Varicose Veins of the Lower Extremities (Varicose Disease)

Varicose veins of the lower extremities (varicose veins) is a vascular disease characterized by dilation of the subcutaneous (superficial) veins and impaired venous outflow. This condition is caused by incompetent valves in the veins and weakness of the venous wall. With varicose veins, blood cannot flow efficiently through the veins, which causes them to widen and cause characteristic symptoms.

There are two types of varicose veins: primary and secondary. Primary varicose veins are associated with congenital weakness of the venous wall and defects in the valves that usually prevent backflow of blood. Factors that contribute to the development of primary varicose veins include pregnancy, obesity, prolonged standing, genetic predisposition and the use of constrictive underwear.

Secondary varicose veins develop as a result of disturbances in venous outflow caused by factors such as post-thrombotic syndrome after thrombosis, the presence of tumors or injuries. In these cases, obstructions in venous blood flow lead to increased venous pressure and dilation of the superficial veins.

The physiology of venous circulation plays an important role in the development of varicose veins. Blood from the lower extremities returns to the heart thanks to the muscle pump and arterial pulsation. When the muscles of the leg and thigh contract, the veins contract and blood flows from the superficial veins to the deep veins, which are equipped with valves. Healthy valves in the deep veins prevent backflow of blood from the superficial system. However, in the presence of varicose veins and valve incompetence, a reverse flow of blood occurs from the deep veins to the superficial, causing them to dilate.

Increased pressure in the superficial veins leads to various symptoms and complications. One of the main symptoms of varicose veins is the expansion and protrusion of veins. As the disease progresses, fatigue, heavy legs, soreness, cramps, and numbness may occur. Swelling often develops late in the day and is worse after prolonged standing, but may improve with a night's rest. Over time, in addition to symptoms, trophic disorders may occur, such as induration (thickening of the skin), pigmentation, dermatitis and trophic ulcers.

To diagnose varicose veins, the doctor performs a physical examination and reviews the patient's medical history. Additional diagnostic methods may include ultrasound examination of the veins, venography (X-ray examination of the veins using a contrast agent), and duplex scanning, which allows visualization of the structure and function of the veins.

Treatment of varicose veins is aimed at relieving symptoms, preventing progression of the disease and eliminating complications. Conservative methods include the use of compression stockings or bandages, lifestyle changes (avoiding prolonged standing or sitting, physical activity), and elevating the legs to improve circulation. In cases where conservative methods are ineffective or there are complications, surgery may be required. Surgical methods include removal or hardening of dilated veins (phlebectomy or sclerotherapy), laser or radiofrequency ablation, and reconstructive surgery on vein valves.

Varicose veins of the lower extremities are a common condition that can cause significant discomfort and complicate normal daily activities. It is important to see a doctor at the first signs of illness to receive a correct diagnosis and treatment recommendations. Timely intervention helps prevent the progression of varicose veins and reduce the risk of complications.