What to do if the veins in your legs are painful. Veins on the back of the legs: why they are visible and how to remove them

Superficial veins

Superficial veins of the lower limb, vv. superficiales membri inferioris , anastomose with the deep veins of the lower limb, vv. profundae membri inferioris, the largest of them contain valves.

In the foot area, the saphenous veins (Fig.,) form a dense network, which is divided into plantar venous network, rete venosum plantare, And dorsal venous network of the foot, rete venosum dorsale pedis.

On the plantar surface of the foot, rete venosum plantare receives efferent veins from the network of superficial plantar digital veins, vv. digitales plantares And intercapitate veins, vv. intercapitulares, as well as other veins of the sole, forming arches of different sizes.

The subcutaneous venous plantar arches and superficial veins of the sole along the periphery of the foot widely anastomose with the veins running along the lateral and medial edges of the foot and are part of the cutaneous dorsal venous network of the foot, and also pass in the heel into the veins of the foot and further into the veins of the leg. In the area of the edges of the foot, the superficial venous networks turn into lateral marginal vein, v. marginalis lateralis which passes into the small saphenous vein of the leg, and medial marginal vein, v. marginalis medialis, giving rise to the great saphenous vein of the leg. The superficial veins of the sole anastomose with the deep veins.

On the dorsum of the foot in the area of each toe there is a well-developed venous plexus of the nail bed. The veins that drain blood from these plexuses run along the edges of the dorsum of the fingers - these are dorsal digital veins of the foot, vv. digitales dorsales pedis. They anastomose between themselves and the veins of the plantar surface of the fingers, forming at the level of the distal ends of the metatarsal bones dorsal venous arch of the foot, arcus venosus dorsalis pedis. This arch is part of the cutaneous dorsal venous network of the foot. Along the rest of the dorsum of the foot, the feet stand out from this network dorsal metatarsal veins of the foot, vv. metatarsales dorsales pedis, among them are relatively large veins that run along the lateral and medial edges of the foot. These veins collect blood from the dorsal as well as from the plantar venous networks of the foot and, heading proximally, directly continue into two large saphenous veins of the lower limb: the medial vein into the large saphenous vein of the leg, and the lateral vein into the small saphenous vein of the leg.

1. (Fig.; see Fig. , , , ), is formed from the dorsal venous network of the foot, forming as an independent vessel along the medial edge of the latter. It is a direct continuation of the medial marginal vein.

Heading upward, it passes along the anterior edge of the medial malleolus onto the tibia and follows in the subcutaneous tissue along the medial edge of the tibia. Along the way it receives a number of superficial veins of the leg. Having reached the knee joint, the vein bends around the medial condyle from behind and passes to the anteromedial surface of the thigh. Following proximally, it pierces the superficial layer of the lata fascia of the thigh in the area of the subcutaneous fissure and flows into the v. femoralis. The great saphenous vein has several valves.

On the hip v. saphena magna receives numerous veins that collect blood on the anterior surface of the thigh, and the accessory saphenous vein of the leg, v. saphena accessoria, formed from the cutaneous veins of the medial surface of the thigh.

2. Small saphenous vein of the leg, v. saphena parva(see Fig., ), comes out from the lateral part of the subcutaneous dorsal venous network of the foot, forming along its lateral edge, and is a continuation of the lateral marginal vein. Then it goes around the back of the lateral malleolus and, heading upward, passes to the back surface of the leg, where it runs first along the lateral edge of the calcaneal tendon, and then in the middle of the back surface of the leg. On its way, the small saphenous vein, receiving numerous saphenous veins of the lateral and posterior surfaces of the leg, widely anastomoses with the deep veins. In the middle of the back surface of the leg (above the calf) it passes between the layers of the fascia of the leg, runs next to the medial cutaneous nerve of the calf, n. cutaneus surae medialis, between the heads of the gastrocnemius muscle. Having reached the popliteal fossa, the vein goes under the fascia, enters the depth of the fossa and flows into the popliteal vein. The small saphenous vein has several valves.

