The disease caused by a violation of the structure of the vascular walls, their thinning, with pronounced stagnant blood flow processes, is called varicose veins. The disease often affects the lower extremities, although it can be localized to the rest of the body. According to the International Classification of Diseases of the Tenth Revision of ICD 10, varicose veins are assigned the code 183, which consists of four headings describing various manifestations of the disease.
How did varicose veins appear?
The first mentions of varicose veins were found in ancient Greek papyri. History and confirmed scientific facts say that varicose veins of the lower extremities were found in the Egyptian mummy found - it can be argued that the disease accompanies humanity throughout its existence.
Outstanding doctors - Avicenna, Hippocrates, Galen tried to treat varicose veins of the lower extremities. In the 19th century, painful and traumatic treatment methods were used, which involved dissecting tissue in the thigh and lower leg to damage the saphenous veins, followed by bandaging. It has been understood that in this way it is possible to avoid the processes of stagnant blood flow and varicose veins will be eliminated. However, the methods left terrible and extensive scars on the patients' bodies and helped damage nerves, arteries and disrupt lymphatic flow.
A little later, the history of the treatment of varicose veins experienced a positive breakthrough - in 1908, for the first time, a metal probe was used as a means of minimally invasive effect on the walls of blood vessels. The discovery of radiography made it possible to perform more precise and efficient surgeries to remove varicose veins. Now, when a correct diagnosis and treatment of the disease is needed, duplex and triplex scanners, strong drugs, laser therapy and sclerotherapy are used. Surgical intervention is only used in cases where varicose veins cannot be removed sparingly.
The main causes of the disease
Varicose veins are a great danger, the pathology has become "younger" - before, most of the elderly suffered, now varicose veins are diagnosed in young patients, extremely rarely in children.
Causes of the disease:
- Genetic predisposition.
- Overweight, overweight, obesity.
- Inactive sedentary lifestyle.
- Poor diet, poor blood quality.
- Concomitant disease of the cardiovascular system.
- Professional activity.
- Prolonged standing, intense physical exertion.
- Pregnancy and hormonal changes.
- Individual features of the structure of the vascular system.
- Pathological congenital diseases.
- Wear high heels, tight clothes.
- Thermal treatments.
Any of the above reasons can provoke the development of varicose veins, the consequences are dangerous, including death.
The structure of the venous vessels
To understand the causes of varicose veins of the lower extremities, you need to get an idea of the structure of the vascular system and the mechanism of its work. It represents all the main perforating veins (deep and superficial) and conjunctiva (communicating).
The small superficial vein begins in the region of the foot, runs along the back of the leg, branches out below the knee into two branches, connects with the popliteal vein and the deep femoral vein.
A large superficial saphenous vein forms in the ankle region, runs along the surface of the leg and knee joint, and connects with the femoral vein. The deep veins are located along the branches of the arteries, and the entire venous system is connected by perforating vessels.
With normal blood flow, oxygenated blood flows directly to the heart, and special venous valves prevent backflow. Varicose veins of the lower extremities involve strong pressure, the diameter of the venous lumen increases significantly, the valves do not cope with the task, reflux occurs - the reverse blood flow. Poor blood circulation causes excessive expansion (stretching) of the vascular walls, their thinning, venous obstruction and blood stasis. As a result - bloating, swelling of the veins, the formation of knots.
Symptoms and clinical presentation
Varicose veins can develop for a long time in a latent form, then the signs appear:
- The formation of spider veins is an accumulation of meshes of small dilated veins.
- Well-defined pattern of congested veins protruding under the skin.
- The formation of places of compaction of blood vessels - varicose veins in the form of distinct tubercles on the legs.
- A change in the normal color of the skin, cyanosis, blackness appears, the upper layer (dermis) acquires a loose structure.
- Sensation of pain, heaviness, distension and fatigue in the legs, reduced mobility, difficulty walking.
- With varicose veins of the lower extremities, 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 disease with ulcer, with inflammation, with ulcer 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, segmental. No pathological venous discharge is observed.
- Segmental with reversed blood flow, occurs through the superficial and perforating veins.
- Distributed with reverse blood flow through the superficial and perforating veins.
- Varicose veins with reversed blood flow in the deep veins.
It is customary to divide the disease according to additional signs of the clinical picture:
- On examination or palpation, there are no symptoms.
