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Valvular insufficiency of the veins of the lower extremities

Treatment of valvular insufficiency of the veins of the lower extremities begins with determining the cause of the development of the disease. It is noteworthy that this disease has already been diagnosed in adolescents. Doctors consider physical inactivity and malnutrition as one of the causes of premature development. Next, we will talk about the types of venous insufficiency and how to get rid of this disease.

The essence and features of venous insufficiency

Many doctors believe that in every person there are pathologies of venous vessels. The reason for this phenomenon lies in the fact that the blood in the veins has to constantly overcome gravity. Its effect is enhanced by an upright posture. A person's vasculature is made up of subcutaneous lines (10%) and deep vessels (90%). It is the deep veins that form the basis of blood flow. For the same reason, people's panic of removing the vessels dilated due to varicose veins is unfounded, because, on the contrary, the blood supply normalizes.

The development of venous insufficiency is accompanied by an abnormal movement of blood towards the lower body, that is, towards the feet. This process leads to a stretching of the vessel walls and dysfunction of the valves. Normally the valve closes when blood flows upwards. When a person develops a mistake, the valve stops holding back blood. It starts to seep away.

Causes of occurrence

The failure of the valves of the veins of the lower extremities requires immediate treatment, but the problem is that the etiology of their development is not entirely clear. The general reasons that affect the appearance of diseases of the vascular system are obesity, lack of physical activity and excessive load on the veins. Sometimes hormonal imbalances associated with the development of the body or pregnancy become the catalyst for the development of the disease. Possible causes of venous insufficiency are:

  • age-related changes in the body;
  • Problems with the work of the gastrointestinal tract (constipation);
  • Hypertension;
  • Taking drugs that affect blood viscosity and hormone levels.

Symptoms and manifestations of pathology

The disease manifests itself similarly to varicose veins. The patient complains of a constant feeling of heaviness in the legs and edema. The patient has spider veins on his legs. As the disease progresses, a pain syndrome is added to these manifestations of the disease. Due to malnutrition, the skin becomes whitish-yellowish. Some patients have seizures. Most often, patients encounter them at night, which leads to chronic fatigue. When the valves are inadequate, a person may experience the following symptoms:

  • Hair loss on the legs;
  • severe itching of the skin;
  • a sudden feeling of numbness in the limbs;
  • excessively low temperature of the legs;
  • a sudden onset of heat.

The features of the manifestation of the disease directly depend on the stage of failure. Some patients can develop the disease for years, so they do not pay attention to the symptoms that are present. During the physical exam, a surgeon may visually assess the patient's condition for signs of venous insufficiency. But it is better if the patient goes to a phlebologist himself, with frequent swelling of the legs and a feeling of heaviness in the limbs.

Diagnosis of venous insufficiency

When determining the disease, the patient's complaints and the results of the examination play a role. In addition to a visual assessment of the condition of the vessels of the lower extremities, laboratory diagnostics and hardware examination of the legs are required. The doctor will assess the general condition of the patient and then give instructions for the necessary tests. Hardware methods for diagnosing valve regurgitation include:

  • Doppler ultrasound;
  • Venography;
  • Lymphography.

A complete blood count is mandatory. Based on the indicators of platelets, hemoglobin and erythrocytes, the phlebologist can draw a conclusion about the indicators of blood viscosity. If they deviate significantly from the norm, the patient is referred for evaluation of hemostasis. This procedure helps determine the likelihood of blood clots in a particular patient.

Types of diseases

When it comes to valve problems, doctors talk about acute and chronic venous insufficiency. The disease can also be functional and lymphovenous. Acute venous insufficiency is considered life-threatening. It is characterized by a complete clogging of the vessel. The development of a chronic form of the disease with timely therapy can be stopped completely.

Chronic

Chronic circulatory failure is characterized by damage to the saphenous vein. If left untreated, it will continue to progress, which can lead to deep vein damage and disability. The disease is accompanied by edema in the lower leg. Not only the calf muscles are affected, but also the ankles. At the second stage of the disease, the patient begins to lose hair on the legs, and there is a violation of tissue pigmentation. In the third stage of chronic insufficiency, the patient is faced with ulcers and trophic disorders.

Sharp

When a vein is blocked, blood flow is severely disrupted. Doctors call this condition acute vascular insufficiency. This condition is dangerous for two reasons. First, it always develops in deep veins, which in itself is very bad because they provide the body with 90% of the blood. Second, this disease most often develops under the influence of leg injuries. Because of this, we can say that the ship is damaged or jammed.

The disease is accompanied by severe pain in the limbs. The pain gets worse when you try to stand or move your leg. If you suspect acute venous insufficiency, you should call an ambulance immediately. Cold compresses can relieve the patient's condition. A dense natural fabric is used for them. It is dipped in cold water and then applied to the affected area. This manipulation must be repeated for at least 60 minutes. You cannot take any medication until the ambulance arrives.

Lymphovenous

This type of disease affects around 40% of middle-aged people. The disease manifests itself in a mild and severe form. As the name suggests, patients with this disease not only have difficulties with blood flow, but also with lymph flow. This disease is treated with medication, but surgery for this type of disease is rarely beneficial.

