Causes, symptoms and treatment of venous insufficiency

Venous insufficiency is a pathological condition that occurs due to impaired outflow of venous blood. In practical medicine, this term refers to disorders of the lower extremities.

Reasons

In most cases, chronic venous insufficiency of the lower extremities (CVI) develops. The following diseases and pathological conditions can lead to it:

varicose dilation of the veins of the lower extremities;
postthrombophlebitic syndrome;
some congenital malformations of deep and superficial veins;
phlebothrombosis - blockage of venous vessels;
phlebopathy is a type of vein pathology in which venous stasis is observed in the absence of visible signs of the impression of such vessels;
traumatic lesion. Injuries are a rather infrequent cause of the development of venous insufficiency, but it should be remembered.

Of the congenital defects that most often lead to venous insufficiency of the legs, the following are most often found in the clinic:

congenital hypo- (underdevelopment) and aplasia (absence) of deep veins - this disorder is called Klippel-Trenone syndrome;
congenital arteriovenous fistulae – pathological passages between arteries and veins (or Parke-Weber-Rubashov syndrome).

There are also factors that make venous insufficiency more common:

genetic predisposition;
female gender;
old age;
reception of hormonal contraceptives, as well as some other hormonal drugs;
hypodynamia;
lifting loads;
fasten.

Classification

Clinical manifestations of venous insufficiency can be different. Therefore, for convenience, the clinic uses the international classification of chronic venous insufficiency according to the so-called CEAP system, which takes into account the causes, development, and manifestations of this pathology. Within such a system, a scale of reduced working capacity is also used, according to which the degrees of chronic venous insufficiency are distinguished:

0 – no symptoms;
1 – there are symptoms, but the patient is able to work;
2 – performance is possible only with the use of supporting means;
3 – even with the use of supportive drugs, the patient is unable to work.

Symptoms

How is chronic venous insufficiency manifested? Symptoms of lower extremities can be very different.

Symptoms in the initial stages:

heaviness in the legs, which increases in a vertical position;
edema;
convulsions at night;
increased pigmentation (darkening) of the skin in the lower leg;
dryness of her skin;
deterioration of skin elasticity

As CVI progresses, local (local) circulatory insufficiency increases, signs of trophic disorders appear (they are absent in acute venous insufficiency). Clinical picture:

increasing symptoms already indicated;
formation of trophic ulcers;
signs of deposition (accumulation) of blood in the lower extremities - dizziness, loss of consciousness, symptoms indicating the development of heart failure.

The physical and mental capacity of such patients deteriorates over time.

Diagnostics

Diagnosis is made taking into account patient complaints, anamnesis data (medical history), results of additional examination methods. The most practical importance are:

ultrasound examination;
duplex angioscanning;
phlebography is an X-ray contrast examination method.

Treatment of venous insufficiency

Treatment of chronic venous insufficiency is conservative and operative.

The basis of conservative therapy:

regulation of physical exertion;
elastic compression (to prevent stagnation of venous blood);
venotonics.

If the results of conservative therapy are not satisfactory, surgical treatment of venous insufficiency is carried out. Most often, phlebectomy is performed - removal of veins.

Prevention

Venous insufficiency is easier to prevent than to treat. Simple but effective methods of prevention:

restriction of being in a static position (this is standing and sitting with the legs down);
vigorous physical activity;
correction of body weight.

Patients at high risk of CVI should:

wear elastic stockings;
apply elastic bandaging of the lower limbs.

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