The disease caused by the violation of the structure of the blood vessel walls, their thinning, is called varicose veins with pronounced stagnant blood flow processes. The disease often affects the lower extremities, although it can be localized in the rest of the body. According to the international classification of the 10th revision of the ICD, varicose veins are given code 183, which contains four chapters that describe the different manifestations of the disease.
How did the varicose veins appear?
The first mention of varicose veins was found in ancient Greek papyri. History and confirmed scientific facts say that varicose veins of the lower limbs were found in the found Egyptian mummy - it is arguable that the disease accompanies humanity.
Excellent doctors - Avicenna, Hippocrates, Galen tried to treat the varicose veins of the lower extremities. In the nineteenth century, painful and traumatic treatment methods were used, which consisted of dissecting the tissues of the thighs and lower legs to damage the saphenous veins, followed by bandaging. It was understood that in this way, stagnant blood flow processes could be prevented and varicose veins would cease. However, the methods left terrible, extensive scars on the patients ’bodies and contributed to nerve, arterial damage, and disruption of lymph flow.
A little later, the history of varicose veins received a positive breakthrough - in 1908, a metal probe was first used as a means of minimally invasive effect on the vessel wall. The discovery of radiography has made it possible to perform more precise and effective surgical operations to eliminate varicose veins. Now that the disease needs to be properly diagnosed and treated, duplex and triplex scanning, effective medications, laser therapy, and sclerotherapy are being used. Surgery is used only in cases where varicose veins cannot be gently removed.
The main causes of the disease
Varicose veins are a great danger, the pathology has become "younger" - previously mostly elderly people have suffered, now varicose veins are diagnosed in young patients, extremely rarely in children.
Causes of the disease:
- Genetic predisposition.
- Overweight, overweight, obesity.
- Sitting, inactive lifestyle.
- Improper diet, poor blood quality.
- Concomitant disease of the cardiovascular system.
- Professional activities.
- Long job, hard physical effort.
- Pregnancy and hormonal changes.
- Unique characteristics of vascular structure.
- Congenital diseases.
- Wearing shoes with heels, tight clothing.
- Heat treatments.
Any of the above causes can provoke the development of varicose veins, the consequences are dangerous, including death.
Structure of venous vessels
To understand what causes varicose veins in the lower extremities, you need to get an idea of the structure and mechanism of action of the vascular system. It represents the totality of the main (deep and superficial) and connecting perforating (communicating) veins.
The small superficial vein begins in the region of the foot, extends to the back of the lower leg, branches into two branches below the knee, connecting the popliteal vein and the deep femoral vein.
In the region of the ankle, a large superficial saphenous vein is formed, running along the surface of the lower leg and knee joint, and joining the femoral vein. Deep veins are located along the branches of the arteries and are connected by perforating vessels throughout the venous system.
With normal blood flow, oxygen-saturated blood flows directly into the heart, and special venous valves prevent backflow. Varicose veins in the lower limbs put strong pressure, the diameter of the venous lumen increases significantly, the valves cannot cope with the task, reflux occurs - reverse blood flow. Improper blood circulation causes excessive dilation (stretching), thinning, venous occlusion, and stagnation of blood vessels. As a result - bloating, swelling of the veins, the formation of nodules.
Symptoms and clinical appearance
Varicose veins are able to progress in a latent form for a long time, and then the signs appear:
- The formation of spider veins is the accumulation of a network of dilated small blood vessels.
- A well-defined pattern of congested veins protruding under the skin.
- Formation of blood vessel compression sites - varicose veins in the form of well-distinguished tubercles on the legs.
- Changes in the normal color of the skin, cyanosis, blackness appear, the upper layer (dermis) gets a loose structure.
- Pain, difficulty, tension and fatigue in the legs, decreased mobility, difficulty walking.
- Swelling of the soft tissues may occur in the varicose veins of the lower extremities.
Ignoring timely treatment leads to serious and dangerous consequences when a person can only be cured by immediate surgery.
Classification of diseases
Varicose veins according to ICD 10 can be classified into ulcerative, inflammatory, ulcerative, and inflammatory diseases if these signs are absent. According to the International Classification of Chronic Venous Diseases, established in 1994, varicose veins are divided into:
- Intradermal, segmental. No abnormal venous secretions are detected.
- Segmental reverse blood flow occurs through the superficial and perforating veins.
- It is distributed by reverse blood flow through superficial and perforating veins.
