Varicose Veins

Varicose veins (varicose veins, varicose veins, varicose veins) are visible, superficially under the skin running, morbidly dilated veins, partly with knotigen Ausackungen. Varicose veins occur predominantly on the legs and are mostly noticed for the first time around the age of 30. Women are affected three times as often as men. Varicose veins are a common disease affecting more than 30% of adults.

 

Complaints

  • Cosmetically disturbing broom and varicose veins

  • Tired, heavy legs

  • Swelling, tingling, itching and pain in the legs

  • Increase in symptoms after standing or sitting for a long time, and in the case of heat, to improve the complaints when the legs are raised (exactly the reverse is the case with the PAD)


  • Evening swelling of the ankles


  • Nocturnal calf cramps

The Illness

If the superficial veins grow older because of the loss of elasticity of the vessel walls, and the venous lobes become leaky, varicose veins develop gradually over a period of years. This is largely due to hereditary predisposition, but is favored by long standing or sitting, lack of exercise, pregnancies and severe overweight (primary varicose veins).

In addition, varicose veins can also form circulatory circuits in the case of flow impediments (eg postthrombotic syndrome) in the deep vein system (secondary varicose veins).

The superficial veins can expand finger-widened or spread like a netting or as spider-weave nerves. They preferably occur on the inner side of the upper and lower limbs as well as on the rear side of the lower limb.

The disturbed blood flow, which causes the feeling of strained, heavy, tired legs, is at first restricted to the superficial venous system. If the perforation veins are also detected by the degenerative changes, blood can circulate between the superficial and the deeper venous system rather than the flow of the heart. In an advanced stage, the disturbed venous blood flow leads to the deep veins being dilated and their valves becoming leaky. There is a chronic venous insufficiency, which also occurs as the final stage or the after-effects of deep venous thrombosis.

The aim of the treatment of varicose veins is, in addition to the weight loss or the termination of repeated varicose vein bleeding or inflammation, also the extension of the disease course to the deep vein system to prevent.

When a varicose vein begins to bleed (variceal rupture, venous rupture), considerable blood loss occurs. Place the leg up and press the bleeding vein with a wound pad until the bleeding stops. A subsequent pressure bandage prevents rebleeding. It must be renewed regularly until healing of the wound. Discuss with your doctor whether surgery or sclerotherapy of the vein is appropriate. Repeated bleeding varicose veins not only deplete the body by the blood loss, but can also become the starting point of badly healing wounds with severe infections, open leg.

Therapie

Examination of the legs while standing shows which superficial vein sections are expanded. Ultrasound (Doppler and duplex sonography) is used to check the blood flow in the veins, the tightness of the venous lobes and the patency of the deep venous system. In addition, after signs of advanced chronic venous insufficiency such as edema and skin changes are sought. An X-ray examination with contrast medium is not necessary.

It is not possible to cure the varicose veins, since no effective drugs are available. Thus, only the possibilities remain to eliminate the varicose veins by an operative procedure or to support the normal blood flow in the varicose veins by a permanent pressure (compression) from the outside.

Compression treatment. For the compression treatment there are stockings of compression classes I (light) to IV (very strong compression). Supporting stockings correspond to the compression class I, they are a help with heavy, tired legs and small varicose veins. For advanced varicose veins with a tendency to swelling, Compression Class II compression socks are required to prevent the flow of blood through leaking venules. This is to prevent the progress of varicose vein formation as well as inflammation, bleeding and open skin areas. Even after a venous operation, the sustained surgical success is supported by wearing compression stockings. Compression stockings of compression classes III and IV are indicated in exceptional cases in severe chronic venous insufficiency.

Operational treatment. Operative measures can eliminate or permanently eliminate varicose veins. Small varicose veins are caused by laser therapy or sclerotherapy (sclerotherapy)


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