V. saphena magna and v. saphena parva widely anastomose with each other.

Deep veins

Deep veins of the lower limb, vv. profundae membri inferioris , identical with the arteries that they accompany (Fig.). Begin on the plantar surface of the foot on the sides of each toe plantar digital veins, vv. digitales plantares, accompanying the arteries of the same name. Merging, these veins form plantar metatarsal veins, vv. metatarsales plantares. Perforating veins depart from them, vv. perforantes, which penetrate the dorsum of the foot, where they anastomose with the deep and superficial veins.

Heading proximally, vv. metatarsales plantares flow into plantar venous arch, arcus venosus plantaris. From this arch, blood flows through the lateral plantar veins, which accompany the artery of the same name. The lateral plantar veins connect with the medial plantar veins to form the posterior tibial veins. From the plantar venous arch, blood flows through the deep plantar veins through the first interosseous metatarsal space towards the veins of the dorsum of the foot.

The beginning of the deep veins of the dorsum of the foot are dorsal metatarsal veins of the feet, vv. metatarsales dorsales pedis, which flow into dorsal venous arch of the foot, arcus venosus dorsalis pedis. From this arch the blood flows into the anterior tibial veins, vv. tibiales anteriores.

1. Posterior tibial veins, vv. tibiales posteriores(Fig. , ), paired. They are directed proximally, accompanying the artery of the same name, and receive on their way a number of veins extending from the bones, muscles and fascia of the posterior surface of the leg, including quite large ones peroneal veins, vv. fibulares (peroneae). In the upper third of the leg, the posterior tibial veins merge with the anterior tibial veins and form the popliteal vein, v. poplitea.

2. Anterior tibial veins, vv. tibiales anteriores(see Fig.,), are formed as a result of the fusion of the dorsal metatarsal veins of the foot. Moving to the lower leg, the veins go up along the artery of the same name and penetrate through the interosseous membrane onto the back surface of the lower leg, taking part in the formation of the popliteal vein.

The dorsal metatarsal veins of the foot, anastomosing with the veins of the plantar surface through perforating veins, receive blood not only from these veins, but mainly from the small venous vessels of the ends of the fingers, which, merging, form vv. metatarsales dorsales pedis.

3. Popliteal vein, v. poplitea(Fig.; see Fig.), having entered the popliteal fossa, it goes lateral and posterior to the popliteal artery, the tibial nerve passes superficially and lateral to it, n. tibialis. Following the course of the artery upward, the popliteal vein crosses the popliteal fossa and enters the adductor canal, where it receives the name femoral vein, v. femoralis.), sometimes a steam room, accompanies the artery of the same name in the adductor canal, and then in the femoral triangle, passes under the inguinal ligament in the vascular lacuna, where it becomes v. iliaca externa.

In the adductor canal, the femoral vein is located behind and somewhat lateral to the femoral artery, in the middle third of the thigh - behind it, and in the vascular lacuna - medial to the artery.

The femoral vein receives a number of deep veins that accompany the arteries of the same name. They collect blood from the venous plexuses of the muscles of the anterior surface of the thigh, accompany the femoral artery on the corresponding side and, anastomosing with each other, flow into the femoral vein in the upper third of the thigh.

1) Deep vein of the thigh, v. profunda femoris, most often comes with one barrel, has several valves. The following paired veins flow into it: a) perforating veins, vv. perforantes, go along the arteries of the same name. On the posterior surface of the adductor magnus muscle, they anastomose with each other, as well as with v. glutea inferior, v. circumflexa medialis femoris, v. poplitea; b) medial and lateral veins circumflexing the femur, vv. circumflexae mediales et laterales femoris. The latter accompany the arteries of the same name and anastomose both with each other and with the vv. perforantes, vv. gluteae inferiores, v. obturatoria.

In addition to these veins, the femoral vein receives a number of saphenous veins. Almost all of them approach the femoral vein in the area of the saphenous fissure.

