What are the enlarged veins?

Expanded veins on the feet are those veins that have lost their biological function - namely, healthy veins carry blood from the leg to the heart, thanks to vein bites, ie smaller vein valves that aid the flow of venous blood versus gravity. Expanded veins have damaged flaps, which have lost their function, resulting in retention of blood in the veins of the leg and widening of the vein (Figure 1). This is a very common medical problem, involving approximately 15% of men and 25% of women.

picture 1. Vascular waves prevent the flow of blood in the healthy veins of the leg in the direction of gravity, while in enlarged (varicose) veins the vascular bends release.

Koji su znaci proširenih vena na nogama?

What are the signs of extended veins on your feet?

Foot injuries can be manifested, in the slightest cases, as smaller skin sprays (so-called "capillaries"), then as varicose (pelvic) veins in the legs and in the form of wrinkled legs, and in severe cases hardening and dulling of the skin occurs In the most severe forms of illness, skin lesions are formed ("vascular ulceration"). The sufferers can not feel any trouble for a long time, but as the disease progresses, itching and burning in the lower limbs, then itching, weight in the legs, fatigue, night cramps and discomfort. The vein of the leg can be complicated by the creation of vein thrombies, which can potentially lead to life threatening pulmonary embolism. Vein bleeding is also possible.

Clinical examination usually distinguishes 6 stages of disease (the so-called ECAP classification):

  • Stage 1 - teleangectics (tiny, parotid veins, measuring up to 1mm wide), venules (veins measuring up to 2 mm wide) or reticular veins (up to 4 mm wide) are seen.
  • Stage 2 - varicose veins (bags) are visible, measuring more than 4 mm in width.
  • Stage 3 - see edema (swollen leg), but no skin changes.
  • Stage 4 - Changes in the skin that are caused by the disease of the vein (pigmentation, vein eczema, lipodystrophy, hardening and dimming of the skin) are seen.
  • Stage 5 - Changes in the skin, with the ulcer (wound) seen, which has healed.
  • Stage 6 - Changes in the skin are seen with the presence of open ulcers (wounds).

If the enlarged veins do not cause the symptoms or are not clearly visible, pay attention to skin skincare changes, darker pigmented skin, appearance of the capillary nerve around the ankle or more common dermatological problems such as eczema ...

What causes enlarged veins?

The main cause of enlarged vein in the legs is the genetic predisposition - in the vast majority of the diseased, the appearance of the vein of the leg disease with close relatives is noticed. In addition to genetics, the appearance of illness will also contribute to lifestyle and habits, such as long-term standing or sitting, excessive weight, multiple pregnancies, taking contraceptive pill, frequent wearing of high heels, and clothing that clings to the waist.

Expanded veins are divided into three basic groups:

  • varicose veins,

  • reticular veins,

  • spider veins or teleangiectation.

Spider veins are visible on the surface of the skin as red, blue or purple lines. Varicose veins are bigger and deeper and often look like blue-skinned underneath the skin.

If not treated, ...

Varicose veins represent a progressive disease. Spider veins often accompany varicose veins. You can feel pain during standing or walking, with itching, choking or painful sensation around the eye and the varicose vein, with the ankle and the foot. Also possible is the occurrence of thrombosis, flebitis, venous ulcers, skin color changes, lipodystrophy and skin atrophy. Although spider veins are primarily considered a cosmetic problem, they can cause problems such as burning, numbness, and can progress to varicose veins with all the problems they carry.

How to treat enlarged veins?

Expanded veins are cured by removing diseased veins from the bloodstream and redirecting venous blood to the healthy veins in the legs. Until ten years ago, this was done by surgically extracting extended veins from the body. Since such surgery involves multiple cuts and seams on the skin, most commonly with the use of general anesthesia, in the 21st century a minimally invasive vein treatment method was developed, which is based on the closure of damaged veins in the body. Closure of the vein is much less aggressive than the vein removal and is more effective in aesthetic and functional terms.

All patients can not be treated the same way. One method is better than the other in a particular case, but only for that patient or only for a certain type of vein.

It is often necessary to combine more techniques with the same patient in order to obtain an adequate, in the first place, functional but also aesthetic result.

A detailed overview of your veins involving colorectal dermatitis, but sometimes MSCT venography, are key to planning your treatment mode and order.

Introducing color doppler into daily phlebological practice is surely the biggest advancement in diagnosis and treatment of the vein. In order to properly treat illnesses of the reflux source juice, any contraindications to the treatment should be identified and excluded. Ultrasound is painless and non invasive. Regular controls after treatment are extremely important, with later annual control, upon completion of treatment.

