Varicose veins, edema and skin changes develop due to diseases of the veins that carry dirty blood from the leg.
There are three types of veins in the leg. These are the superficial veins where varicose veins develop, and they lie just under our skin. The second are deep veins, they run through the middle of the leg muscles and carry 90% of the dirty blood. The third is the veins that connect the deep and superficial veins.
The most important structural feature of our veins is that they have valves that allow blood flow only from the legs to the heart. These valves open when the blood moves up, and close immediately when the blood moves backwards.
How do varicose veins develop?
Deterioration in these valves due to a variety of reasons and Varicose veins, edema and skin changes develop as a result of the high pressure in the leg due to the valves leaking blood backwards when they close.
Varicose veins are the appearance of superficial veins and their branches, which are not normally seen, anywhere in the leg, except for the back of the foot. It is described as varicose veins.
Varicose veins can manifest themselves as capillary varicose veins on the skin or as large varicose veins originating from the branches of the superficial vein.
What complaints develop?
Patients may sometimes present with edema or skin changes only in the legs without varicose veins. In the legs, symptoms such as unilateral edema, darkening in color and hardening of the skin in the ankle area are usually observed. In patients who have been under the influence of high pressure for many years, eczema and wounds begin to appear in the ankle area. Burning on the soles of the feet appears along with itching in this area. In addition, these people develop leg cramps due to dirty blood pooling in the legs and harmful metabolic waste products. The most disturbing situation is the severe pain in the legs in the evenings.
In addition to complaints such as pain, itching, and cramps, patients also experience cosmetic problems such as varicose veins, edema, and skin lesions.
At this stage, patients experience cosmetic problems such as varicose veins, edema, and skin lesions. One of the most feared situations is varicose veins, where blood pools and becomes immobile. This creates a basis for clot formation. It develops especially after long travels. The most feared complication of blood clot formation in the leg is life-threatening pulmonary embolism.
What are the approaches to diagnosis and treatment?
Patients now seek treatment when serious deterioration in their quality of life begins. They apply.
Patients cannot fully understand which department they will be treated by due to pain, edema and skin changes in their legs. Accordingly, after going through many clinics such as physical therapy, orthopedics and dermatology, they apply to cardiovascular surgery. There are many differences in each physician's approach to patients after applying for cardiovascular surgery.
However, a consensus has been formed regarding treatment in the world on this issue. This approach generally involves first fully revealing the patient's complaints, fully evaluating the vein and skin changes, and performing tests to determine the cause.
The crucial approach after the examination is venous Doppler ultrasound by the cardiovascular surgeon himself and a radiologist. It needs to be done. Treatment is planned by taking into account the physician's own findings and the findings revealed by the radiologist.
If obstruction is detected in the deep veins in the Doppler examination of the patients, varicose veins in the superficial veins are left untouched. They serve as carriers of dirty blood. This is a condition we see very rarely.
The most common finding we see in Doppler ultrasound performed on patients with varicose veins in the legs is that the superficial vein joins the deep vein in the groin area through a valve. Normally, this valve only allows passage from the superficial vein to the deep. However, if retrograde flow is detected from the deep to the superficial vein, this is called venous insufficiency. Leaks, which initially occur only in the groin area, create high pressure in the lower parts of the superficial vein, causing leakage in the valves below.
Doppler detects leaks in the valves of the deep, superficial and connecting veins. It is the degree of these leaks that will shape the treatment.
During the Doppler, the patient should make a straining movement. It is done to stop the venous blood flow. At this stage, as the blood moves downward, the valves close and blood moves downward for only half a second. If there is a leak down the valves for 1 second, we say there is mild venous insufficiency; if it lasts for 2 seconds, we say there is moderate venous insufficiency; if it lasts for 3 seconds, we say there is serious venous insufficiency.
When deciding on treatment, we make a decision based on the patient's complaints, examination findings and the results obtained on the Doppler.
There are many different approaches to treatment. Lifestyle changes and drug treatment may be sufficient for people with mild edema and slight leakage on Doppler.
People with severe edema or varicose veins in the legs are often accompanied by serious leaks on Doppler. The most important approach in the treatment of these patients is to eliminate these leaks. For this purpose, open surgical approaches were used in the past by making 5-10cm incisions. Nowadays, surgical treatments have been replaced by closed methods. Leaks are eliminated using intravenous treatments such as laser, radiofrequency or adhesive. After the leaks are eliminated, varicose veins on the skin are removed painlessly through small 1 mm incisions. Get rid of varicose veins in the legs, which cause major cosmetic damage, in a short time. After these procedures, patients are discharged on the same day.
If there are also varicose veins on the legs, foam sclerotherapy is applied after 15 days. In this, the detergent-derived sclerosing substance, which affects the inner layer of the vein and causes it to disappear, is foamed with air, allowing it to penetrate more capillary varicose veins. With a few injections into the capillary varicose veins, the foam is filled into the capillary varicose veins. Then, after a few stages of changes in the vein, capillary varicose veins disappear within a few months.
Can varicose veins or complaints recur after these treatments?
This Recurrence after treatment occurs due to the persistence of leakage or the reappearance of leakage that had previously disappeared.
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