2) Superficial epigastric vein, v. epigastrica superficialis(Fig. ), accompanies the artery of the same name, collects blood from the lower parts of the anterior abdominal wall and flows into v. femoralis or in v. saphena magna. Anastomoses with v. thoracoepigastrica (flows into v. axillaris), vv. epigastricae superiores et inferiores, vv. paraumbilicales, as well as with the vein of the same name on the opposite side.

3) Superficial vein circumflexing the ilium, v. circumflexa superficialis ilium, accompanying the artery of the same name, runs along the inguinal ligament and flows into the femoral vein.

4) External genital veins, vv. pudendae externae, accompany the arteries of the same name. They are actually a continuation anterior scrotal veins, vv. scrotales anteriores(among women - anterior labial veins, vv. labiales anteriores), And superficial dorsal vein of the penis, v. dorsalis superficialis penis(among women - superficial dorsal vein of the clitoris, v. dorsalis superficialis clitoridis).

5) Great saphenous vein of the leg, v. saphena magna, is the largest of all saphenous veins. It drains into the femoral vein. Collects blood from the anteromedial surface of the lower limb (see “Superficial veins”).

The main deep veins of the thigh: part of the popliteal vein, femoral vein, deep femoral vein. The popliteal and femoral veins often duplicate to form a plexus (Dodd and Cockett 1956).

The deep femoral vein connects with the femoral vein in two places, the lower connection with the plexus in the adductor canal, and the upper one 5 cm below the inguinal ligament. These veins receive venous branches from surrounding muscles and perforating veins, the largest tributary being the great saphenous vein.

The upper part of the popliteal vein lies on the lateral surface of the popliteal artery, and passing through the m. The adductor magnus becomes the femoral vein. This vessel intersects with the femoral artery behind it from the lateral to the medial border, and passes through the adductor canal and the femoral triangle. The femoral vein can have up to 6 valves, but usually 3. One of them is immediately distal to the junction with the deep bodiline vein, the other just below the inguinal ligament.

Superficial veins of the thigh - the great saphenous vein and its tributaries. The great saphenous vein begins behind the medial femoral condyle and runs in the medial part of the thigh. It deviates slightly anteriorly and connects with the femur 4 cm below and slightly lateral to the pubic tubercle. Its posteromedial branch (tibial accessory saphenous vein) runs along the posterior surface of the thigh, where it often has a connection with the small saphenous vein, connects with the great saphenous vein at the level of the border of the upper and middle third of the thigh, sometimes higher.

The anterolateral branch (peroneal accessory saphenous vein) begins along the lateral surface of the upper leg, sometimes associated with the lateral branch of the small saphenous vein, or the superior peroneal perforating vein. It runs obliquely up the anterolateral surface of the knee, then runs along the anterior surface of the thigh and joins the great saphenous vein at a point midway between the mid-thigh and the opening of the saphenous vein. Three tributaries flow into the great saphenous vein at the mouth - the superficial circumflex iliac vein, the superficial epigastric vein, and the external genital vein.

The average number of valves in the long saphenous vein of the leg is plus a permanent valve at the mouth of the vein. There is almost always another valve 5 cm below the mouth (Cotton 1961).

The most common perforating veins in the thigh connect the great saphenous vein with the femoral vein in the adductor canal or Gunter's canal and are therefore called the superior, middle, and inferior Gunter's perforating veins.

The upper one penetrates through the roof of the adductor canal in its upper part. The middle one is constant, passes behind m. sartorius. The inferior one pierces the deep fascia above the medial femoral condyle and connects to the knee venous plexus.

There are three other perforating veins in the thigh that deserve mention. The two are connected to the anterolateral branch by the great saphenous vein, at the point where it intersects a vertical line from the edge of the patella. This vessel connects with the venous branches of the lateral circumflex vein of the thigh. At the point where the posteromedial venous branch of the great saphenous vein crosses the tendons of the m. semimembranosus and m. semitendinosus, there is often a perforating vein.