Dilatirano safeno-femoralno ušće I refluks na primarnoj valvuli

Dilatirano safeno-femoralno ušće I refluks na primarnoj valvuli

Thanks to our co-operation with eminent experts / dr. Anton Krnic / Zagreb, Croatia, Dr. Karl-Hermann Klein, Burbach, Germany /, the leading equipment manufacturers / Biolitec, EVRF, Kreussler, Gigaalaser, General Electric, Continuous and Continuous Education European centers for the treatment of veins, we are able to offer you a complete and quality service in the treatment of vascular disease:

  1. UGFS treatment-ultrasonic-controlled injection of foam into diseased veins

  2. endovenska laser ablation of the vein (EVLA)

  3. Energy Radio Frequency Freeze Ablation (EVRF)

  4. Ambulatory miniflebectomy

  5. Miniskleroterapija

  6. Laser and RFA capillary treatment

  7. Compressive therapy

Most common missaperhension on veins

Over the past few years, enormous progress has been made in understanding the disease and in successfully treating the vein. This advancement has most facilitated the routine use of ultrasound ultrasound dyes in the diagnosis of vascular disease and advances in laser, radio frequency technology and many previous concepts that were considered to be correct and taken for granted were virtually "turned upside down" or proved to be totally wrong.

The most common misconceptions about veins are the following:

  1. "Women have more problems with venoms than men"

    Conversely, more studies have shown that men have more vascular varicose veins than women, but are much less inclined to seek medical help, even when it comes to their health.

  2. "Pregnancy causes enlarged veins"

    Studies have shown that only women who have pre-pregnancy already have venous reflux (damage to the veins) are getting extending veins during pregnancy and after pregnancy, in fact, it is only becoming apparent or much more pronounced because of hormonal changes in the body, higher circulating volume while pregnant women who do not have an existing problem with the veins of such problems will not have, so pregnancy does not cause enlarged veins, but the problem gets worse or makes it obvious. On the other hand, and without pregnancy, the problem will appear sooner or later throughout life. A predetermined number of women (1-2% of the total population) have so-called Congestive Pelvis Syndrome (enlarged veins of small pelvis) and their pregnancy and natural birth will indeed be a cause for the appearance of pronounced vaginal vulva varicose veins and varicose veins in the hip and upper parts thigh. Since pregnancy causes vein enlargement, there would be a lot more women with varicose veins than men, which is not the case and we would also see significantly more extended veins in pregnant women, which is also not the case.

  3. "There is no need to rush with resolving the problems of extended veins"

    This is often the opinion of even medical staff today, although it is wrong for several reasons, because: - the problem is easier soluble while small - the smallest pathological changes will occur on the skin of the area from which varicose veins occur - a smaller number of veins will to be irretrievably damaged and lost as soon as the procedures are in place - the procedure is simpler, the recovery is much faster in the earlier than the distant phase of the disease - the subsequent deterioration (including that in and behind the pregnancy) will be prevented

  4. "Varicose veins are just a cosmetic defect and can be left to such"

    Plavix or greenish enlarged veins that are visible on the skin surface are not a problem in themselves, but the sign that the vein pump does not function properly, ie removing visible veins in any way, will not solve the problem that led to their appearance, rather than it has to solve the cause of the venous pump. A detailed color dopler vein examination and sometimes some other examinations are necessary to make an adequate treatment plan and the problem will not come back!

  5. "There is no purpose to intervene on enlarged veins because they are back"

    Varicose veins have been for a long time by patients, but also medical personnel considered irrelevant or just a cosmetic problem, and often diagnosed only on the basis of what was seen with the naked eye or fingerprints, and even the operation was done only on the basis of the knowledge acquired by the team so there is no wonder that a large percentage of vascular restoration is behind such procedures (in different studies 20-25% in the first year after surgery and up to 75% in 10 years after surgery). Only the use of color doppler enabled the size of the problem, potential causes of enlarged veins, to be seen, and adequate treatment for such a finding. Properly treated enlarged veins should no longer come back but it should be noted that in some patients there is a new spread of veins due to the inherent weakness of the walls (risk is 3-4% per year) and therefore it is recommended once a year to make a control colour dopler and so newborn vein extensions are solved immediately while they are small (usually by a foam or transcutaneous laser treatment).

  6. "Staying Longer, Causes Extended Veins"

    Studies have shown that up to 9 years of age, 5% of children have a certain degree of damage to the ankles on their feet, with a color doppler up to 18g, this number is 10%, although only a small number of these children are enlarged veins and seen on the skin . Later, during their lifetime, the problem will become more apparent and more visible, just as pregnancy is only a factor that favors the manifestation of a disease in people who already suffer from damage to the veins (which they know or not). Hence, varications are formed faster, they are even bigger with complications if you are dealing with occupations where longer standing time is needed (teachers, doctors, salespeople, ...), but standing alone is not the cause of the disease

In addition to non-surgical and surgical measures of vein treatment, it is applied additionally to all patients and combinations of various other measures:

