varicose veins

   Varicose veins 



SECTION INDEX 

»Varicose veins: Anatomy

  »Varicose veins: Introduction and epidemiology

    »Varicose veins: Causes and Classification 

»Varicose veins:

Symptoms and Diagnosis 

»Varicose veins: Therapy

  »Varicose veins: Drugs to treat varicose veins

   »Varicose veins: Remedies for varicose veins

Generality The World Health
Organization defines varicose veins (or varicose veins) as abnormal and saccular dilations of the veins, especially the lower limbs, which often take a tortuous pattern.

Varicose veins These are a frequent but generally well-tolerated pathology, for which the patient commonly adopts spontaneous remedies such as rest with raised legs, elastic stockings, massages with appropriate ointments. Only in rare cases, therefore, the varicose veins come to the attention of the doctor.

Only 1.1% of males and 2.2% of females are admitted for surgery to varicose veins of the lower limbs. The most frequently affected sites are the superficial veins of the lower limbs. Epidemiology

In the general population the varicose disease has a frequency of 15-30%, if we consider only the degeneration of the systems of the vein Safena and its collateral (see: anatomy veins); if you want to extend the concept even to the modest varicosities of only aesthetic relevance, this figure reaches 35%. There is a considerable difference between countries: the disease is much more common in Europe than in Africa or Asia, where there is a prevalence of 10 times lower. Causes Factors that can make varicose veins develop:  

Constipation, which hinders the return of venous blood to the top 

 Obesity 

 Deficiency of the muscle pump

  Work in orthostatism (standing position) in a warm environment (which favors an expansion of the vessels)  

Alterations of the veins present at birth (congenital);

  Age (between 30 and 50 years);

  Sex (female predominantly). The factor that most influences venous blood pressure is posture; during the upright position, especially if prolonged, the venous pressure increases considerably, up to ten times the normal pressure. As a result, occupations requiring standing posture for long periods of time or long journeys by car or plane, often lead to the emergence of a marked venous stasis and the appearance of edema (swelling due to the presence of liquid) on the feet. .

 Varicose veins are much more common after 50 years of age, in obese and especially female, due to the high venous pressure that pregnancy determines in the lower limbs. Furthermore, the high levels of estrogens present in the female sex facilitate the release of the musculature of the venous wall. It is believed that the familial tendency found in varicose vein disease is due to an altered development of the venous wall. The real cause of the dilation of the veins of the lower limbs, however, has not yet been defined; there are basically two hypotheses for which the valves and the structure of the venous wall are respectively responsible. The hypothesis of a valve degeneration today seems difficult to sustain: the techniques with ultrasound have allowed us to underline how the branches of some veins of the lower limbs can undergo a varicose degeneration even when there is a good valvular continence. The researchers' attention then turned to the structure of the varicose vein wall, in which there seems to be less collagen and elastin than in the normal venous wall. If varicose veins exist with insufficient valvular systems of the saphenous vein and of the communicating veins, part of the blood pushed towards the heart during walking tends to flow back into the superficial circle and from this to pour back into the deep circle, thus implementing a vicious circle. The hemodynamic effect of this mechanism consists in a lower drop in ambulatory pressure of 20 centimeters of water and in a faster restoration of the basal pressure values ​​of 80-100 cm of water. Failure to reduce venous pressure during muscular exercise is the basis of almost all the pathologies of the venous system, both superficial and deep, and as such represents a risk factor for varicose veins.