All perforating veins of the thigh have valves that allow blood to flow only from the superficial to the deep veins.

Among possible vein diseases, the most common are varicose veins, thrombosis and thrombophlebitis. The symptoms are quite typical, and treatment should be prescribed by a doctor.

Painful sensations in the vessels of the lower extremities (or on the lower leg) are more disturbing to middle-aged and elderly people. There are a number of predisposing factors leading to the development of venous diseases. What are these diseases and what to do with them?

Predisposition

High growth.
Overweight.
Hereditary factor (there were symptoms of venous disease in close relatives).
Occupational hazards, such as prolonged standing (salespeople, hairdressers, surgical doctors).
Carrying heavy objects, walking for a long time with a heavy bag (postman, traveling salesman, loader).
Excessive exercise, including professional sports (athletics, lifting and throwing weights - in this case, the knee joints and the veins behind the knee are especially affected).
Hormonal disorders (including pregnancy).

Symptoms of venous insufficiency increase gradually, that is, the patient is not always in a hurry to see a vascular surgeon (for example, the vein does not suddenly swell, but slowly expands). It is this insidious feature that leads to late diagnosis of various diseases of the venous bed and certain difficulties in their treatment.

A symptom that has arisen once, for example, a reddened and clearly visible vein under the knee at the back, which is swollen in comparison with others, will not disappear spontaneously, but will only grow, taking over previously healthy areas.

Modern methods of treating diseases of the venous bed, including surgical ones, make it possible, if not to completely cure such a patient, then to significantly slow down the further progression of the disease.

Possible vein diseases

Venous insufficiency can manifest itself in different ways; symptoms can appear suddenly or grow rather slowly over several years. Among the most common diseases of the veins of the lower extremities are:

phlebeurysm;
thrombosis of deep (less often superficial) veins;
thrombophlebitis.

The final answer to the question of why the veins in the legs hurt and which treatment method is preferable in a particular situation, what exactly needs to be done and what should not be done categorically, can be given by a vascular surgeon (phlebologist).

Development mechanism

swelling of the legs suddenly and sharply increases, which does not disappear after rest;
legs hurt more;
the affected vein (or several) is swollen and may be hot to the touch;
The area under the knee most often suffers - in places where tissues are naturally compressed.

limited motor activity for the entire acute period;
heparin-based ointments to reduce blood clots;
anti-inflammatory (“Troxevasin”) ointments;
vitamin complexes.

Timely treatment within a week will eliminate all symptoms.

Vascular thrombosis of the lower extremities

Its peculiarity is rapid and sudden development. A thrombus from a vein or any other part of the body completely or partially blocks the lumen of the vessel and disrupts blood flow. Its possible signs:

sharp pain in one place (for example, behind);
the pain only intensifies and is not relieved by anything;
increasing swelling and numbness of tissues;
the thrombosed vein is swollen relative to the others.

The main thing to do is to go to the hospital as soon as possible. With prolonged disruption of blood flow, tissue necrosis develops, which may be irreversible. In the case of thrombosis of a large vessel and prolonged cessation of blood flow, there may be talk of the need for limb amputation.

You should understand that (on the lower leg or behind the knee) is not a reason to think about the worst, but you shouldn’t put off a visit to a vascular surgeon for a long time either.

The most common cause of protruding veins, not just on the legs, is varicose veins. Women are more susceptible to the negative effects of the disease than men; 7 out of 10 patients are girls. This is explained by changes in hormonal levels and strong pressure in the intra-abdominal cavity during pregnancy. The problem is not only a cosmetic manifestation, but also means serious deviations in health, well-being significantly worsens, and in some cases causes death. At the initial stages, the most important thing is to slow down the progress of varicose veins, then bulging veins on the legs will not appear for a long time.

If the veins in your legs are bulging, this is the first sign of varicose veins, you should take this symptom seriously and make an appointment with a doctor.