  1. general hygienic-dietetic measures
    • wear comfortable, anatomically shaped footwear, as needed orthopedic inserts - poor static and loose ligaments at flat feet have a significant impact on the development of a vein's leg disease. Avoid tight clothing, especially in the groin area.
    • Maintaining an ideal body weight reduces the possibility of extra load on the vein system that occurs each kilogram of excess weight.
    • Avoid long-term standing and sitting, hold your feet at an elevated position
    • It is advisable to drink plenty of liquid during the day and nutrition rich in fiber, raw fruits, vegetables, wholemeal grains, vitamin C etc.
    • Such a diet reduces the appearance of constipation, which thus favors the formation of vein enlargement.
    • Some fruits like peaches, blueberries, black currants, broccoli are extremely rich in bioflavonoids - joints that tighten the vein walls and make it more elastic, thus preventing or slowing the vein spread. Bioflavinoids can also be found in certain tablets.
    • Avoid excessive exposure to sunlight, and use protective sun protection agents. Sauna and Jacuzzi yes, but: soak up the cold water with your feet after use and lift them up. Soak your feet with cold water and after a hot bath. This narrows the blood vessels and helps to properly transport the vein circulation.
    • Avoiding heavy loads and exerted physical exertions - in the case of severe physical exertions, the abdominal pressure increases, which directly affects the spread of the veins on the feet
      consider the need to take oral contraceptives and the possibility of other latent contraceptives with your gynecologist
    • Relaxation and sleep: Place your feet 15 cm above the heart rate so that the pillow is placed under the mattress, not under the pillow !!!
  2. Medications

    Medications are, in principle, very limited in effect and serve only as a supplement to basic therapy. There are tonic tonics that activate the muscles of the blood vessels, increasing elasticity, which helps a faster flow of venous blood to the heart. Products that prevent the formation of edema (swelling) are designed to prevent blood vessel permeability, thus preventing increased fluid retention in the surrounding tissues. One and the other type of medication can be supplemented with compressive socks therapy and significantly reduce the feeling of pressure and weight in the legs. The most known active substance is the extract of wild chestnut and preparations containing bioflavinoids.

  3. Physical Activity
    Regular exercise is very important in the prevention and treatment of vascular disease. All exercises and sports that trigger joints and activate the muscles are appropriate. Weighing heavy weights and jumping are forbidden. The following sports are good for your veins: walking, jogging, swimming, gymnastics, biking, cross-country skiing and dancing, while sports with sudden start-ups are not advisable: martial arts, tennis and squash, skiing, boarding, ball sports. For patients with vein problems, special exercises have been designed and should be conducted at least 10 min 2 x per day to achieve visible success:
    • bathing with lukewarm water, in a standing position; lifting and lowering exercises on the toes of the foot
    • ankle movements, which depends on the effectiveness of the muscular pump (see picture)
    • while sitting - circle your feet on a pair of circles in one side and the other - lift your feet alternately to your fingers and your heels and back-rely on your heels and lift your entire foot - alternately swing your feet from your toes and fingers
    • walking in the water to the belt
    • yoga

    Klikom na sliku dobićete uvečani prikaz

  4. COMPRESSIVE THERAPY Compressive therapy is the basis of conservative therapy in the treatment of a vein disease.

    Compressive bands and compression socks also support the feet and reduce the vein diameter so that the vein bends can re-close and prevent blood flow in the wrong direction-meaning the opposite of the heart. The medical compressive stocking prevents the formation of new varicose veins and keeps the existing sick veins under control. If the vein sickness is neglected and not treated, it can accelerate rapidly and become chronic. For this reason it is extremely important to prevent aggravation and complications by wearing compression socks.

    The compressive sock has a mechanical constrictive effect. Ingredients such as wild chestnut extract have the internal healing effect of the wall of the vein. Mediven compressive-comfort gel and cream contain extract of wild chestnut and are specially designed for those carrying compressive socks. The gel cools under a compressive stocking during the day. At night, the cream provides tired skin with the necessary eyewash and skin care needed for the next day.

How does compressive stocking work?

It's easy to explain how a compression stock works: socks pressure decreases the diameter of the vein. Veneer swings can re-close and reduce the amount of blood that comes back down the leg. Smaller vein diameter means that blood flows again much faster, preventing the formation of blood clot or thrombus. The medically prescribed metered pressure that is greatest in the ankle area from where it gradually decreases to the lower extremities, serves as a blood flow accelerator back to the heart. When the foot is moved, the sock creates an external border with the muscles, making muscle pumping activity more effective.

Carrying compressive socks is generally not uncommon, as it is thought. If you wear a sock that is selected by measuring your leg at least 3 places, relief is at the moment and helps keep your feet healthy.

Compression levels

Different vein diseases require different degrees of pressure.