Functional

A distinctive feature of this form of insufficiency is that it manifests itself in people with completely healthy veins. Most often the reason for its occurrence is the high growth of a person, the presence of excess weight and the use of hormonal drugs. Surgeons, teachers, hairdressers and other specialists who have to be on their feet for a long time face dysfunction. Treatment is mostly conservative. Patients take medication and wear compression stockings to keep the disease from affecting the veins.

Forms of valve insufficiency

This disease is difficult to detect in the acute stage. The patient can suffer from a single symptom or face the full spectrum of manifestations of the disease. The standard classification of CVI (chronic venous insufficiency) includes the following types of diseases:

  • Deep vein insufficiency;
  • Inadequacy of the saphenous vein;
  • Insufficient perforation veins.

Subcutaneous and perforating vessels are most commonly affected. Deep veins are rarely affected. Doctors speak of a secondary form of the disease in such cases ..

Deep vein insufficiency

This pathology occurs in patients with a genetic predisposition to varicose veins. The vessel walls of the legs are under constant high pressure. Blood begins to seep through the veins to other adjacent tissues, causing excessive swelling and hardening. Smaller vessels also suffer from this disease because swollen tissues begin to press on them. Treatment of deep venous insufficiency is often conservative. Patients are advised to exercise more and apply heparin ointments.

Inadequacy of the saphenous vein

Most often, this type of disease is diagnosed in patients. The valves of the subcutaneous canals are destroyed, which is accompanied by vertical reflux. Numerous studies confirm that absolutely all valves can be damaged due to illness. Blood can flow to the hip and large subcutaneous lines. The disease can easily be detected through ultrasound examination.

Insufficient perforation veins

Perforating vessels connect the deep and saphenous veins. Valve insufficiency in this section of the circulatory system is associated with horizontal blood reflux. This pathology can only be eliminated with the help of surgery. Most often the disease develops in the lower leg.

The inadequacy of the perforation veins is accompanied by the destruction of muscles, collagen and elastic tissues. As a result, the blood begins to stagnate, and the vessels become denser. Due to the fact that the valves are not working well, blood flow is compromised. The fluid enters the subcutaneous vascular network, causing pain, protruding veins, and a feeling of heaviness. The disease is accompanied by trophic ulcers and thrombophlebitis.

Valve insufficiency

It is necessary to treat the disease from the first symptoms, but patients rarely go to the doctor so quickly. The patient comes more often when the valves are badly damaged and do not perform their functions well. Formally there are 4 degrees of severity of the disease. Their detailed description is shown in the following table.

DegreeFeatures of manifestation
zeroThe patients have practically no signs of valve regurgitation.
Vascular networks begin to appear on the skin.
Veins appear on the legs after prolonged or heavy physical exertion.
At the end of the day there is a feeling of heaviness in the limbs ..
The firstThe legs feel heavy.
A mild pain syndrome occurs.
The patient gets tired faster.
The secondLeg swelling occurs not only at the end of the day or after physical exertion, but also in the morning.
Age spots appear on the surface of the skin.
Limb pain becomes severe.
Movement problems occur.
thirdTrophic ulcers are added to the symptoms listed above.
Blood clots form in the veins, which increases the risk of thromboembolism.

Treatment methods

There are several treatments available for deep venous valve insufficiency in the legs. Unfortunately, with the help of surgery, it will not be possible to get rid of the disease. Removing veins is effective when they are damaged by varicose veins, but valve problems remain with you. The main goal of treatment is the normalization of the work of the vascular valves. This can be achieved in the following ways:

  • Taking drugs that normalize tissue trophism and blood composition;
  • Performing special leg exercises;
  • Normalization of diet;
  • Use of physiotherapy techniques;
  • Surgically remove severely damaged veins.

Methods of treating the disease directly depend on the state of health of a particular patient. Compression therapy is not for everyone, as is the use of anticoagulants. If the doctor allows, you can use herbal cookings to normalize your condition.

drug

The basis of drug treatment are drugs that improve blood flow to tissues and help restore vascular elasticity. Doctors often prescribe anti-inflammatory drugs to patients, which not only help relieve pain, but also reduce the general edema of the extremities. For blood clots, patients should take aspirin and other antiplatelet drugs. Most often, patients are prescribed the following drugs:

  • Lyoton;
  • Chlorhexidine;
  • Diclofenac;
  • Troxerutin;
  • Aescusan.

The type of medication prescribed depends on the patient's condition. For trophic ulcers, external preparations containing antiseptics are prescribed, which accelerate wound healing. In patients with dermatitis and eczema, doctors recommend the use of topical glucocorticosteroids. Phlebotonics are prescribed to absolutely all patients.

Magnetotherapy

As the name suggests, this physiotherapy treatment is based on the use of magnetic fields. This effect is believed to decrease blood viscosity, relieve joint pain, etc. The patient is placed in a special device (magnetoturbotron) that creates magnetic fields. During the procedure, the properties of the magnetic field are set individually for each patient. The course of treatment is 10-15 sessions. Doctors recommend having a procedure at the same time.

