Phlebeurism

A team of qualified cardiovascular surgeons/phlebologists at the medical clinic diagnoses and treats all types of varicose veins and related pathologies at any stage of the disease. Our proudest asset is treatment according to Israeli protocols that show maximum effectiveness in clinical practice.

Varicose veins - the trigger for the development of varicose veins is considered to be a violation of the normal functioning of the venous valves with the formation of a reverse flow (reflux) of blood.

As a rule, valves subjected to maximum mechanical stress are affected first. At this time, pathological secretion of blood occurs from the mouth of the large and small saphenous veins, sometimes through large perforating veins. Excessive blood volume in the superficial veins gradually leads to excessive stretching of the venous wall. The total volume of blood in the superficial venous bed of the lower extremities increases. This increased blood volume continues to flow through the perforating vessels into the deep system, causing them to become excessively constricted. As a result, dilatation and valvular insufficiency occur in the perforating veins.

Symptoms and signs of the disease

Symptoms of the disease are not necessarily related to pain. On the contrary, most patients claim that they are more interested in aesthetic problems than pain at the beginning of the disease.

The clinical picture depends on the localization of the pathological process, as well as the stage of the disease.

Varicose veins of the lower extremities manifest themselves as follows:

• Heaviness in the legs, feeling of fullness in the legs.
• The appearance of cramps in the calf muscles, spasms of the legs and fingers.
• Feeling tired after walking for a long time.
• Swelling of the ankle in the evening.
• Venous relief pattern on the skin, spider veins, spider veins.
• Symptoms accompanying the disease are cellulitis, itching of the feet, dryness of the ankles and calves, thinning and sagging of the skin, ulcers that do not heal for a long time, uneven pigmentation - from dark spots to colorless areas, light nodular formations from blue to dark purple or dark red. , trophic ulcers.

Progressive venous disease is accompanied by deterioration of general health:

• Unstable blood pressure, hypertension, hypotension.
• A feeling of chronic fatigue, apathy develops.
• Arrhythmia, tachycardia.
• Shortness of breath, frequent diseases of the respiratory system.

In women, the obvious symptoms of varicose veins of the lower extremities may appear stronger before menstruation and decrease after it.

The symptoms of venous pathology in the upper extremities are characterized by numbness of the hands, spastic condition of the fingers, abdominal pain, tingling and feeling of coldness.

Varicose veins of the esophagus are manifested by belching, burning sensation, pain behind the sternum, inflammation in the esophagus and stomach, difficulty in swallowing and symptoms of reflux esophagitis, anemia.

Diagnosis of the disease

Effective treatment of varicose veins cannot be carried out without initial comprehensive diagnosis. The diagnosis is clarified by analyzing the clinical picture and data after hardware studies.
The following methods are most often used for diagnosis:

• duplex or triplex ultrasound angioscanning;
• phlebography with contrast;
• MRI with venography;
• contrast angiography.

Several test manipulations are performed to determine the presence of reflux in the affected vessels and to assess blood flow:

• Examination of veins with compression in different segments.
• Valsalva maneuver or stress test.
• Parana test with imbalance to evaluate veins in the calf region.
• Walking test at different intensities.

Additional methods to clarify the diagnosis:

• Plethysmography to determine venous reflux, obstruction.
• CT, MRI for visualization of tissues and structures in the affected area.
• Infrared thermography to assess the temperature balance in the affected area of the body.
• Intravascular ultrasound uses a catheter to visualize the vessel walls from the inside.

The results of any diagnostic studies performed are thoroughly evaluated. Any diagnosis helps a lot in determining the next treatment tactics.
Clinical laboratory tests of blood and urine complete the picture of the disease and can show accompanying pathologies.

How are varicose veins treated?

If disturbing symptoms of varicose veins appear, you should consult a doctor to make a diagnosis and start timely treatment. In regional medical institutions, general surgeons deal with this issue, in clinics - phlebologists and angiosurgeons.

A team of surgeons with extensive practical experience in a multidisciplinary medical clinic has a well-equipped phlebology department. The center offers a high level of service and quality of treatment, which is reflected in the excellent clinical results we are proud of.

Varicose veins of the lower extremities and other types of pathologies can be treated in the first stages of development. As the process progresses, it becomes more and more ineffective, partially retaining only symptomatic value.

Therapeutic effects cannot completely eliminate the disease, but as long as it is possible to delay the destruction of blood vessels and the development of complications, this should be done by all available means.

Conservative treatment

• At the beginning of the treatment of varicose veins, drugs are limited to venotonic agents.
• Anticoagulants and low molecular weight heparin-fragmin injections are used to reduce the risk of thrombosis and occlusion.
• New oral anticoagulants.
• For inflammatory phenomena in blood vessels and surrounding tissues, the use of external non-steroidal anti-inflammatory drugs with diclofenac and indomethacin is indicated.

How to additionally treat varicose veins?

