Varicose veins

Apr 7, 2012 , Kateřina Hudecová

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Varicose veins are a common condition that affects the veins of the lower extremities and is manifested by their swelling, pain and typical changes on the skin. Varicose veins occur as a result of their long-term overloading. Varicose veins are a disease which can be prevented by following certain preventive measures.

Varicose veins

Varicose veins are one of the most common diseases of the venous system, usually in the lower extremities. This typical localization is caused mainly because the veins of the legs, along with their valvular apparatus, must overcome gravity to supply the blood towards the heart. Varicose veins more often affect women. This is probably due to the influence of female hormones or pregnancy.

Function of veins

The veins in our body have a very important function, since they transport oxygen deprived blood from the tissues back to the heart. So the blood from the legs gets to the heart, these veins have valves that prevent backflow of blood. The blood from the lower extremities is exported by two venous systems, called superficial and deep vein systems, which are mutually interconnected by venous connections, called perforators. These connections also have valves and ensure that blood from the superficial veins reaches the deep veins. The deep vein system removes most of the blood from the lower extremities.

Causes of varicose veins

The nature of varicose veins is the swelling of the venous wall. Due to this also the venous valves are damaged, do not contract well and are not able to provide adequate blood flow. Damaged are also valves in the venous connections and the blood from the deep system begins to overload the superficial system, which is not adapted for this. The blood in the veins starts to accumulate and often blood clots are formed here and the blood flow is impaired. Swelling of the venous wall may be caused by the increased volume of blood in the veins and with that associated higher pressure of blood on their wall, which then flares outwards. But also frequently the weakness of the venous walls is congenital and hereditary. Female sex hormones or pregnancy are also involved in the formation of varicose veins.

Types of varicose veins

Varicose veins affect most often the venous system of the lower extremities. Basically there are two types of varicose veins, primary and secondary.

  • Primary varicose veins occur mainly in the superficial veins of the thighs and calves and are caused by the actual malfunction of these veins. This occurs by genetically influenced weakening of the venous walls, or standing at work. The deep venous system is not affected.
  • Secondary varicose veins are due to impairment of the deep venous system. They occur most often after deep vein thrombosis due to increased pressure in the superficial veins. It is due to the closure of the deep veins of the legs by blood clots. Also damaging the valves during recanalization of the clogged vein leads to the formation of secondary varicose veins.

Symptoms of varicose veins

Initially, varicose veins are simply a cosmetic problem and no significant symptoms occur. Varicose veins are bulging, serpentine veins of dark color, which can be hard on palpation. Typically, later occurs swelling, tightness and pain in the feet. Usually, these symptoms occur in the evening. As a result of blood circulation disorders in the legs, typical skin changes such as pigmentation or itchy skin appear. Also, there are night cramps. This increases the risk of venous ulcers and reduces the ability of healing. Even minor injuries heal very slowly and can cause oozing.

Risk factors of varicose veins

A wide range of risk factors are known to contribute to varicose veins. Heredity plays an important role. Swelling of the venous wall in this case is caused by a congenital disorder of collagen. Collagen is a protein that is involved in the strength of the vascular wall. In varicose veins is less collagen than in normal veins and therefore, their walls are weaker and easier swell. Other risk factors include hormonal changes during pregnancy, obesity, prolonged standing, decreased physical activity and smoking.

Complications of varicose veins

Varicose veins are among the diseases that initially cause no difficulties to the patient but gradually there are many symptoms and they may lead to complications. These are:

  • Chronic venous insufficiency
  • Phlebitis, a vein inflammation
  • Rupture of varicose veins
  • Varicose ulcers
  • Eczema

Diagnosis of varicose veins

Diagnosis of varicose veins is not too difficult because of their visibility on the surface of the lower extremities. Diagnosis of varicose veins is confirmed by using functional tests, which consist in the gradual constricting of limbs and monitoring their refilling after releasing the tourniquet. The basis of the investigative methods is duplex ultrasonography, which gives us information about the veins, their swelling or pathological blood flow.

Treatment of varicose veins

Treatment of varicose veins is necessary due to various complications, which are a result of the disease. Treatment of varicose veins may be conservative, laser, surgical or sclerotherapy.

  • Conservative treatment is the first option and it means wearing compression stockings to prevent swelling of the veins and also reduces pain. Furthermore, are recommended lifestyle measures, which involve a diet rich in fiber and vitamins, frequent walking and standing limitations. Also for the treatment of varicose veins vasoprotectives are administrated, i.e. drugs that reinforce the venous wall and also improve the outflow of blood from the lower extremities. These include glyvenol or other flavonoids. This method of treatment does not cure the disease, only eases its course.
  • Surgical treatment is a definitive effective method of treatment of varicose veins and is used to treat varicose veins involving the main venous trunks. The surgery is performed under general or local anesthesia. Previously the whole vein was removed. These days a mini-invasive method is used where only the damaged part of the vein is removed.
  • Sclerotherapy is a method that is used for smaller veins and consists of injecting substances into the vein, causing its disturbance, closure and the body gets rid of it by itself. This procedure is outpatient and the patient is burdened only minimally.
  • Laser treatment of varicose veins is the latest method where a laser fiber is introduced inside the vein and seals it. This type of treatment is not covered by insurance and therefore it must be paid by the patients themselves.

Prevention of varicose veins

The best way to prevent varicose veins, of course, is to avoid the risk factors. This means increasing physical activity, reducing overweight and obesity and quitting smoking. It is also advised to wear shoes with low heels and elastic drawstring stockings that help blood flow in the veins. Suitable is the use of drugs to reduce swelling or seizures. To strengthen venous walls is also vein gymnastic recommended, which consists of showering the legs alternately with hot and cold water. Also exercise and movement of the limbs is suggested, suitable is walking or swimming. It is necessary to avoid prolonged periods of standing and for at least 10-15 minutes a day to lift feet up above the level of the heart and thus promote and facilitate blood circulation in the legs.

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