venous insufficiency

Venous insufficiency: description

Venous insufficiency (venous insufficiency) is widespread. Often swollen legs after prolonged standing or more prominent veins provide the indication that the veins are not working properly. The venous insufficiency develops slowly and progresses untreated gradually, which is why it can be divided into different degrees of severity.

blood flow

Veins are all blood vessels in the body that collect the blood from the body periphery and transport it back to the heart. The blood, after it has given oxygen and nutrients into the tissue, first passes through hair-thin blood vessels (capillaries) into the so-called venules. These small vessels then reunite to form the veins. The initially superficial, small caliber veins finally lead the blood into deeper veins with a larger diameter. Lastly, the two largest veins of the body, the superior and inferior vena cava, bring the oxygenated blood back to the heart. The heart pumps it into the pulmonary circulation, where it becomes oxygenated again before it flows back to the heart and then through the arteries to the tissues and organs.

Failure of the venous valves causes venous insufficiency

Because the veins, which are located below the heart, carry the blood up to the heart against gravity, they have a special structure. Inside there are so-called venous valves, which prevent similar to a valve, that the blood flows back. Mostly, venous insufficiency begins with a gradual failure of these venous valves. If these no longer close properly, the removal of the blood is impaired, it accumulates in the upstream vein sections. Over time, the pressure on the wall of the vein causes the vein wall to contract more and more, and the vein expands. Such dilated veins eventually appear on the surface of the skin as fine spider-web-like spider veins or, in the case of larger veins, as bluish-veined, distinctly prominent varicose veins.

If the venous insufficiency progresses, it can develop into a disease that medical professionals call chronic venous insufficiency (CVI). Most swelling and skin changes are associated with this disease.

Venous insufficiency: symptoms

People with venous insufficiency often complain of swollen, tired or aching legs, especially at the end of a day. Especially in the warm summer months, the symptoms may increase as the blood vessels expand due to the heat. The symptoms of venous insufficiency may vary, depending on severity. Possible signs of venous insufficiency are:

• small, reddish to bluish cobweb-like fine vein drawings (spider veins), especially on the side or back of the thighs
• clearly protruding veins, especially on lower leg, calf or popliteal fossa
• Varicose veins: They are usually on the lower leg and calf and are well recognized by the bulging, thickened, serpentine bluish veins.
• Water retention (edema) around the ankle or lower leg
• Skin lesions: brownish pigmentation in the ankle area, dry, scaly, itchy skin areas (eczema) or open skin. Such changes indicate chronic venous insufficiency.

Venous insufficiency: causes and risk factors

Often, the cause of venous insufficiency is a hereditary predisposition. Thus, a venous disease usually affects several members of a family. Even with increasing age, the risk of venous insufficiency increases. The first signs notice most affected people from the age of 30 or later at the earliest.

Women are much more likely to be confronted with venous problems such as venous insufficiency, spider veins or varicose veins; probably the special structure of the connective tissue is a reason for them. The female sex hormones, especially the estrogen, provide a loose connective tissue. Therefore, the pregnancy, during which the estrogen concentration is particularly high, is also considered a risk factor for venous insufficiency. In addition, in pregnant women presses the steadily growing stomach on the veins in the pelvis and burdens the leg veins additionally.

In addition, overweight and also previous blood clots in the veins (thrombosis) increase the risk of venous disease. Long sitting or standing activities also promote venous problems such as venous insufficiency.

Venous insufficiency: examinations and diagnosis

For the diagnosis of venous insufficiency, it is advisable to consult a specialist in vascular and venous diseases (phlebologists). In a detailed conversation, he first inquires about the medical history (anamnesis). He asks, among other things, whether several family members have to deal with venous insufficiency or other vein problems and whether thromboses have occurred in the past.

During the subsequent physical examination, the doctor looks at the veins in the area of ​​the patient’s legs. He pays particular attention to whether spider veins or varicose veins are to be seen. Swelling of the legs or changes in the skin give him important evidence of venous insufficiency, they may indicate a chronic venous insufficiency.

With the help of an ultrasound examination, the condition of veins can be assessed well. If the venous valves are defective, the doctor can recognize this well. A special procedure, the so-called Doppler sonography, makes the bloodstream visible within the vein. In this case, the doctor can detect a disturbed blood flow or possibly also a blood clot.

Venous insufficiency: treatment

Which therapy is suitable for the venous insufficiency depends above all on their severity. An important step in the treatment is to support blood flow in the veins. For example, compression stockings or dressings are helpful here. Through them, the veins are compressed, which prevents a backwater of the blood. They are available in specialist shops in different strengths. In certain cases, they can also be customized.

With pronounced symptoms of venous insufficiency, such as severe edema, dehydrating medications that the doctor must prescribe may be helpful. Skin eczema treatment doctors with moisturizing, partially anti-inflammatory creams and ointments.

Spider veins usually disturb those affected more for cosmetic reasons; From a medical point of view, they do not necessarily require therapy. The doctor can soil them by injecting a chemical substance into the vessel in question (sclerotherapy). The method is also suitable for small varicose veins of superficial veins. For larger varicose veins, however, removal of the affected vein sections may be required for health reasons. This happens, for example, in the context of an operation (venous stripping) or by the doctor closing the affected vessel sections by radio waves or with a laser.

Venous insufficiency: prevention

Since venous insufficiency is inherited in many cases, it is often not possible to prevent it in principle. However, there are some measures that prevent venous problems from increasing:

• Exercise as often as possible, do sports several times a week, such as cycling, swimming or walking. Take the stairs instead of lift or escalator.
• If you spend a long time sitting or standing, do foot exercises. Move your toes alternately towards the tibia and the floor. From the heels, repeatedly rock the toes and back, let your feet circle.
• Try to avoid being overweight by eating a healthy diet, so eat lots of fresh fruits and vegetables, as well as little sweets and fats. Excess kilos favor and aggravate one venous insufficiency.

Venous insufficiency: history and prognosis

The course of a venous insufficiency depends primarily on the degree of its severity. Treating a mild, early onset of venous insufficiency early can usually be stopped or at least slowed down. If varicose veins are already present as a result of venous insufficiency, the risk of further diseases, such as venous thrombosis, increases.