Symptoms and causes of protruding leg veins

There are many reasons why veins protrude on the legs, some depend on lifestyle and can be eliminated without much difficulty, others are caused by genetic changes in the structure of the body and require treatment. If the veins in the legs protrude, the reasons most often come down to certain pathological abnormalities in the body and are triggered by an unhealthy lifestyle.

The most common cause is varicose veins; it is characterized by dilation of veins due to any deficiencies in the vascular valves. As the disease progresses, the walls lose their elasticity and can become significantly thinner, which leads to an increase in their volume. If the veins in the legs protrude, then nodes have probably already formed, the veins have become tortuous, and abnormalities are observed in the membranes. Most experts point to congenital causes of pathology;
Hereditary factor. There is a high probability that if the veins in the legs of the parents stand out, the children will also suffer from this disease;
Obesity. In overweight people, blood vessels appear much more often, as excess pressure is created on the veins;
Pregnancy creates many reasons for veins to appear on the legs. The load on the legs increases, quite significantly. Also, due to the difficulty of maintaining an active lifestyle, many people spend time sitting or standing, which creates static loads. A lot of pressure is formed in the abdominal cavity, which inevitably affects the vessels of the legs. Often the placenta presses on certain veins, which slows down the blood flow in it. Hormonal levels play an important role;
Job. Some types of work provoke a long stay in one place in a sitting or standing position, then veins protrude on the legs due to lack of blood circulation, which provokes reverse, or stagnation;
Strong physical stress;
The destructive influence of bad habits.

You should consult a doctor after detecting the first symptoms of the disease. At the beginning, minor manifestations are observed or they are completely absent. Subsequently, the veins stand out and over time protrude greatly. Even in the early stages of the disease, you need to know which doctor to contact - a vascular surgeon or phlebologist.

If you ignore the primary symptoms on your legs, then a feeling of heaviness and increased tension begins. Cramps often occur at night. Next, a noticeable stage of the disease begins, the veins begin to protrude, while they bend and increase in diameter. The presence of protruding vessels is a good reason to start treating varicose veins, otherwise pain will begin to appear over time.

Protruding veins are a stage of varicose veins

The causes and treatment of protruding veins largely depend on the type of disease. In fact, few diseases have such a specific manifestation and varicose veins cannot be confused with other diseases. For authenticity, you can study the photo. When the veins begin to stand out, it is important to know what to do in this case, what kind of disease it is - varicose veins.

Varicose veins are characterized by an increase in the volume of blood vessels. This is caused by stagnation of blood or increased pressure on the vessels. As the load on the veins increases, they become larger, as the walls lose some of their properties. With significant expansion, the formation of blood clots in the lumen of the affected vein is possible, especially often observed due to the strong density of the blood. In other cases, trophic ulcers may appear.

People seek help not only because of an aesthetically unattractive appearance, but also to prevent the development of the disease. If you start treatment in the initial stages, it is possible to eliminate the disease without surgical intervention or prevent the onset of serious consequences.

Treatment methods for varicose veins

There are several basic methods for removing varicose veins; this greatly depends on the stage of the disease and the type of complications.

Conservative approach. Medications are used, usually tablets or creams. This option for dealing with protruding veins is used in the mild and medium stages of the disease. It can significantly alleviate symptoms and prevent further development of the disease. The dilation of the vein itself is irreversible; therefore, if you want to completely eliminate the vein, you will have to undergo surgery;
Surgical approach. It is used in advanced stages, the conclusion about the feasibility of the technique is made by a specialist;
Folk remedies. They often only supplement therapy or are used when only a little vein is visible.

External preparations

Women experience severe discomfort when they have diseases of the feet, legs and thighs, as the aesthetic appearance of their legs is greatly deteriorated. In such cases, you can reduce the manifestations through a simple approach - applying creams.

