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Neurology, Ophthalmology, Cardiology, Oncology, Obesity, Endocrinology, Vascular surgery - Causes, Symptoms, Diagnosis, Treatment, description of the disease.

Monday, 25.09.2023, 16:40
Main » Vascular surgery » Chronic venous insufficiency 
Chronic venous insufficiency

What is venous insufficiency?

Venous insufficiency - a disease caused by lack of deep vein valves. The disease is very common and familiar to many people, however, suffers from lack of attention, both from the patient and, until recently part of medicine, has emerged as retribution for human bipedalism. Features of modern life - lack of exercise, prolonged sitting and standing at work, as well as some inherent features of the vascular system and the hormonal status lead to problems of venous outflow of blood.

The main substrate of chronic venous insufficiency is, as already mentioned above, the lack of venous valves. Valves are available in both the deep veins, and in the surface. When deep-vein thrombosis of lower extremities of the lumen blocked. However, over time, their clearance is restored. This is due to the so-called recanalization. However, after such a restoration of the lumen of the veins is no restoration of their valves. Veins become inelastic, comes to fibrosis. The valves of veins are destroyed and normal blood flow stops.

As you know, the valves prevent the backflow of blood through the veins of the legs. With their failure develops so-called post-trombophlebitic syndrome, and as its principal manifestation - venous insufficiency. Its manifestations are diverse. What is seen CVI? Symptoms varied with the presence of only one symptom or several. Patients were concerned about pain, heaviness, swelling in the evenings, going in the morning, night cramps, discoloration of the skin in the lower third of the leg and loss of skin elasticity, presence of varicose veins. The latter feature does not always appear in the initial stages of the disease.

What are the causes of chronic venous insufficiency?

The mechanism of chronic venous insufficiency is the following. Damaged valves of deep leg vein can not prevent reverse blood flow in them. This leads to a significant increase in blood pressure. The result is that the liquid part of blood - plasma - begins to "propotevat" through the wall of the vein into surrounding tissue. This leads to swelling and compaction fabrics. Swelling of the skin squeezes tiny blood vessels in the leg. Especially the ankles. This can lead to ischemia, resulting in sores appear - one of the main signs of venous insufficiency. For chronic venous insufficiency can cause the factors that contribute to the development of varicose veins of legs (primary or secondary), deep vein thrombosis feet, and the primary valve insufficiency of deep veins of the lower extremities.

Diagnosis of chronic venous insufficiency

Diagnosis of chronic venous insufficiency is primarily based on the ultrasonic diagnostic methods. That the following methods:
  • Doppler ultrasound
  • Duplex ultrasound scanning

In addition, for further clarification causes of chronic venous insufficiency can be applied X-ray techniques such as venography.
As shown chronic venous insufficiency?

The main manifestation of chronic venous insufficiency include:
  • Edema of lower limbs
  • Dull pain arching, aggravated by prolonged standing and decreasing at rest
  • Cramps in the calves at night
  • Pigmentation of the skin in the lower part of leg
  • Dermatitis, eczema
  • Ulcers, mainly in the ankles
  • Treatment of chronic venous insufficiency

Treatment of venous insufficiency is practically the same events, which are used in postthrombophlebitic syndrome and varicose veins.

We list these treatments:

Compression therapy is used as varicose veins, and postthrombophlebitic syndrome and chronic venous insufficiency. For compression therapy applied elastic bandage, but more special compression stockings. Depending on the pressure generated by it is divided into four classes. The action of compression hosiery is based on the fact that when superficial veins are compressed feet, the outflow of blood from the deep venous system in the superficial veins become impossible.

Sclerotherapy. This method of treatment of varicose veins has been known since the time of Hippocrates. At one time in our country, this method has been unfairly rejected. However, overseas, this method has successfully developed and applied. The founder of the method is considered to be John Fegan. His technique of sclerotherapy has been known since 1967. This technique is also known as compression sclerotherapy. The method consists in the fact that the vein entered the special substance that irritates the inner wall of the veins leading to its chemical burn. This leads to adhesion of the walls of veins and imperforate. At the present time vachestve these drugs - sclerosants - used fibroveyn, etoksisklerol and trombovar. After the introduction of sclerosant into the vein, it is compressed latex pillow, and then bandaged. Thus, all the veins sclerotherapy. As a result, lower limb is bandaged. Instead, apply a bandage is now more stockings.

Compression of veins extends to three months. It should be noted that this method is not without drawbacks, namely, it does not guarantee against recurrence of varicose veins.

Surgical methods. Troyanov-Trendelenburg operation - the technique is ligation of the confluence of the thigh saphenous vein into the femoral vein, as well as the removal of the conglomerate varicose veins. To do this in the hip area along the entire varicose vein incision.

Operation and Linton Kokketa - this technique is that carried out the cut in the leg, and tied perforating veins. In this operation at Linton they tied tied under the fascia, and with operations Kokketa - over the fascia. This operation is effective for valve insufficiency of perforating veins, the so-called postthrombophlebitic syndrome. Currently, these operations are modified so that the ligation of these veins is performed with minimal incision. This so-called technique of remote crossings perforantov. In addition, for this purpose used an endoscopic technique. This so-called minimally invasive technique.

Babcock operation - is that in early saphenous vein thigh incision. Provided saphenous varicose Vienna. In a vein injected flexible probe, the other end of which is derived from the other end of varicose veins in the knee area. At the end of the probe has a rounded education. Vienna is fixed to it and displays the probe. Currently applied methods of stripping and miniflebektomy, which are essentially modifications of the Babcock operations, but instead of using a thick section of a puncture, after which little remains of the scar.

Prevention of chronic venous insufficiency

Prevention of venous insufficiency is the prevention of diseases that cause its development. One of the important methods of prophylaxis is to wear compression hosiery.

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