Compression therapy

This treatment is based on increasing the ambient pressure around the veins. Compression therapy improves venous outflow, normalizes the vascular valves, decreases blood viscosity, decreases the amount of interstitial fluid, and relieves edema. Such treatment will help get rid of leg cramps, promote healing of trophic ulcers. Compression therapy includes:

  • wear special jersey;
  • the use of elastic bandages;
  • Hardware procedures for creating variable compression.

It is convenient for patients to use compression stockings in everyday life. Putting them on is as easy as normal tights or stockings. All products have been developed with the anatomical structure of the legs in mind, so that they do not cause discomfort when worn. Compression products can have a preventive and healing effect. Your doctor will determine your appearance. An elastic bandage can be practiced as a preventive measure in the event of complications of heart valve insufficiency and in the absence of funds to purchase compression stockings. The dressing rules are as follows:

  1. The role is always thrown out.
  2. The leg begins to wrap itself from the toes.
  3. The heel should be tightly wrapped with a bandage.
  4. Special pads are placed on flat areas of the legs and pads are placed on the ankles to prevent pressure ulcers from forming.
  5. In the direction of the thigh, the pressure tends to decrease rather than increase.
  6. When the bandage is properly applied, fingertips will turn blue when lying down, but will return to their natural color when walking ..

If the valve failure progresses, a compression effect with special devices is indicated. The most commonly used pneumatic compression. Devices of a similar type can also be purchased for home use. Mercury compression is used when the patient has a severe form of insufficiency that is accompanied by trophic disorders in the tissues.

Home remedies

Herbal treatment is called complementary. By itself, it won't be able to deal with valve regurgitation, but it can clear up some of the uncomfortable symptoms of the disease. People suffering from this disease are advised by healers to take a decoction of mountain ash bark. To prepare it, you need 200 grams of dry product and 1 liter of boiling water. The bark is placed in a thermos, filled with liquid and left to steep for 10 hours. The resulting broth is taken three times a day at 30 ml / day. The following funds are considered to be effective:

  • Infusion of hazelnut bark and leaves. Mix 1 teaspoon of each type of raw material, then pour 250 ml of boiling water. Take the resulting broth 75 ml three times a day.
  • Needle foot bath. 1 kilogram of chopped needles is poured with 5 liters of boiling water. The solution should be infused for 1-2 hours. Apply a mixture for the baths. The liquid temperature should not be too high.

Exercise for sickness

The main goal of physical education with valve regurgitation is to normalize blood flow in the vessels. This is made easier by both walking in place regularly and swinging your legs. Sitting in a chair can simulate steps. The movement should start from the heel. The exercises "bicycle" and "scissors" contribute to the normalization of the blood flow in the vessels. They can also help you get rid of a small belly.Doctors recommend that patients jog lightly.

Consequences and complications

One of the most common complications of heart valve insufficiency is trophic lesions. There are several negative points here. First, ulcers cannot be completely cleared until blood flow is restored. Second, viruses, bacteria, and other harmful microorganisms can enter the body through trophic skin lesions. The most dangerous complication is thrombosis, which is accompanied by an embolism. A blood clot through the circulatory system can reach the pulmonary artery and cause thromboembolism. Possible complications of venous valve insufficiency are:

  • Dermatitis;
  • Erysipelas of the lower leg;
  • Blood clots in deep and superficial veins.

prevention

People with a genetic predisposition to vascular disease should be more outdoorsy. Walking encourages the natural drainage of blood from the limbs. Regular warming up helps prevent swelling and heaviness in the legs. In the office, you shouldn't be sitting at the computer all the time. Doctors recommend doing light exercise or at least walking around the office every 2-3 hours. Preventive measures include:

  • Wearing a medical jersey with a slight degree of compression;
  • Taking multivitamins;
  • eat lots of plant foods;
  • Normalization of body weight;
  • Reducing the amount of salt.

Doctors recommend avoiding strenuous physical activity in people with valve regurgitation. Such patients should not get carried away with tanning, because ultraviolet light negatively affects not only the condition of the skin, but also the condition of the blood vessels. In the presence of varicose veins, it is necessary to leave the bath, sauna and hot baths. They should be replaced with a contrast shower that tones the whole body.

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Walking against varicose veins. The role of the musculovenous pump.

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The muscles of the legs pump blood through the veins, they are the peripheral heart for the venous system. The well-coordinated work of the muscles and veins of the lower extremities is called the musculovene pump or pump. The venous system of the lower extremities supplies blood to the heart from peripheral tissues.

For this system to work, two basic conditions are required: 1) normal functioning of the venous valves, which prevent the backflow or recirculation of blood under the influence of gravity; 2) a system of impulse aspiration pumps - muscle venous pump.

The musculovene pump can be divided into four components. Their synchronized work while walking was described by Gardner and Fox about 30 years ago:

  • Foot pump, lateral veins of the sole (lateral plantar network)
  • Calf pump (soleus muscle)
  • Calf muscle (works in the hollow of the knee and pumps blood over the knee)
  • Thigh pump (semitendinosus, hamstrings and quadriceps)

The second and third components are the most important, together they take over the main transport of venous blood.

Just as important is the synchronization of these pumps when walking: the foot, then the lower leg, the hollow of the knee and finally the thigh.