Phlebotonics improve the quality of blood vessels and relieve unpleasant symptoms of the disease. Among the best niche drugs are:
Varius, Detralex, Troxevasin and Venoruton;
Anticoagulants prevent blood clots from forming in stagnant, swollen veins. At the same time, the blood thins, which improves its outflow and eliminates the formation of edema. Recommended for use:
Varius, Venolife, Curantil, Heparin ointment, Lyoton 1000;
Anti-inflammatory drugs are prescribed to eliminate the infection. The drugs Indomethacin and Diclofenac are used.

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Drugs

For the treatment of varicose veins, special means are indicated for use; they are used as soon as a vein begins to appear or certain pathologies are detected. The most commonly prescribed tablets are venotonics and anticoagulants. Trade marks:

Detralex has an angioprotective effect and is classified as a phlebotonic. It has no contraindications other than allergies. Use 2 tablets per day, which are consumed 1-2 times;
Phlebodia has a venotonic effect and helps reduce congestion in the body and increases vascular tone. Use 1 tablet 1 time per day, drink in the morning on an empty stomach. Course 2 months;
Venarus includes the properties of angioprotectors and phlebotonics. Contraindicated for use during lactation. Use 1-2 tablets 2 times a day;
Troxevasin acts as an angioprotector. It should not be used for ulcers in the gastrointestinal tract, gastritis, or the first trimester of pregnancy. Drink 1 pill three times a day.

Surgical intervention in the classical view today is carried out only in extreme cases. In most cases, minimally invasive treatment methods are preferred. A simplified operation to remove a vein today can be performed through punctures - this is a miniphlebectomy. After the procedure, there are no scars left and general anesthesia is not required.

Laser coagulation allows you to occlude a vessel by inserting a small LED. Heat affects the blood and it clogs the vein, which prevents the circulation of fluid and gradually eliminates the appearance of the vessel. The radiofrequency method is approximately similar, but a different device is introduced.

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Treatment methods for advanced stages

Treatment of a disease in an advanced stage is not an easy task, because with the growth of symptoms and manifestations, other life-threatening or health-threatening manifestations may occur. The great danger lies in the high risk of complications, for example, thrombophlebitis, trophic ulcers. In this case, treatment must be carried out under the supervision of a doctor.

Carrying out therapy in the initial stages is much easier, since the use of creams or tablets is sufficient. At advanced stages, you will have to combine many drugs at once, sometimes there is nothing left except expensive drugs. If necessary, surgery is performed, capsules, creams, diets, exercise and wearing compression garments are used.

Tablets with a venotonic effect and anticoagulants, for example, Detralex and Troxevasin, are often used.

Treatment with folk remedies

For treatment, make a tincture or decoction of acacia, nettle, chestnut, and birch buds. 2 tbsp. raw materials are used for 0.5 liters of vodka and infused for 2 weeks. Apply such lotions at night.

Apple cider vinegar is considered an effective remedy, diluted with water 1 to 10 and you can either drink it or wipe the skin.

You can prepare a decoction of nettles: 2 tbsp. plants for 1 cup of boiling water. Drink 50 ml twice a day.

Prevention

Physical education, gymnastics;
Diet;
Do warm-ups at work;
Take vitamins;
Wear comfortable clothes and shoes;
Use compression stockings;
Periodically throw your legs up for a few minutes;
To refuse from bad habits;
Do not use hot baths, saunas, baths.

Do you still think that getting rid of varicose veins quickly is difficult?

An advanced stage of the disease can cause irreversible consequences, such as gangrene, blood poisoning. Often the life of a person with an advanced stage can only be saved by amputation of a limb.

Under no circumstances should the disease be started!

Femoral vein thrombosis is the most dangerous of all types of deep vein blockages. The disease poses a threat to human life. The problem is further aggravated by the fact that in the early stages the disease is asymptomatic, and it can be very difficult to diagnose it in a timely manner.

Definition

Deep vein thrombosis (DVT) is the formation of blood clots that block (partially or completely) the internal lumen. Most often, the process is localized in the lower extremities, for example, in the femoral vein. Classic signs of DVT:

swelling;
pain;
redness of the skin in the affected area.

