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Sep 12, 2020
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Everything is at our feet. Why does varicose veins appear and how to get rid of it

It used to be thought that one in five suffers from varicose veins. But recently, more and more people are faced with this problem.

Tells Head of the Department of Cardiovascular Surgery, Scientific and Practical Center for Interventional Cardioangiology, Sechenov University, Andrey Pankov...

Lydia Yudina, AiF: Andrei Nikolaevich, most people consider varicose veins to be just an annoying cosmetic problem ...

Andrey Pankov: Varicose veins are a pathology in which the venous wall expands. This is a dangerous condition, as blood clots can form in the dilated veins. Prevention of thrombus formation is the main indication for the treatment of varicose veins.

By the way, varicose veins occur not only in the legs, but also in the small pelvis. But this problem often occurs in pregnant women when the load on the venous system increases sharply.

Sitting and standing

- Can anyone have varicose veins?

- In the vast majority of varicose veins, people with a hereditary predisposition and women during pregnancy are susceptible. Also, venous pathology often appears after a previous venous thrombosis of the lower extremities.

However, the disease can also occur in a person with initially healthy veins. As a rule, sedentary or standing work contributes to the appearance of varicose veins. If earlier it was believed that every fifth patient suffers from varicose veins, recently there have been noticeably more patients. This is largely due to the fact that the number of those whose activities are related to working at a computer has increased.

- For the prevention of illness, doctors recommend wearing compression hosiery and not sitting cross-legged. It helps?

- No prevention method can give a 100% guarantee. However, vigilance and preventive measures reduce the risk of developing the disease.

People at risk (office workers and those with a hereditary predisposition) should not only wear compression hosiery and observe other classic rules for the prevention of varicose veins (see infographics), but also take a course of special drugs - venotonics several times a year.

It is also advisable for each of us to visit a phlebologist at least once in our life, who, after an ultrasound scan, will assess the state of the venous system, the risk of varicose veins and draw up an individual prevention plan.

If there are alarming symptoms - edema, tired legs syndrome (feeling of heaviness in the legs at the end of the day), you should immediately contact a specialist. At this stage, the development of varicose veins can be prevented if you undergo a course of treatment prescribed by your doctor.

Pill or surgery?

- You mentioned venotonics. These drugs are expensive, but they do not give a visible effect ...

- Venotonic drugs really cannot "remove" veins (what patients expect). You need to understand that varicose veins is an irreversible process. If the veins are already dilated, the disease will only progress. The only thing that can be done is to slow down the pace of its development. Taking venotonic drugs exactly solves this problem. Venotonics tone the vascular wall, which prevents the further spread of varicose veins at the rate at which this process would develop without them. They work best in patients who have a predisposition to varicose veins, but who have not yet developed the disease.

- If the disease goes far, then doctors recommend surgical removal of dilated veins. How effective is it? There are people who have undergone several such operations, but after a short time the varicose veins returned.

- If the operation was performed correctly, he should not return. Most often this happens in cases where, against the background of complete valve insufficiency, the surgeon removed only the visually altered segment of the vein. In the branches left behind, the process continued and became noticeable after the operation. If the large saphenous vein was removed completely and a relapse occurred, this most likely indicates a surgeon's mistake.

We must not forget that after the surgery, the doctor's recommendations must be followed: wear compression hosiery for two weeks, avoid unnecessary stress, and take the necessary medications. But after this period, it will be possible to forget about compression tights (from which patients are so tired).

Once and for all

- Are there really reliable treatments for varicose veins that guarantee long-term results?

- There is no single "gold standard" for the treatment of varicose veins. It is different for each patient.

A good result is given by modern, recently appeared methods of treatment - laser coagulation (a low-traumatic procedure without the use of surgical instruments, in which, under the influence of high temperature, the vein is "welded" from the inside and eventually turns into connective tissue) and radio frequency coagulation, which works on a similar principle.

However, the classic phlebectomy (surgical removal of the great saphenous vein) is still used. It is indispensable for widespread, far-reaching varicose veins, since in such cases the use of minimally invasive techniques gives a high probability of relapse. Also, radical surgical interventions are indicated for trophic changes or ulcerative defects (discoloration and long-term non-healing skin defects due to chronic inflammation). The phlebologist's task is to determine which of the patients is suitable for which method.

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