Role of venous valves

Venous valves play a key role. During contraction (cones), the muscles push the blood upwards. However, during muscle relaxation (diastole), the blood flows downwards under the influence of gravity. At this point, the valves of the venous valves close, preventing blood from returning (reflux). The valves ensure unilateral blood flow from the bottom up and from the superficial veins downwards.

Venous valves consist of two crescent-shaped cusps that are attached to the walls of the veins.

There are valves in both deep and superficial veins. In the places where small veins flow into larger ones, there are always valves called ostia (at the mouths of the veins). Other valves are located along the length of the vein and are called a stalk.

The anatomical features of the valves create a number of dynamic effects.

Lurie and Kistner were the first to propose a concept that describes local hemodynamics, which is determined by the orientation and movement of the valve leaflets. Under the action of a muscle pump, the blood flowing through the valve forms a jet or stream with a maximum blood flow rate in the center. This effect is created by valve cusps, which form a funnel at the moment of maximum muscle contraction. The position of the valves also plays a major role. The valves of the veins that merge into a larger trunk are at such an angle to each other that their merging forms a spiral flow. Thus, the valves optimize blood flow and prevent hemodynamic problems when two veins with different diameters merge.

The muscle pump does not function without normal venous valve function. The blood flow becomes multidirectional, delay zones (stasis) and high pressure arise. This leads to the development of chronic venous insufficiency.

The muscle venous pump works like a functional chain: First, we observe how the venous reservoirs of the foot are emptied with every step while walking. The blood circulates freely between the superficial and deep veins of the foot.

Then this activity is picked up by the pump of the soleus muscle of the lower leg. Most importantly, the lateral venous plexus m. Soleus, which is drained through the peroneal vein. Smaller veins of the medial part of the soleus muscle communicate with the posterior tibial vein through horizontal collaterals.

In the hollow of the knee, slightly above the joint, we observe the strongest venous pump of the gastrocnemius muscle. There is a strong ejection into the popliteal vein, which pushes the venous column of blood upwards and creates an aspiration effect below the knee joint. Then the muscles of the thigh are activated, mainly the biceps and hemi-diaphragm muscle, the venous arcades of which form shunts between the popliteal vein and the deep femoral veins that act as "safety valves" and protect the popliteal veins from excessive pressure.

Finally, the quadriceps of the thigh comes into operation and pumps blood into the common femoral vein. Knowledge of the anatomy of the venous pumps of the lower extremities, especially the venous pump of the lower leg, explains the mechanism of the development of venous insufficiency with limited mobility of the ankle and deformity of the foot.

Anatomy of the vein of the lower extremities

Number: 1 Correct function of the venous valves

There are two types of blood vessels in our body - arteries and veins. With the help of arteries, oxygen-rich blood flows from the lungs and heart to all organs and tissues, including the legs. The function of the veins is to carry deoxygenated blood back to the heart and lungs. There are special venous valves that allow the blood to flow upwards from the legs against gravity, which only allow it to pass in one direction. As you walk, the muscles of the lower leg contract, compressing the deep veins, and the blood is thrown up. This mechanism is known as the venous-muscular pump. Therefore, patients with varicose veins are advised to lie down or walk more and to stand or sit less.

In the legs, the deep venous system and the system of the saphenous veins (superficial), as well as the perforation veins connecting them, are isolated. With varicose veins, the vein expands and the valve lobes no longer reach each other, blood begins to flow between them in the opposite direction. These are varicose veins. In the vast majority of cases, not deep, but superficial veins surrounded by soft subcutaneous adipose tissue are exposed to varicose veins.

The large and small saphenous veins are isolated in the superficial network of veins (Fig. 2). The first starts from the inner ankle and continues to the inguinal fold, where it flows into the deep venous system. The second starts at the outer ankle and runs down the back of the lower leg. It flows into the deep venous system in the area below the knee. Varicose veins make the tributaries of the main saphenous veins visible (Fig. 3). Our doctor-phlebologists also frequently see spider veins in patients (Fig. 4).

Number: 2 Schematic anatomy of the saphenous vein of the lower extremities

It must be said that in most patients with varicose veins of the lower extremities, we do not see the main saphenous veins, but their tributaries, that is, the veins that flow into them (Figure 3).

There is also an expansion of the smallest intradermal veins, also known as "spider veins" (Figure 4). This is a separate disease that we describe in the dedicated section of the website.

Number: 3 extended tributaries of the great saphenous vein (the largest saphenous vein itself (trunk) is not visible, only its tributaries - branches are visible)

Number: 4 spider veins (dilated intradermal veins)

All methods of treating varicose veins are aimed at eliminating dilated saphenous veins. The most frequent question from patients at the same time: "How does the blood flow back then?" But as we said before, the blood no longer flows through the varicose veins only to the heart, but on the contrary - the deoxygenated blood between the valves flows downwards. That is, patients already live not only without these veins, but also under the conditions that these veins are harmful.

Thus, increased stress falls on healthy veins, and if we remove varicose veins and dilated veins, it only becomes easier for healthy ones. In addition, you always have a deep venous system which, as mentioned above, almost never goes through varicose veins because it is surrounded on the outside by dense muscles, bones, and ligaments rather than soft adipose tissue. To date, endovenous laser coagulation and its tributaries - miniflebectomy and sclerotherapy - are the most modern methods of treating the great saphenous vein.

