins and stasis of their blood. As a result - bloating, swelling of the veins, the formation of nodes.
Symptoms and clinical picture
Varicose veins can develop for a long time in a latent form, then the symptoms appear:
- The formation of spider veins is the accumulation of mesh from small dilated veins.
- A clear pattern of congested veins protrudes under the skin.
- Formation of blood vessel compaction sites - varicose veins in the form of well -distinguished tubercles in the legs.
- Normal discoloration of the skin, cyanosis, darkness appears, the upper layer (dermis) acquires a loose structure.
- Pain, heaviness, deformity and fatigue of the legs, decreased movement, difficulty walking.
- With varicose veins in the lower part of the leg, the formation of soft tissue swelling is possible.
Ignoring timely treatment leads to serious and dangerous consequences, when a person can be cured only with immediate surgical intervention.
Classification of diseases
Varicose veins according to ICD 10 are classified as diseases with ulcers, with inflammation, with ulcers and inflammation, when these signs are absent. According to the international classification of chronic venous diseases, created in 1994, varicose veins are classified into:
- Intradermal, segment. No pathological venous discharge was observed.
- Segmental with reverse blood flow, occurs through superficial and perforated veins.
- Distributed by reverse blood flow through superficial and perforated veins.
- Varicose veins with backflow of blood through deep veins.
It is customary to divide the disease according to the additional signs of the clinical picture:
- On examination or palpation, there are no symptoms.
- Reticular veins are expressed.
- There are varicose veins.
- There is swelling of the soft tissues.
- Violation of normal skin color.
- Revealing lipodermatosclerosis.
- There was an ulcer that healed.
- Active ulcers are noted.
Symptoms are absent or subjective (patient's feelings). In addition, varicose veins are classified for the following reasons: congenital, primary, secondary, with unknown factors that provoke the development of the disease.
Diagnosis of varicose veins
The main way to identify varicose veins is visual examination and palpation of the patient. To determine the severity of the disease carefully and choose the right treatment, when the medical history is studied and palpation is used, the phlebologist prescribes:
- A complete blood count is the primary standard for determining red blood cell counts and hemoglobin levels. According to blood clotting, conclusions are drawn about the stage of disease progression and the predisposition to thrombosis.
- Doppler ultrasound. This method consists in ultrasound diagnostics of the speed and direction of blood particles. This allows you to determine in which direction the blood flow is being conducted, whether the speed is sufficient.
- Ultrasonic agnioscanning. It is used for visual inspection of vascular walls, their structure, direction and speed of blood flow in real time on an ultrasound machine monitor.
- Plethysmography. Diagnostics based on the detection of electrical resistance in foot tissues. With proper circulation, the parameters should indicate a normal standard.
- Diagnostic Rheovasography. Based on the determination of tissue blood filling index. The rheographic index helps determine the degree of varicose veins - compensation, subcompensation or decompensation.
The history of the disease and its study, by obtaining comprehensive diagnostic data, allows the physician to choose the method of treatment.
Conservative drug therapy
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, used as an additional method of treatment in the formation of varicose veins, boils, eczema.
The main groups of drugs prescribed are:
- Phlebotonics and phleboprotectors. Venotonic medicine is standard, which means conservative treatment. Promotes the restoration of the structure of the vascular wall, strengthens and tightens blood vessels.
- Means for effective blood thinning. They contribute to an improvement in quality composition, blood flows faster through the veins, reduce the risk of blood clots, restore normal blood circulation, and relieve pain.
- NSAIDs (anti-inflammatory drugs). Relieves pain, prevents cramps, effectively relieves inflammation and swelling.
Conservative treatment helps by referring precisely to a phlebologist, at an early stage possibly affecting the composition of the blood and the condition of the vascular wall. With complex forms of the disease, drastic action is required.
Laser therapy
Laser therapy is recognized as a gentle and least traumatic method when varicose veins in the legs require treatment classified according to ICD code 10 183. The idea of this method is to use laser beams that actively affect the vascular wall and increase its adhesion. The LED connected to the laser device is inserted into a vein by piercing the skin. The beam is selective and does not affect nearby healthy tissue. Important advantages of laser therapy in the treatment of varicose veins:
- Quick positive effects.
- Absence of pain and injury.
- Stable results, long -term forgiveness.
- Restoration of normal blood circulation.
Contraindications to its use are thick or too thin vessel walls, lumus large veins, pregnancy, oncology and other concomitant diseases.
Sclerotherapy for varicose veins
This method is based on the introduction into the blood vessels affected by varicose veins a special preparation of liquid or foam - sclerosant. They replace endothelial cells with fibrous tissue. To perform sclerotherapy, needles, syringes and sclerosants are used.
The treatment technique consists of the following steps:
- pathological vein piercing;
- pumping (throwing) all the blood from the vessel;
- administration of sclerosant preparations;
- imposition of appropriate knitted bandages or compresses.
This method gives lasting results. The procedure is painless, the consolidation of vascular tissue with varicose veins is an alternative to surgery.
Perform surgery
The most painful and traumatic method of treating varicose veins is surgery. Indications for conducting it are extensive vascular lesions, the presence of varicose veins, dangerous consequences of this disease, for example, acute thrombophlebitis.
Phlebectomy is performed under local anesthesia, the pathological vein is entangled, the required number of incisions are made to remove it, and removed. Surgery is recognized as an effective method of treatment, showing results in eighty percent of cases. But phlebectomy has a number of side effects: wound complications, trauma to the lymph nodes, in extreme cases, with damage to the deep nerves, immobilization and deformity can occur.
To avoid dangerous complications of varicose veins, which are manifested by: varicose veins, boils, bleeding, phlebothrombosis, pulmonary embolism and other serious consequences, you should see a doctor in the early stages of varicose veins!