- The reticular veins are expressed.
- There are varicose veins.
- There is soft tissue swelling.
- Violation of normal skin color.
- Lipodermatosclerosis revealed.
- There is a healed ulcer.
- An active ulcer was revealed.
Symptoms are absent or subjective (patient feelings). In addition, varicose veins are classified for reasons: congenital, primary, secondary, with an unknown factor that provoked the development of the disease.
Diagnosis of varicose veins
The predominant way to identify varicose veins is by visual examination and palpation of the patient. In order to carefully determine the severity of the disease and choose the appropriate treatment, when the medical history is studied and palpation is applied, the phlebologist prescribes:
- A complete blood count is the main standard for determining the number of red blood cells and hemoglobin level. Depending on the coagulation of the blood, conclusions are drawn about the degree of development of the disease and predisposition to thrombosis.
- Doppler ultrasound. The method consists of ultrasound diagnosis of the speed and direction of blood particles. This allows you to establish in which direction the blood flow is carried out, whether it has a sufficient speed.
- Ultrasound agnioscanning. It is used for visual examination of vascular walls, their structure, direction and speed of blood flow in real time on the monitor of the ultrasound machine.
- Plethysmography. The diagnosis is based on the detection of the electrical resistance of the tissues of the leg. With good circulation, the parameter should indicate the normal norm.
- Rheovasographic diagnosis. Based on the determination of the blood filling index of tissues. The rheographic index helps to determine the stage of varicose veins - compensation, under-compensation or decompensation.
The history of the disease and its study, obtaining comprehensive diagnostic data, allows the doctor 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, is used as an additional method of treatment in the formation of lymph nodes, ulcers, eczema.
The main groups of prescribed drugs are:
- Phlebotonics and phleboprotectors. Venotonic drugs are the norm, involving conservative treatment. Promote the restoration of the structure of the vascular walls, strengthen and tone blood vessels.
- Means for effectively thinning the blood. They contribute to the improvement of the quality composition, the blood circulates more quickly through the veins, reduces the risk of blood clots, restores normal blood circulation and relieves pain.
- NSAIDs (anti-inflammatory drugs). Eliminate pain, prevent cramps, effectively relieve inflammation and swelling.
Conservative treatment helps to timely orient a phlebologist. At the initial stage, it is possible to influence the composition of the blood and the condition of the vascular walls. With the complex forms of the disease, drastic measures are needed.
Laser therapy
Laser therapy is recognized as a gentle and less traumatic method when varicose veins in the legs require treatment classified according to ICD 10 code 183. The idea of the method is to use a laser beam that actively affects the vascular walls andpromotes their adhesion. . An LED connected to a laser device is inserted into the vein by piercing the skin. The beam is selective and has no effect on adjacent healthy tissue. Significant advantages of laser therapy in the treatment of varicose veins:
- Quick positive effect.
- Absence of pain and injury.
- Stable result, long-term remission.
- Restoration of normal blood circulation.
Contraindications for use will be thick or too thin vessel walls, large venous lumens, pregnancy, oncology and other serious concomitant diseases.
Sclerotherapy of varicose veins
The method is based on the introduction into the vessels with varicose veins of special liquid or foamy preparations - sclerosants. They replace endothelial cells with fibrous tissue. To perform sclerotherapy, needles, syringes and sclerosants are used.
The treatment technique consists of the following steps:
- piercing of a pathological vein;
- pumping (withdrawing) all the blood from the vessel;
- administration of a sclerosing preparation;
- the imposition of a suitable bandage or knitted compression.
This method gives a lasting result. The intervention is painless, the fusion of vascular tissues with varicose veins is an alternative to surgery.
Perform an operation
The most painful and traumatic way to treat varicose veins is through surgery. Indications for carrying out will be extensive vascular damage, the presence of varicose veins, dangerous consequences of the disease, for example, acute thrombophlebitis.
The phlebectomy is performed under local anesthesia, the pathological vein is ligated, the required number of incisions are made to remove it, and then removed. The operation is recognized as an effective method of treatment, shows the result 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 disability can occur.
In order to prevent dangerous complications of varicose veins, which are manifested by: lymph nodes, ulcers, bleeding, phlebothrombosis, pulmonary embolism and other serious consequences, you need to consult a doctor at the initial stage of varicose veins!