Valves of the veins of the lower extremities and their pathologies

Valves are part of the circulatory and lymphatic systems. They direct and coordinate the flow of fluid in a certain direction. The valves consist of muscle fibers of different structures and endothelial layers. Their role in the bloodstream is so great that work disorders lead to blood stagnation, thrombus formation and burns.

The venous valves in a person's lower extremities ensure that blood rises to the heart against gravity. The muscles of the legs help them do this. The coordinated work of muscles and valves ensures the return of blood to cleanse the heart. Vascular disease is a serious problem that often leads to irreversible consequences.

The structure of the veins of the lower extremities

There are three types of leg veins - superficial, deep, and perforating. The deep venous system consists of the common femoral vein, the inferior vena cava, the paired veins of the lower leg, and others.

The small and large saphenous systems form a system of superficial veins. They always occupy a certain position and their numerous tributaries have individual characteristics for each person.

The large superficial vein is connected to the common femoral vein through an organ called the sapheno-femoral junction. Osteal valves ensure correct blood flow.

The two types of vessels, deep and superficial, are connected by perforating veins. The movement of the blood in the right direction is ensured by valves that support the blood flow from superficial vessels into the depths.

Direct perforation veins create a connection between deep and subcutaneous vessels. The indirect veins connect the subcutaneous system and the muscles.

Functions of the venous system

Blood containing metabolic products returns to the heart through the venous vessels. It contains carbon dioxide, toxins, and other elements that are released during metabolism.

The venous system differs from the arterial system in that it has lower pressure and blood flow. The venous walls are thinner, less elastic, and easy to stretch. The great saphenous vein has the greatest length.

Most veins have valves that direct blood flow to only one side. The venous network has a strictly hierarchical structure, the movement goes from the foot upwards, from the superficial vessels to deep through the communicating veins.

Venous valves - how they work

The pressure in the venous vascular system is low. Heartbeats increase blood flow in the arteries, but not in the venous system. The blood flow is provided by the muscles of the legs during movement (muscle pump).

During the contraction of the calf and thigh muscles, the blood is pushed up and when it relaxes the valves kick into work preventing it from returning down. Thus, the valves in the veins ensure both the movement of the blood from the foot and its retention until the next time it is lifted.

The valves are paired valves of semicircular vessels which, when closed, must completely close the lumen. The function of the valves of the venous vessels is to divide the duct into separate parts, facilitate movement in one direction and prevent backflow.

The normal valve function ensures natural blood flow. In violations of their work, backflow occurs - a backward movement due to open doors. This leads to stagnation and expansion of blood vessels due to an excess of unpumped blood ..

What is valve failure and how is it treated?

Venous valves in the vessels of the lower extremities of a person are exposed to the effects of the external and internal environment during life and are pathologically changed.

Sometimes the failure of the venous humps during the mother's pregnancy is placed in the fetus and continues after birth. In most cases, however, valves lose their function during their service life.

The inability of the valves of the veins of the lower extremities to provide natural blood flow and determine their failure.

In this case, there is an expansion of the blood vessels and an increase in pressure on their walls. With a larger diameter, the doors can no longer completely close the channel, which increases blood stagnation. Standing blood, oversaturated with decay products, destroys them even more.

Another dangerous factor is a change in the elasticity of the vessel walls that regulate blood flow ..

The reasons that provoke various pathologies:

  • Leg injuries;
  • long work, standing or sitting, small physical activity without which there is no help from a muscle pump in the bloodstream;
  • excessive stress such as exercise or hard physical work;
  • hereditary factors, pathology is often a family disease;
  • Metabolic disorders, diabetes mellitus, all diseases that affect the composition of the blood and contribute to the formation of thrombus;
  • wrong diet;
  • Hypertension.

Inadequacy of the valves leads to an acute course of the disease. It is characterized by a feeling of heaviness in the legs, swelling, the appearance of a vascular network first, and then cyanosis of the legs. All ships as well as individual ships can be affected. Most often the process begins with an inadequacy of the valves of the perforation veins of the lower leg.

This leads to the release of blood into the superficial vessels, their protrusion and swelling. Instead of the bumps, the skin darkens, gross, trophic lesions appear if left untreated.

The status of the valves is diagnosed using ultrasound. Examination sometimes reveals the defeat of all the cusps of the large superficial vein. An inadequacy of the great saphenous vein ostial valve causes blood to flow from the pelvic veins to the surface and reflux to develop.

Lack of treatment leads to stagnation of blood and the development of pathologies such as thrombosis and thrombophlebitis. The great saphenous vein ostial valve is not replaced; during surgery, the vein is usually removed or a portion of it excised.

Important! Patients should be aware that it is not possible to restore lost valve function.

therapy

Treatment of valve failure of the veins of the lower extremities is aimed at improving blood flow and preventing blood stagnation.

This is what the main treatment methods are aimed at. The formed clots and blood clots interfere with the work of the valves, do not allow them to close. Preventing the development of thrombosis and thrombophlephitis is the main task. During operation, inoperative valves must be cut out along with the sections of the vessels.

