Varicose veins are dominant disease of the superficial venous system. Varicose veins are actually every kind of dilated, curved and prominent superficial leg veins. The disease of varicose veins is a part of the most massive group of diseases according to the World Health Organization, 10-30% of the total human population suffers from this disease.
Varicose veins usually develop after the age of 15 and strongly manifested at the age of 30-60. Varicose veins are directly caused by poor circulation in legs.
The final stages of the disease are most pronounced in the age after 60, when changes occur in the skin and subcutaneous tissue (dermatitis, dermatosclerosis) and then they are difficult to treat. Vein diseases occur more frequently in women than in men.
Varicose veins symptoms
In many cases the disease is asymptomatic, accompanied by aesthetic issues, especially in women.
- feeling of heaviness and tension in the legs at the end of the day or after prolonged standing that disappears during the night or by raising the extremities,
- itching of the skin and painful muscle cramps during the night,
- leg swelling in the region of ankles which generally reverts during the night or by raising the extremities.
Disorders of venous flow cause damage to the microcirculation and the lymphatic system. This condition is manifested by pain, feeling bloated, occasional convulsions (especially at night), numbness, swelling at a standstill, and skin damage especially in the area around the feet and ankles, and similar manifestations. In patients with this stage painful varicose thrombophlebitis with possible expansion process and the involvement of the main superficial venous tree are frequent. Varicose veins sometimes can lead to the frequent leg cramps.
There is a general agreement that, in addition to hereditary factors, the most common causes of varicose veins are long standing in one place, obesity and pregnancy.
Basics of diagnosis of venous varices are determined through the inspection in the upright position of patients. Careful palpation may reveal the existence of thrombosis mass inside the varices, and auscultation excludes the possible existence of arterio-venous connections (shunts). For precise localization and level of damage of venous valves function it is necessary to use functional tests (tests for the detection of weak superficial veins). The use ECHO Doppler test is of particular importance, it can significantly reduce the use of phlebography or other invasive diagnostic procedures.
Treatment of varices is difficult and it is accompanied by a significant incidence of re-expansion (recurrent varices). Repeated, sequelae or recurrent varices can be true (reappearance of previously removed varices) or false (the appearance of varices outside the zone of treatment). The frequency of recurrence of varices depends on the type of treatment and implementation of preventive measures. Elastic bandages and avoiding static leg load, significantly prevent the appearance of subsequent varices. Avoiding other risk factors such as weight reduction, activation of muscle venous pump and so on also help in prevention.
The type of implemented therapeutic procedures is dictated by the stage of the disease i.e., the clinical stage of disease.