Primary varicose veins
What are primary varicose veins
Varicose veins represent a chronic superficial venopathy and of the communicating vessels of the lower limbs, with the appearance of irreversible dilatations of the subcutaneous venous system.
What are the causes of primary varicose veins
Primary varicose veins are caused by valvular insufficiency of the superficial veins (more common in the saphenous-femoral junction) which favors venous reflux accompanied by increased vascular pressure with the appearance of varicose dilatations.
The factors favoring the disease are represented by physiological conditions such as pregnancy, menopause, old age but also pathological conditions such as obesity or trauma to the lower limbs (spontaneous ruptures of the perforating veins in athletes). Genetic factors (congenital valvular absence) and professional factors (barbers, surgeons, dentists, bartenders - activities that involve prolonged orthostatism) also play an important role in the onset of the disease.
How the disease manifests itself
The main manifestations of the disease are the feeling of heaviness in the feet, itching or "restless legs" syndrome (Willis Ekbom's disease), altered skin sensitivity to hot/cold with accentuated symptoms when walking.
What is the treatment for varicose veins?
Prophylactic treatment aims to reduce the evolution of primary varicose veins and includes all lifestyle changes that can be taken in this regard:
- Avoiding prolonged orthostatism or shifting body weight from one leg to another;
- Avoiding heels over 3 cm;
- Reducing excess weight;
- Doing regular physical exercises;
- Keeping the feet in an elevated position during the night (feet above the pelvis);
- Wearing compression stockings throughout daily activities;
- Avoid hot bath saunas or cold showers.
Surgical treatment of superficial venous dilatations includes:
Phlebectomy (minimally invasive procedure to remove varicose veins with rapid recovery that can be performed under local anaesthesia);
- Sclerotherapy (injecting a sclerosing chemical with the effect of constricting and closing the vein);
- Venous stripping (removal by classical surgery of chronic venous dilatations);
- Laser photocoagulation (uses a catheter to insert the optical fiber into the venous path; as the catheter is withdrawn, the venous bed is closed by the emitted heat);
- Techniques that use radiofrequency are more recently introduced in the treatment of varicose veins and consist of the use of radiofrequency energy instead of a laser one, for venous sealing.
Preventive drug treatment may include dietary supplements that help support venous circulation by reducing the discomfort caused by venous dilatations - such as diosmin and hesperidin. Other medical preparations are indicated according to the staging of varicose veins according to CEAP and include systemic antibiotics (in case of post-traumatic infections of superficial varicose veins) or local topics.