The disease occurs in approximately 20% of the population and, if untreated, often causes death from pulmonary embolism. The main risk group is men. In women, DVT is common if they are taking hormonal birth control.

Femoral vein thrombosis is the most dangerous of all localizations of blood clots. When complications develop in the form of pulmonary embolism, death occurs in 60% of cases. Thrombosis of the femoral vein is also dangerous due to the risk of clot rupture and penetration into the heart. In most cases, embolism of this organ is fatal. With the development of thrombosis of the iliac and femoral veins, the following symptoms are characteristic:

severe swelling and pain in the legs, starting from the groin area;
cyanosis of the skin of the lower extremities;
petechial rash (small hemorrhages in the form of dots);
increase in temperature due to the addition of phlebitis.

Phlebologists distinguish two stages of acute thrombosis of the deep veins of the thigh. They differ in the color of the skin of the lower extremities: white and blue phlegmasia. The initial stage of thrombosis is characterized by a pale coloration of the skin: due to a reflex spasm of small arteries, blood circulation is disrupted. At this stage you can observe the following:

The pulsation of the arteries of the feet decreases.
Extremities are cold to the touch.
Patients often complain of severe pain.

Important! Blueness of the legs indicates that venous vessels of various sizes are overflowing with blood and is accompanied by darkening of the skin, severe bursting pain and blisters containing hemorrhagic fluid protruding to the surface. At this stage, thrombosis can progress to gangrene.

Causes

Deep vein thrombosis usually occurs when a vessel is compressed for a long time by a tumor (cyst) or a bone fragment during a fracture. Also, the cause of blood clot formation can be circulatory failure, which arises as a consequence of diseases.

Poor blood circulation provokes stagnation, leading to thrombosis. Varicose veins of the superficial veins in the extremities are not only an external defect. Dilated vessels put pressure on the veins, which slows down blood flow and causes blood retention in the periphery, providing all the conditions for the development of thrombosis. The main causes of blockage of deep veins:

slowing down the speed of blood flow in the veins;
increased blood viscosity;
violation of the integrity of the internal walls of blood vessels.

Also, blood flow slows down when you are stationary for a long time. For example, in case of serious illnesses (stroke, heart attack, spinal fracture), forcing the patient to constantly remain in bed, blood clots very often form.

Some professions also have a negative impact on the condition of the deep veins of the lower extremities. Sellers, cashiers, pilots, international drivers - all these people are forced to stand or sit in one position for a long time, so they are at risk for blockage of leg veins by blood clots.

Another cause of DVT is frequently recurring illnesses that cause dehydration:

acute intestinal infections, accompanied by long-lasting diarrhea and vomiting;
chronic diseases of the intestines and pancreas;
excessive intake of drugs with a pronounced diuretic effect;
diseases leading to an imbalance of fats and proteins (diabetes mellitus, atherosclerosis, cancer).

Bad habits also increase the likelihood of platelet aggregation: smoking, excessive consumption of alcoholic beverages. In people dependent on this, the veins of the lower leg are most often affected.

Clinical manifestations

In 50% of patients there are no signs of thrombosis. A complete clinical picture can be provided not so much by DVT itself, but by its complications caused by the addition of an internal infection. The walls of the vein around the blood clot become inflamed. In this case, the patient's body temperature may increase.

Very often, when making a diagnosis, doctors confuse thrombosis with thrombophlebitis. This is explained by the almost simultaneous occurrence and course of both processes. Symptoms manifest differently and depend on the location of the vessel affected by the thrombus. So, with DVT of the lower leg the following are observed:

swelling in the lower part of the limb (ankle);
pain that occurs when bending the leg at the knee joint;
sensory disturbances in the foot (numbness or fever).

Diagnostics

In the case of deep vein thrombosis, timely and correct diagnosis is very important. This helps to prescribe the necessary treatment and avoid serious complications with a fatal outcome. During the initial examination, the doctor compares the temperature and color of the skin on both legs of the patient, and also checks for the presence of a pulse in the feet, and assesses the condition of the superficial veins of the lower leg.