- Varicose veins with reversed blood flow in the deep veins.
It is customary to divide the disease according to further signs of the clinical picture:
- There are no symptoms during the test or touch.
- Reticular veins are expressed.
- There are varicose veins.
- There is swelling of the soft tissues.
- Violation of normal skin color.
- It turned out to be lipodermatosclerosis.
- I have a healed ulcer.
- An active ulcer was detected.
Symptoms are absent or subjective (patient feelings). In addition, varicose causes are classified: congenital, primary, secondary, unknown factor that triggered the development of the disease.
Diagnosis of varicose veins
The main way to identify varicose veins is to visually examine and feel the patient. In order to carefully determine the severity of the disease and to select the appropriate treatment, when the medical history is studied and palpated, the phlebologist prescribes:
- A complete blood count is the main standard for determining red blood cell counts and hemoglobin levels. According to blood coagulation, conclusions are drawn about the degree of development of the disease and the tendency to thrombosis.
- Doppler ultrasound. The method consists of ultrasound diagnosis of the velocity and direction of blood particles. This makes it possible to determine in which direction the blood flow is happening, regardless of whether it has sufficient velocity.
- Ultrasonic agnioscaning. It is used for real-time visual inspection of vessel walls, their structure, direction, and blood flow on the ultrasound device monitor.
- Plethysmography. Diagnosis is based on the detection of electrical resistance in the foot tissue. In case of proper circulation, the parameter should indicate the normal standard.
- Rheographic diagnostics. Based on the determination of the tissue blood load index. The rheographic index helps determine the stage of varicose veins - compensation, undercompensation, or decompensation.
The history and examination of the disease, the acquisition of comprehensive diagnostic data allow the doctor to choose the method of treatment.
Conservative medication
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 in the initial stage is used as an effective, additional treatment method for the development of nodules, ulcers, eczema.
The main groups of medicines prescribed are:
- Phlebotonics and phleboprotectors. Venotonic drugs are the standard, conservative treatment. It helps to restore the structure of the vessel walls, strengthens and tones the blood vessels.
- Means for effective blood thinning. They help to improve the quality composition, the blood flows faster in the veins, reduces the risk of blood clots, restores normal blood circulation and relieves pain.
- NSAIDs (anti-inflammatory drugs). It eliminates pain, prevents cramps, effectively relieves inflammation and swelling.
Conservative treatment helps in timely referral to the phlebologist, in the initial stage it is possible to influence the composition of the blood and the condition of the vessel walls. Complex forms of the disease require drastic action.
Laser therapy
Laser therapy is recognized as a gentle and least traumatic method if the varicose veins of the legs are to be treated according to the classification according to ICD code 10 183. . The LED connected to the laser device is inserted into the vein by inserting it into the skin. The beam is selective and has no effect on adjacent healthy tissues. Significant benefits of laser therapy in the treatment of varicose veins:
- Fast positive effect.
- Lack of pain and injury.
- Stable results, long-term remission.
- Restoration of normal blood circulation.
Contraindicated in use are thick or excessively thinned vessel walls, large venous lumens, pregnancy, oncology and other serious concomitant diseases.
Sclerotherapy for varicose veins
The method is based on the introduction of special liquid or foam preparations - sclerotants - into the vessels affected by varicose veins. Endothelial cells are replaced by fibrous tissues. Needles, syringes, and sclerosing agents are used to perform sclerotherapy.
The treatment technique consists of the following steps:
- piercing of a pathological vein;
- pumping (removing) all blood from the vessel;
- administration of a sclerosing composition;
- application of appropriate bonding or bonded compression.
This method gives a lasting result. The procedure is painless, fusion of vascular tissues and varicose veins is an alternative to surgery.
Perform an operation
The most painful and traumatic way to treat varicose veins is surgery. The indications are extensive vascular lesions, the presence of varicose veins, dangerous consequences of the disease, such as acute thrombophlebitis.
Phlebectomy is performed under local anesthesia, the abnormal vein is ligated, the required number of incisions are removed, and removed. Surgery is recognized as an effective treatment, showing results in eighty percent of cases. However, phlebectomy has a number of side effects: wound complications, lymph node trauma, and in extreme cases, deep nerve damage, immobilization, and disability.
To prevent the dangerous complications of varicose veins, which include: nodules, ulcers, bleeding, phlebotrombosis, pulmonary embolism, and other serious consequences, see a doctor in the early stages of varicose veins.