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Venous insufficiency of the lower limbs, symptoms and treatment

A person faces the problem of venous insufficiency of the lower extremities almost immediately when he begins to walk. Until a certain time, compensatory mechanisms work that prevent this process from progressing.

Under the influence of contributing factors to a certain age, many people face this problem. Consider why this happens and what to do with it.

Content

CVI - What is it?

Venous insufficiency of the lower limbs, symptoms and treatment

Chronic venous insufficiency of the lower extremities (CVI) is a combination of certain symptoms, which are caused by poor outflow of lower extremity veins due to a violation of their hemodynamics.

Two main factors are involved in the pathogenesis of the disease.

  • First, this reduction in the diameter of the vessel and, as a consequence, a decrease in its transmittance.
  • Secondly, there is a violation of the mechanism that ensures the outflow of venous blood from the veins of the lower extremities.

How it looks in practice: in humans, normally, blood flow from the veins of the lower extremities occurs through a system of deep and superficial veins to the heart. Such a flow of blood against the action of gravity becomes possible due to the valve mechanism in the veins that prevent blood from flowing in the opposite direction. A certain role is played by the contraction of the muscles of the thigh and lower leg, as well as the condition of the vascular wall.

If there is a malfunction in the work of this streamlined outflow system, venous blood, instead of rising from the veins of the legs to the heart, is delayed, causing vascular overflow and the appearance of various unpleasant symptoms. Thus, microcirculation processes are gradually disrupted, edema and trophic disorders develop.

Important! The highest venous pressure is in the lower third of the leg; therefore, this is where the first problems with venous outflow begin.

In fact, CVI is not a separate diagnosis. This is a complex of symptoms associated with the disruption of the work of veins, which can occur both in congenital and in acquired pathology.

Causes

Causes of venous insufficiency

Causes of venous insufficiency of the lower extremities:

  • reducing the diameter of the venous bed;
  • violation of the valve mechanism, with problems with which there is a reflux of blood into the vein.

The most common cause of CVI is varicose disease and postthrombotic syndrome. In rare cases, congenital vascular anomalies (fistulas, fistulas) and traumatic injuries cause the problem.

In addition to these key reasons, the contributing risk factors of this pathology are:

  1. Hereditary predisposition to the development of vascular weakness.
  2. Pregnancy. In addition to hormonal adjustment, during this period the load on the vessels increases, which leads to the development of varicose veins and the appearance of chronic venous insufficiency in every third woman.
  3. Hormonal disorders and endocrine pathology.
  4. Excessive exercise.
  5. Overweight and metabolic disorders.
  6. Atherosclerosis.
  7. Congenital anomalies of the veins.
  8. Alcohol and smoking, which reduce the tone and elasticity of vascular walls.
  9. Hormonal contraceptives, etc.

Symptoms of venous insufficiency of the lower extremities

Symptoms of venous insufficiency of the lower extremities

According to the clinical course, there are three stages, first of all it is necessary to select the appropriate therapy - the symptoms and treatment of venous insufficiency of the lower extremities depend on the stage of the disease and are determined:

1. Stage of compensation. At this stage, the symptoms of venous insufficiency of the lower extremities remind of themselves only with cosmetic signs: vascular "stars" appear, varicose veins in the legs are visible, etc.

Some patients report fatigue in the legs and swelling in the evenings, others do not pay attention to it. To learn about the diagnosis and assess the degree at this stage is possible only with the help of special studies.

2. Stage of subcompensation. At this stage, the patient appears trophic disorders that are treatable. Standard patient complaints at this stage:

  • pain and fatigue of the legs;
  • cramps and tingling in the legs;
  • itching of the skin;
  • trophic disorders (ulcer, eczema).

Even at this stage, patients most often turn to a specialist, primarily due to cosmetic defects (ulcer, varicose veins).

3. Stage of decompensation. There are irreversible trophic disorders. The patient is worried about pronounced edema (elephantiasis), severe ulcers develop that are not treatable, the color of the skin on the legs (purple-black) changes, pain is painful, and problems with walking occur.

Important! In addition to the stage, when making a diagnosis of CVI, indicate the main disease that caused the development of the symptom complex, as well as a form of CVI: edematous, painful, varicose, ulcerous or mixed. Therefore, the diagnosis will sound like this: Varicose disease. CVI stage II, edematous pain form.

Treatment of venous insufficiency

Treatment of venous insufficiency - compression underwear

Treatment of venous insufficiency of the lower extremities depends on its degree, form and the presence of associated complications. The problem is solved conservatively and surgically.

Conservative therapy consists of:

  • taking drugs that improve the tone of the vascular wall (phlebotonics) and the rheological properties of blood;
  • eliminate risk factors (weight loss, normalization of nutrition and physical activity, pregnancy planning);
  • physiotherapy;
  • prevention of the progression of the pathological process (wearing compression underwear, bandaging, charging).

Surgical treatment is aimed at eliminating directly varicose veins. For these purposes, sclerotherapy is used (a sclerosant substance is injected subcutaneously, which causes adhesion of the vessel walls), as well as various surgeries for resection of superficially changed veins (according to Troyanov-Trendelenburg, according to Linton and others).

Complications

Most patients mistakenly believe that ugly dilated veins - this is the main complication of the disease, but the problem is much more serious.

Complications of CVI may be:

  1. Trophic ulcers. These are non-healing skin defects that appear in advanced stages. They do not respond to treatment and bring painful pain to patients.
  2. Thrombophlebitis - inflammation of the vein wall with the formation of blood clots (blood clots).
  3. Pulmonary embolism. The separation of a blood clot and its migration along the bloodstream can cause an obstruction of one of the branches of the pulmonary artery and be fatal.
  4. Eczema and erysipelas .

Prevention

Prevention is divided into two groups. The first includes measures aimed at preventing the development of the pathological process:

  • weight loss;
  • physical exercise;
  • rest with raised legs;
  • wearing compression underwear, if necessary;
  • smoking cessation, etc.

The second group includes activities that inhibit the progression of CVI and prevent serious complications from developing:

  • wearing compression underwear of a certain compression class (determined by a specialist);
  • a course of physiotherapy (balneotherapy, massage, etc.);
  • pregnancy planning in the presence of varicose veins;
  • physiotherapy;
  • regular monitoring of the condition of the veins (ultrasound and other research methods).

CVI can cause a lot of trouble if you do not take care of its prevention. Literate regimen, weight loss, monitoring of vascular status and other measures will help to prevent the development of severe complications.

Interesting
Irina
2016-07-26 06:30:45
I suffered from constant swelling and tired legs by the end of the working day. On the leg appeared mesh from the vessels. Turned to a phlebologist, said to wear compression underwear and smear legs with Thrombocide. After it, the severity and swelling disappeared and no longer disturbed. The asterisks have almost disappeared. I did not expect such successful results in a month.

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