Early diagnosis is therefore particularly important.

Treatment methods:

  1. Use of compression garments or bandages. This reduces the stress on blood vessels and increases muscle tone.
  2. Special complexes of physical therapy exercises. Improve the blood supply to the tissues and prevent congestion.
  3. Physiotherapy procedure. They accelerate metabolic processes in tissues, strengthen the walls of blood vessels. Electrotherapy, laser and magnet procedures, hydrotherapy. Lymph drainage foot massage.
  4. Take anticoagulants. They prevent blood clots, thin the blood, and make movement easier.
  5. Anti-inflammatory drugs, venotonics - to improve the condition of blood vessels (phlebodia, troxevasin).
  6. Preparations for the relief of edema - furosemide, Detralex. These agents are applied topically as gels and ointments or orally.
  7. Antihistamines against possible allergic reactions.

Surgical treatment methods achieve the greatest effect. These include:

  1. Endovascular laser coagulation - does not require incisions, is performed under local anesthesia.
  2. Sclerotherapy of veins.
  3. Radiofrequency obliteration - removal of blood vessels using radio waves.
  4. Reconstruction of venous valves - is carried out when a small number of valves are damaged and their functions are partially preserved.

Conclusion

A necessary part of treatment is diet and bad habits. Treating valve veins is a very difficult process. At the first sign of foot problems, rethink your lifestyle, diet, eat healthy foods, and do physical therapy exercises. This prevents the disease from progressing.

Venous valves

Venous valves are irreplaceable elements of the blood system. They prevent blood flow back. The structure of its walls is fragile. First of all, patients suffer from various forms of insufficiency. Violations are harmful to health and require immediate treatment.

  1. What's this
  2. Where are
  3. role
  4. structure
  5. Properties:
  6. Types of pathology
  7. Why violations are dangerous

What's this

Venous valves are folds of the inner parietal membrane made up of muscle fibers. In the connecting vessels, they ensure the movement of blood from the subcutaneous tissue downwards and thus prevent backflow.

Not evenly distributed in the circuit. They are found in large numbers in the lower leg - about 30, and the least in the thigh - 2-3. There are no valves in the arteries. There is only one thing in the body - the aorta.

The structure of the valve walls is specific. When their work is disturbed, a dangerous disease occurs. The injury involves not only complex therapy, but also possible amputation of the limbs.

Where are

These structures are not found in every vein that allows blood to flow to the heart. Most of them are located in the veins of the medium, small caliber of the lower extremities, the internal cervical vessels of the carotid artery, the external and subclavian ..

Active contractions of the muscles of the legs, feet and thighs promote blood flow to the heart. The main functions of venous valves are to move blood fluid forward and prevent it from returning. An interruption in their work leads to the development of varicose veins or chronic venous insufficiency.

At the initial stage, the disease can be completely cured. Restoring blood circulation contributes to the normal functioning of the entire body.

The ostial valve in the vein is located at the confluence of the great saphenus with the femur. Its job is to contain the backflow from the femoral segment. The movement of blood also depends on the pressure in the peripheral vessels and on the low pressure in the lower hollow segment of the system.

structure

The base of the septum is made up of fibrous connective tissue. The opposite sides are different. On the one hand, endothelial cells are transformed into the lumen and have an elongated shape. On the other side - over the flaps.

Such valves have a central shell. It consists of:

  • Bunch of smooth myocytes;
  • elastic collagen fibers.

The outer vascular membrane is represented by a connection of fibrous connective tissue and oval bundles of myocytes. They supply blood vessels and nerves with food.

Properties:

The valve fold in cross section provides connective tissue and smooth muscle cell bundles. This can be observed during microscopic examination. The connecting elements form bundles that extend to the vessel wall. You are responsible for the connection between the roller and the ground.

Usually the roll of the great saphenous and femoral veins is triangular in shape. Its base is located along the wall, and the end is directed into the lumen of the vessel. The main feature is the pronounced connection of the valve fold with the middle venous sheath. It manifests itself as a bundle of collagen fibers.

The roll structure consists of a wing and a wall. In the presence of varicose veins, you can observe various options and structural changes. Usually the roll is pronounced, has a sufficient number of smooth muscle bundles of cells.

Types of pathology

The influence of negative factors leads to malfunction of the venous valves. This leads to the formation of a blood stasis. The walls of the blood vessels gradually begin to increase in size. The fluid gradually seeps into the intercellular space.

Persistent edema forms against this background. Valve insufficiency of the veins occurs when the walls are incompletely closed and their direct functions are weakened. The pathology develops at different ages, is asymptomatic and requires immediate treatment.

Why violations are dangerous

The importance of venous valves is important for blood circulation. Malfunctions lead to reflux - the reverse flow of blood. Stenosis and obstruction also develop. The danger is the development of CVI. It is accompanied by such pathological processes:

A dangerous effect on the venous valves leads to thrombosis. This leads to the complete destruction of such structures in the vein. Microthrombi can occur as a result of injury. The destruction of this movable partition is an irreversible process.