In parallel with the therapeutic treatment, the patient is recommended to do certain exercises that strengthen the muscle corset of the lower extremities and have a general strengthening effect. For example, the best exercises in the lying position are "bicycles", where you alternately pull and extend your toes towards you, as in ballet.

• You should be careful with water and thermal procedures, because hot baths and showers, beach vacations in the sun can worsen the condition. It is necessary to strengthen the vessels, this is facilitated by hardening with a contrast shower, when hot and cold water is poured alternately on the legs.
• Daily cool foot baths with decoctions of oak bark, chamomile, calendula, birch leaves, St. John's wort, white acacia flowers, and horse chestnut are recommended for pain, inflammation, and heaviness in the feet.
• Applying freshly squeezed juice from aloe leaves on the skin is useful, it softens the skin and prevents inflammation.
• It is worth changing your habits and quitting smoking. Foods rich in vitamins, fresh vegetables, citrus fruits and seafood should prevail in the diet.
• You should adjust your drinking regime by drinking enough water (1. 5-2 liters) daily. At the same time, you should reduce the consumption of coffee, strong tea, chocolate and alcohol.

If the veins in the legs are enlarged, the doctor may recommend wearing compression stockings periodically or permanently.

Attention! In any case, you should listen to your doctor's recommendations and follow them strictly. Self-medication is unacceptable!

Causes of the disease

Family history suggests that varicose veins are genetically determined and can be inherited.

In many clinical cases, it is impossible to determine the exact cause of the disease. The researchers concluded that the culprit is a combination of several internal and external factors.

Causes of varicose veins:

• congenital defect of the valve system;
• physical inactivity, lack of activity;
• pregnancy;
• long-term stress on the legs, long-term standing, working conditions in a static position;
• treatment with certain hormonal drugs;
• uncomfortable shoes, high heels;
• obesity;
• tight underwear, clothes that squeeze the hips, knees (for example, very tight jeans, uniform);
• lifting weights regularly;
• systemic pathology of kidneys, heart and blood vessels;
• diabetes;
• regular bowel problems, frequent diarrhea or constipation.

Varicose veins of the lower extremities (varicose veins)- accompanied by expansion of the superficial veins of the lower limbs, valvular insufficiency and blood flow disorders. The term "varicose veins" comes from Latin. varix - "swelling".

As a result, the vessels stop working properly, the entire circulatory system is disturbed, it is complicated by congestion, disruption of trophism in tissues, blockage of blood vessels with blood clots.

Many complications are life-threatening, so if you suspect the onset of varicose veins, diagnosis and treatment should be carried out immediately and professionally.

Types of disease

Blood flow in the veins changes, slows down, and blood clots can form on uneven walls. Changes in the functionality of the vessels lead to blood stagnation, venous insufficiency and continuous disruption of the capillary circulation in the periphery.

According to the World Health Organization, varicose veins occur in 45% of women and 20% of men.

According to the generally accepted CEAP international classification, varicose veins are divided into six classes-stages of the disease based on the complete absence of subjective, visual and clinical signs of C0.

• C1 - the initial stage, manifested by a capillary network and spider veins in the skin.
• C2 – visible thickening of veins under the skin, venous pattern in the form of blue threads in the lower extremities.
• C3 - swelling of the legs appears as a result of standing for a long time or resting (sleeping at night).
• C4 - skin surface changes, uneven pigmented areas appear, venous eczema accompanied by itching and ulcers, lipodermatosclerosis.
• C5 – venous ulcers on the surface of the skin that heal after a while.
• C6 - non-healing venous trophic ulcers.

The classification of varicose veins of the lower extremities distinguishes pathology in superficial and / or deep veins, perforating connecting veins.

According to its origin, venous deformation can be:

• congenital, manifests itself in infants;
• obtained;
• secondary, arising on the background of other pathologies, injuries;
• idiopathic of unknown cause.

The full classification of varicose veins of the lower extremities and organs also includes complications - reverse blood flow, reflux and / or blockage, blockage of the lumen.
Varicose veins of the lower extremities are not the only manifestation of varicose veins, although they are the most common. There are also varicose veins of esophagus, sublingual veins, retina, scrotum (varicose enlargement in men), stomach, rectal cavernous bodies (hemorrhoids), pelvic veins, female genital organs - vulva, labia, uterus.

Surgical treatment of varicose veins

RFO (radiofrequency saphenous vein obliteration)is a modern method of treating varicose veins. The treatment consists of the application of radiofrequency radiation to the inner wall of the vessel. Using the heat effect, the vessel is "welded", separated from the general blood flow and replaced by connective tissue after a few months.

Advantages

• The procedure is performed without general anesthesia, local anesthesia is sufficient;
• Maximum safety for the patient's health
• RFA does not require special preparation;
• During manipulation, the patient does not feel pain or discomfort;
• Radiofrequency ablation of lower extremity veins is highly effective;
• Low probability of complications, almost all patients tolerate this procedure well;
• Radiofrequency ablation can be combined with mini-phlebectomy of the arms or sclerotherapy;
• After radiofrequency ablation, no scars or marks are left;
• A few days after the procedure, the patient will be able to return to a normal lifestyle.