There are four levels of pressure:

  • mild compression up to 20 mm Hg: Prevention in the case of tired, severe legs caused by long standing or during pregnancy
  • moderate compression up to 30 mm Hg Expressed varicose veins, swollen feet, after a vein inflammation, after sclerosis or surgery, in case of varicose veins during pregnancy
  • strong compression up to 40 mm Hg after deep vein thrombosis, constant swelling of the leg, after open knee ulcer
  • extra strong compression up to 60 mm Hg in very pronounced swelling, lymphedema

Compression stock lengths

Depending on the location of the vein damage and how far developed, different compression stock lengths are used. The range moves from height to knee to pantyhose. There are special models for men and women.

What are the different types of compression socks?

Depending on the type of illness, the doctor will prescribe the appropriate quality of socks. From semiprecious, highly elastic socks, through very modern in color to very strong, thicker socks with durable weaving. It is a very easy rule to choose the right socks: The greater the damage to the vein system and the soft tissue of the foot, the stronger and the thicker the socks.

In which situations are compressive socks not to be worn?

Compression socks should not be used in cases of arterial circulation disorders and heart problems that are difficult to cure. Caution is important in cases of sensory impairment due to diabetes or neuropathy (nerve damage).

HOW OFTEN DO I HAVE TO WEAR IT ?

Everyone, but every day! Here is simply no alternative if you want to achieve the best therapeutic result. Your socks are absolutely essential if you stand or sit. When traveling, either by car or plane, the sock prevents the formation of a clot, which occurs also in people with completely healthy veins when they are on the go. If you wear a sock daily when you are exercising or walking, it stimulates the development of muscles, as your muscles put additional strength to overcome the external pressure.

Proper maintenance of compressive socks

Place a compressive sock in the morning immediately after getting up and showering, as your legs do not go up during that period. In the evening after you have changed, you should wash your compression stocking. One of the reasons is that the material stretches and lowers pressure after wearing. Another reason is that the fabric absorbs skin scales, sweat, skin creams, and so can damage the fibers which then lose elasticity. So you need to make sure your sock is pervasive and in the machine and is suitable for the dryer so it is easier to maintain them. In no case shall the sun socket or radiator be dried, as this will greatly affect its shorter life span.

How to properly tighten and compress compressive socks?

Before you start wearing a compression sock, it's best to take off watches and jewelry with your hands and put rubber gloves to avoid fiber damaging. Rubber gloves cling to the material making it much easier to dress the socks. When you wear a sock, avoid suddenly pushing and changing the socks as it will not fit your leg. As a result, the pressure distribution will not be correct, and the sock will fall as a curve and collect on the back of your knees. This leads to an unpleasant feeling of tenseness in the knee.

When stretching:

  • Get in the sock and catch the heel.
  • Pull the sock upside down (from the inside out) to the heel
  • Brush the sock over your feet to the heels
  • Apply the upper part of the socks in the middle of the foot
  • Roll the fabric over the heel
  • Re-apply the fabric that sits with both hands and roll over the heel 7
  • Align the fabric over the thigh
  • Step by Step Tie the sock to the lower leg • Receive the fabric again and roll over the knee
  • Make sure the whole stocking slices with the skin (no wrinkles)

The most common problems in wearing compressive socks?

  1. Regenerating and Sweating Your Leg In the summer time, swim your feet with spray water over the socks or apply a special Mediven comfort gel gel with cooling effect, before the socks are held in the morning. Keep your gel and cream in the fridge. This will further boost the cooling effect, which will affect the narrowing of blood vessels - which is mini-training for your veins. Choose the neutral color of your compression socks (the color of your legs) and over it, carry any nylon in the desired color. That means your stocking is almost invisible, so your choice of colors is not narrowed. The zipper or sock-nip will protect the extra compression stocking from the shoe and extend its shelf life.
  2. The sock hacks? Train your compressive socks with trained specialist shop staff. The sock that is too thick is down and folds into the knee. If dressing is not a reason, you should check your feet again at a specialist dealer.
  3. Dry skin? This is a common problem, since my weakened venous system is poorly supplied by changing skin and subcutaneous tissue. specialty products for people who are using compression socks, such as Mediven Compression-Comfort Cream. If you wear it in the evening after removing the socks, your skin will receive all the necessary care and nutrition for the next day.
  4. Strength Compressive therapy must exert pressure on the leg. Since the ankle is farthest from the heart, the pressure must be the strongest in that position. You will get used to that feeling after a short time. Disease of the vein is often prone to pain and tenderness of swelling. Almost all patients experience a sock on their feet as a sort of relief given their previously tired and sometimes painful legs. Do not forget the fact that the stocking keeps your feet fit and allows flow of blood.
  5. Hardwearing Socks Today, practical tools for compressive socks can be used. The simplest aids are rubber gloves that are easier to snorkel and make it easier to dress, and on the other hand protect the sock from nail polish or jewelery.