Number of people suffering from venous insufficiency of lower limbs is constantly growing. The reason for this is mostly sedentary lifestyle. 

Sometimes the symptom is the feeling of heavy legs after standing or sitting for a long time. In other cases it can be small spider veins and in more serious conditions – large varicose veins, which not only adversely influence the esthetic looks of the legs, but above all can cause serious consequences like venous ulcer or venous thrombosis.

Justyna Wilczko, MD

The feeling of heavy legs, pain and swelling after a day sitting behind a desk, it may be the first symptoms of venous insufficiency of the lower limbs.

Disease description

Varicose veins

 

 

Causes of venous insufficiency of lower limbs

  • primary varicose veins of the lower legs
  • secondary varicose veins of the lower legs
  • history of deep vein thrombosis with post-thrombotic syndrome
  • venous valves insufficiency (congenital or acquired)
  • pressure on the vein from outside (e.g. in pregnancy)

Risk factors of venous insufficiency development

  • being a female
  • age
  • family history (in most cases the condition is hereditary)
  • pregnancy
  • obesity
  • staying in standing or sittng position for many hours
  • chronic constipation
  • poor posture (e.g. flat feet)
  • hormonal therapy (oral contraceptives, hormone replacement therapy)
  • being tall

Mechanism of development

The triggering factor of symptomatic venous insufficiency is hypertension in the venous bed. It causes distension of the veins, venous reflux and spider veins on the skin.

With time the changes in the subcutaneous and cutaneous tissues, supplied by the insufficient venous vessels, become persistant. Pathological blood flow results in thrombosis, high-protein fluid effusion and swelling.

Important issues

1

What are the symptoms ov venous insufficiency?

Venous insufficiency of the lower limbs is characterized by a wide spectrum of symptoms that result from the mechanism of its formation, individual patient's sensitivity and the severity of the disease.

Venous insufficiency of the lower limbs is characterized by a wide spectrum of symptoms that result from the mechanism of its formation, individual patient's sensitivity and the severity of the disease.

  • discomfort and the feeling of heaviness and tension in the lower leg muscles after many hours of standing or sitting, relieved after rest or placing the legs higher
  • bothering cramps of the lower legs, especially at night
  • itchiness
  • restless legs syndrome
  • pain along the vein
2

What can be observed on the legs of patients suffering from venous insufficiency?

Advanced venous insufficiency of the lower limbs usually occurs a few years after the first alarming skin symptoms, such as spider veins and expanded reticular veins.

Advanced venous insufficiency of the lower limbs usually occurs a few years after the first alarming skin symptoms, such as spider veins and expanded reticular veins.

  • distended branches of the varicose veins of twisted shape visible through the skin
  • spider veins (so called teleangiectasia)
  • swelling
  • skin discolorations – dark brown discolorations especially in the ankle area
  • indolent wounds and ulcers
  • eczema venostaticum
Stages of advancement of venous insufficiency of the lower limbs

Stages of advancement of venous insufficiency of the lower limbs

3

Diagnosis of venous insufficiency

The basis for accurate diagnosis of venous insufficiency is a thorough medical interview and examination (signs, complaints, skin changes). The most important, however, is a Doppler ultrasound of the venous system performed by an experienced ultrasonographist, working mainly in the area of phlebology.

The basis for accurate diagnosis of venous insufficiency is a thorough medical interview and examination (signs, complaints, skin changes). The most important, however, is a Doppler ultrasound of the venous system performed by an experienced ultrasonographist, working mainly in the area of phlebology.  In Phlebology Clinic, if necessary, a comprehensive Doppler examination is performed, including the assessment of the vein system:

  • lower limbs (deep and superficial system, stabbing and intramuscular veins)
  • small pelvis and abdominal cavity (with evaluation of the inferior vena cava, iliac and gonadal veins)
  • intimate areas (vulva and crotch in women, scrotal sac in men)
4

Therapy of venous insufficiency

Modern medicine has developed a wide range of methods to treat venous insufficiency of the lower legs. Each Patient should start with changing their unhealthy habits, like placing leg over leg, staying for a long time in one positon, taking hot baths, using sauna, intensive sunbathing, etc.

Modern medicine has developed a wide range of methods to treat venous insufficiency of the lower legs. Each Patient should start with changing their unhealthy habits, like placing leg over leg, staying for a long time in one positon, taking hot baths, using sauna, intensive sunbathing, etc.

When it is already too late for prophylaxis, the compression therapy is recommended. Stockings or socks chosen by professionals specifically for the individual Patient will bring relief and improve the condition of the veins.

If the varicose veins have already developed, more advanced treatment is necessary. The techniques we apply include:

  • microsclerotherapy
  • ultrasound foam guided sclerotherapy
  • mechano-chemical endovenous obliteration (Phlebogriffe)
  • endovenous ELVeS 1470 laser ablation or vascular glue techniques (VenaSeal or VariClose)
  • surgical procedures (microphleboctomy, miniphlebectomy, varicose veins removal and stripping)
Atypical varicose veins

Atypical varicose veins

Methods of treatment

Jak wygląda leczenie nawrotowych żylaków kończyn dolnych?

Leczenie niewydolności żylnej kończyn dolnych powinno uwzględniać wszystkie możliwe przyczyny powstawania choroby, a więc patologie układu żył miednicy i jamy brzusznej oraz efekty wynikające z niedomogi naczyń na nogach. Współczesne podejście do leczenia oparte jest na możliwie małoinwazyjnym postępowaniu z wykorzystaniem technik wewnątrznaczyniowych.

Summary

  1. discomfort, feeling of heavy legs, leg cramps, restless leg syndrome are the first symptoms of venous insufficiency
  2. what is most important is prophylaxis: compression therapy, avoiding standing or sitting for many hours, hot baths, sauna or tanning salons.
  3. the most basic test performed prior to any venous procedure, even the minimally invasive one, is Doppler ultrasound examination
  4. modern treatment methods do not require long periods of immobilization or hospitalization and are usually performed under tumescent local anesthesia

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