How is it going?

The intervention is performed under ultrasound control. Before the procedure, local anesthesia is administered so that the patient does not feel pain or discomfort during the treatment.
Let's see how RFA is performed step by step:

• Before the operation, the lower limbs are thoroughly treated with antiseptic agents. The doctor then uses a marker to mark the vein that is prone to varicose veins. Then the doctor inserts a radiofrequency catheter into the vein and treats the desired area with radiofrequency waves.
• At the end of the procedure, the catheter is removed, the doctor applies a bandage and helps the patient to put on compression garments.
• The procedure lasts from 30 to 50 minutes. To stop the flow of blood from a weakened vein, it must be destroyed. Then the body itself will redirect the blood through healthy vessels. As a result, after ablation, the walls of the veins stick together and form scar tissue inside (safe and invisible), varicose veins disappear.

Rehabilitation

Immediately after the operation, the patient should walk (about 30 minutes) to prevent blood and lymph stagnation. After radiofrequency ablation of the veins of the lower extremities, it is necessary to carefully follow the recommendations of doctors:

• It is forbidden to increase physical activity and lift heavy loads during the week;
• It is necessary to walk more, to be in the same position as little as possible (except for sleep);
• For 3-4 weeks, you need to stop taking a hot bath, you can only take a shower;
• You should stop visiting the bathhouse for at least a month;
• It is necessary to drink as much plain water as possible, on average about 2. 5 liters, it is necessary to minimize the amount of salt consumed;
• A week after the operation, you should start physical therapy, which the doctor will inform you about;
• It is possible that after the radiofrequency ablation of the veins of the lower extremities, the doctor will prescribe some medications.

Following these rules will help you avoid complications and prevent the further development of varicose veins.

One week after the operation, it is necessary to re-examine (ultrasound examination of the vessels of the lower extremities). You can learn more about radiofrequency ablation of veins of the lower extremities during a personal consultation with a specialist.

Laser coagulation of veins

Endovasal (endovenous) laser coagulation (obliteration) of varicose veins (EVLK, EVLO) is a modern method designed to eliminate backflow of blood in superficial and perforating veins using thermal energy of laser radiation. EVLO allows you to do it without incisions and does not require the patient to be hospitalized in a hospital. The international term is EVLA (endovenous laser ablation).

The main stages

• Venous puncture. It is performed under ultrasound control.
• Placement of the light guide. The light guide is a thin optical fiber. Laser radiation is given to the end. The light guide is inserted into the diseased vein. Its tip is installed at the anastomosis, where the varicose vein flows into healthy deep veins.
• Swollen anesthesia. An anesthetic "cushion" is created around the vein to better press the vein against the light guide and prevent damage to the surrounding tissues.
• Laser vascular coagulation. Laser radiation is supplied to the working part of the light guide.
• At the same time, the light guide is slowly removed from the vein. Thus, the vessel is heated uniformly by the laser to a temperature of 85 °C. Heated blood, like any protein, shrinks when heated. The lumen of the vessel disappears, blood flow through it stops.

Rehabilitation

Immediately after the operation, the patient should walk (about 40 minutes) to prevent blood and lymph stagnation. After EVLO of the veins of the lower extremities, it is necessary to follow the recommendations of doctors:

• It is forbidden to increase physical activity and lift heavy loads during the week;
• It is necessary to walk more, to be in the same position as little as possible (except for sleep);
• For 3-4 weeks, you need to stop taking a hot bath, you can only take a shower;
• You should stop visiting the bathhouse for at least a month;
• It is necessary to drink as much plain water as possible, on average about 2. 5 liters, it is necessary to minimize the amount of salt consumed;
• A week after the operation, you should start physical therapy, which the doctor will inform you about;
• The doctor may prescribe some medicines after the operation.

Sclerotherapyis a non-surgical (minimally invasive) method of removing varicose veins and spider veins of the lower limbs.

Benefits of vascular sclerotherapy:

• absolute outpatient care that does not require additional preparation;
  execution speed,
• no need for anesthesia,
• lack of complications typical for surgical treatment methods such as nerve damage,
• Absence of "thermally induced phlebitis" accompanied by friction pain along the clotted vein, characteristic of coagulation methods.

Thus, today, sclerotherapy of veins for varicose veins is an effective and safe method, in some cases it can be used as an alternative to other types of surgical interventions.

The sclerotherapy method is based on the obliteration of the vessel by introducing a chemical substance into the lumen, which "washes" the inner layer (endothelium) with the subsequent development of endofibrosis. The degree of damage to the endothelium depends on the concentration and volume of the administered drug.

The modern medical center uses advanced technologies for the treatment of varicose veins and ensures the maximum effectiveness of all treatment measures. The use of modern equipment by experienced specialists will free you from varicose veins in the shortest possible time, without complications and from the need for long-term rehabilitation.

Treatment in a modern clinic means a significant improvement in health and quality of life.