The state and health of the body depend on the right robots of the venous system. Therefore, at the first signs of violations, you should consult a doctor. Timely diagnosis and therapy will help avoid dangerous consequences.

15 questions about varicose veins

What causes the malfunction of the venous valves and what to do about it?

What causes the malfunction of the venous valves and what to do about it?

1. What is chronic venous insufficiency?

Under this term, doctors combine a number of diseases that lead to long-term, sometimes lifelong, impairment of the venous outflow from the legs. The most common causes of chronic venous insufficiency are varicose veins and deep vein thrombosis (post-thrombotic and / or post-thrombotic diseases). Congenital diseases of the venous system are less common. Note that disturbances in venous flow are not always associated with disease. They can occur during pregnancy, obesity, long trips, flights, prolonged standing, and a sedentary lifestyle.

2. How common is this disease?

According to the latest data, 35-60% of people of working age in developed countries suffer from CVI. In addition, there are 4-6 women per man with this disease. With age, the number of patients with different forms of CVI increases. By the age of 50, almost 40% of women and 20% of men have significant problems with the venous system of the legs.

3. How does the venous system work?

The outflow of blood from the legs occurs through the depth, which is in the thickness of the muscles, and through subcutaneous veins that pass into the subcutaneous fat. The deep and superficial venous systems of the lower extremities are connected by the so-called perforation veins. A fundamental feature of the structure of the leg veins are the valves, which strictly direct blood flow to the heart. Additionally, valves in the connective veins allow blood to flow from the saphenous veins into the deep veins and prevent it from returning. The venous valves are unevenly distributed: the largest number is on the lower leg (up to 20-30) and the smallest (2-3) on the thigh.

4. What causes the blood to flow through the veins to the heart?

Most importantly, these are active contractions of the muscles of the foot, lower leg, and thigh. With every movement, the contracting muscles act as a type of pump that pushes blood out of the veins and pushes it to the heart. Valves prevent the return of blood. The suction of the chest as it alternates between inhalation and exhalation, the energy of heart contraction, and some other not-so-important mechanisms are of minor importance.

5. Why is the work of the venous valves disturbed?

The main reason is the disruption of the normal functioning of the venous valves. The flow of blood becomes chaotic, and in the veins, especially the subcutaneous ones, the pressure increases so much that the walls of the vessel cannot withstand and begin to expand. In addition, other symptoms of the disease appear. Gravity is the most important.

They say venous disease is a kind of human payment for the ability to walk upright. That is, people who spend a lot of time on their feet, such as doctors, salespeople, hairdressers, are at greatest risk for the disease. Because the pressure in the veins is directly proportional to growth, tall people are believed to be more prone to chronic venous insufficiency ..

Another major cause of valve malfunction is an increase in intra-abdominal pressure. This happens when lifting weights, pregnancy. Venous thrombosis kills the valves, almost completely destroying the valves in the affected vein. In addition, venous valves can be destroyed by frequent domestic or sports injuries.

6. Why does the risk of chronic venous insufficiency increase during pregnancy?

There are mutliple reasons for this. Mechanical factor: From the second half of pregnancy onwards, the growing uterus compresses the inferior vena cava and the iliac veins more and more. The compression of the retroperitoneal veins reaches its maximum towards the end of pregnancy.

Blood circulation: As the gestation period increases, the circulating blood volume (BCC) increases by 15-25%. This known fact is associated with the need to ensure placental blood flow. An increase in BCC in turn puts additional stress on the heart and the vascular bed.

Hormonal factors: An increase in sex hormone levels during pregnancy leads to a number of changes that affect the venous system. The dilation (expansion) of the venules (small veins) develops, their inner and middle layers thicken. In the intima (the inner part of the veins) immune complexes begin to accumulate, which leads to aseptic inflammation of the phlebitis type. The result is progressive phlebostasis. Estrogens and progesterone not only act directly on the vein wall, but also cause a whole cascade of changes in the hemostatic system.

Dysproteinemia: During pregnancy, the level of albumin (proteins) in the blood decreases, which disrupts the colloid-osmotic balance.

Hemostasis and hemorrheology: Changes in the hemostatic system occur as early as the first trimester of pregnancy. By the third trimester, the fibrinolytic activity of the blood (an indicator that reflects the ability of the blood to dissolve the clots that have formed) decreases significantly and its viscosity increases. The depression of the anticoagulants reaches its maximum.

7. How is venous insufficiency manifested?

The first signs of venous system malfunction are swelling of the leg and foot at the end of the day, a feeling of heaviness and stretching in the calves. Patients make sure that shoes that are comfortable in the morning start pressing in the evening; Socks or knee socks leave deep marks on the skin. Typically, these symptoms are relieved by walking and after a night's rest.

Later there is bursting pain in the calves, a sensation of heat in the legs, and night cramps in the calf muscles. External changes also take place. Small blue-red vascular stars, dark blue intradermal veins and bizarre twisted varicose veins form on the thighs and legs.

Varicose veins in the form of dark blue conglomerates that resemble grapes quickly appear on the thighs and lower legs. As the disease progresses, the skin of the lower leg becomes dry and sensitive to various injuries. Then small dark brown islands appear, which gradually merge into a single archipelago. In its center, an area of ​​skin that resembles a drop of stearin is formed, and after that a trophic ulcer opens.

8. How does a doctor make a diagnosis?

Various ultrasound methods are used in treatment and diagnostic centers to examine the venous system. The doctor examines the image of the vessel, examines the flow of blood through the vessel and evaluates the function of the venous valves. Modern diagnostic devices enable the reconstruction of a three-dimensional color image of a vessel, which significantly increases the reliability of the study.

The advantage of ultrasound diagnostics is a high information content, painlessness and complete safety. The patient can undergo an ultrasound examination on an outpatient basis. In the most severe cases where the doctor suspects that the cause of the disease was a previous deep vein thrombosis or a congenital disorder of its normal development, additional tests may be recommended.

9. Or is it not necessary to treat CVI at all?

Basically, the question is reasonable. After all, dozens and even hundreds of people walk with "veins on their legs" all their lives and supposedly nothing happens to them. So they say. In fact, they experience very painful sensations and are constantly at risk of complications. Ulcers are not the most uncomfortable. In a number of studies, mainly in Europe, on fair-skinned people, the incidence of venous thromboembolism, standardized for age and sex, ranged from 30 to 117 cases per 100,000 people. What is it and how can you understand it?

Venous thromboembolism occurs when a blood clot first forms in the veins, then breaks off and enters the heart. Then the heart stops. Now just count the number of people living in Krasnoyarsk, divide the number by 100,000 and you will see for yourself if there is any risk. Better yet, try on an ulcer. Do you need it? In addition, modern technologies make it possible to eliminate these problems quickly, almost painlessly and effectively. One of the most effective is the EVLK (endovascular laser coagulation) method.

10. What is special about EVLK?

Before the advent of EVLK, none of the previously known methods could so quickly, easily and effectively remove swollen veins in the legs. The main advantage of EVLK is an excellent cosmetic result with minimal trauma. In contrast to open surgery, the procedure takes 20 to 40 minutes, does not require anesthesia, is performed without incisions, and under local anesthesia it is possible to treat both legs at the same time. At the same time, the patient has minimal pain, no bruises and bruises. There is no need for hospitalization, there is no disability. There are minimal post-operative complications.

Removing veins that have lost their function is also possible with the help of miniflebectomy, a gentle procedure for removal through a small incision or puncture.

For the treatment of varicose veins in the initial stages of the disease and on vessels of not very large diameter, the clinic uses the method of sclerotherapy, which is very effective and inexpensive. The procedure is not surgical in nature, it consists in introducing special drugs directly into the affected vessel using a syringe with a very thin needle. Spider veins, nets and small wreaths that shine through the skin are removed.

11. If there is a relapse, who is to blame and what to do?

Subject to all medical and preventative measures, relapse is rare. The fact is that the weakness of the vein wall is a property of the body, just like eye color, nose shape, hair color, fingerprints. You are made that way. It is impossible to remove all veins during treatment and it is not necessary. The disease can recur in the remaining veins. In addition, such patients often have anatomical features of the structure of the venous system.

But we must always remember that illness cannot defeat us only as long as we resist it. As soon as we end the resistance, the disease comes with new strength. Consequently, preventive measures and recommendations from the doctor must be followed, even if everything appears to be fine.

12. Is it possible to exercise for patients with CVI?

Patients believe that venous insufficiency and exercise are incompatible. It is not so. On the contrary, active sports such as running, cycling, walking and especially swimming are useful and necessary for improving the venous system. Only exercises that lead to leg injuries should be excluded. However, exercising too hard over a long period of time can also be harmful. Moderation is important in everything. If you run, then not for long, go - not far. Various types of physical education, gymnastics, and aerobics are ideal.

13. Is it possible to drive a car, fly in an airplane?

Prolonged immobility (driving, in a bus or airplane seat) disrupts blood flow through the veins, which can lead to an increase in venous insufficiency. It is therefore necessary to "play it safe" on long journeys. First, bandage your shins with an elastic bandage or wear special medical knee socks, stockings or tights. Start taking medications that improve venous outflow, such as Detralex, Antistax, Ginkor, Anavenol, 10-15 days before travel.

If you are traveling by car, stop every 1.5 to 2 hours and walk briskly for 10 to 15 minutes. For long flights or bus transfers, it is advisable to get up and walk around in the cabin for a few minutes. Regular vigorous flexion and extension of the ankle is also helpful. So there are no particular contraindications for traveling by car or plane.

14. How about sunbathing in the sun or in a solarium?

Prolonged exposure to the sun is harmful. Patients with the initial stages of the disease can sunbathe before 11 and after 17 hours, if the spectrum of sunlight does not contain harsh ultraviolet rays. With severe forms of the disease, it is better to be in the shade. Under the influence of ultraviolet light (including artificial light), venous vascular "stars" can form.

15. Is it possible to have a massage?

A vigorous foot massage, especially as part of the anti-cellulite program, can exacerbate the manifestations of venous insufficiency, provoke the progression of varicose veins, and even cause thrombophlebitis. Therefore, before a massage, contact the "No varicose veins" clinic and consult a phlebologist

Article on the superficial veins