DVT in the calf muscles is characterized by increased aching, nagging pain when bending the leg at the ankle joint, when the patient pulls the toe towards himself. Also, thrombosis of the deep veins of the leg manifests itself as pain when the calf muscle is compressed by the tonometer cuff. If in a healthy leg the patient feels pain at 150-180 on the scale, then in the affected limb pain occurs already at levels from 80 to 100 mmHg.

To make a more accurate diagnosis, ultrasound and Dopplerography of the veins of the thigh and leg are used. They help to identify the exact location of the thrombus and the level of its fixation on the vessel wall. The phlebography method is also used in diagnostics. A contrast agent is injected through an intravenous injection, then an x-ray is taken. If deep and multiple damage to the veins by blood clots is suspected, an MRI examination is prescribed.

The most accurate diagnostic method is angioscanning. A prerequisite for its implementation is strict bed rest the day before. At the end of the diagnostic procedure, if an occlusive or parietal form of thrombosis is detected, patients must immediately begin active therapy.

Treatment

Treatment methods for deep vein thrombosis depend on the causes of the disease and the presence/absence of complications. The age of the patient, as well as his general health, are also important.

Conservative therapy is indicated in cases where the blood clot does not completely block the vessel, sits “firmly” in place and is unlikely to break off. Treatment goal:

restoration of normal vein patency;
preventing the destruction of a blood clot and preventing the possibility of embolism of blood vessels of vital organs;
eliminating tissue damage.

Thrombolytic therapy is a type of drug treatment. The main objective of this method is to restore blood flow in the vascular bed. Achieved by dissolving the blood clot. The method consists of activating the fibrinolytic properties of blood by converting plasminogen into plasmin, the active form. The drugs used in the thrombolytic method of treatment differ from heparins in the principle of action. While heparins only inhibit the formation of clots, thrombolytics destroy existing blockages in the veins. This method of treating DVT is most effective in the first three days after the formation of a blood clot.

Anticoagulant therapy is indicated for all patients with deep vein thrombosis. Treatment should begin with injections of blood thinning drugs. It is preferable to use low molecular weight heparins (LMWH) or fondaparinux with a gradual transition to indirect drugs (Warfarin).

Elastic compression involves wearing compression stockings (class 2-3). If a patient has obliterating diseases of the leg arteries, compression stockings should be used with caution.

Compression therapy is contraindicated if tibial posterior artery systolic pressure is less than 80 mmHg. Art. It is often used as concomitant therapy during surgical interventions to remove blood clots.

Surgical methods

If the patient’s condition allows, then in emergency cases or in case of individual intolerance to drugs, blood clots are removed through surgery. Also during the operation, the patency of the vein cavity is restored while preserving the functions of the valves.

Important! The cause of PE (pulmonary embolism) in most cases is untreated deep vein thrombosis.

Considering the high percentage of deaths from the penetration of detached blood clots into the lungs, the prevention of their formation during surgery is given great importance.

So, for several days before surgery and in the postoperative period, the doctor prescribes the patient to wear compression stockings or apply elastic bandages. On the second day after surgery, exercise therapy is prescribed. If the patient is paralyzed, he is prescribed massage.

Prevention

To prevent the formation of blood clots, blood thinning drugs are prescribed to patients with heart problems. Femoral vein thrombosis can also be prevented by regular general examination. A timely diagnosis of DVT can prevent many serious complications:

thrombophlebitis with threat of sepsis;
gangrene of the limbs and internal organs;
infarction pneumonia as a result of thrombosis of the small branches of the pulmonary artery.

Nutrition

The substances we get from foods can affect blood thickness in different ways. In case of increased coagulability, in order to avoid the formation of blood clots, the following should be limited or completely eliminated from the diet:

lard, fatty meat and sausages, canned meat, butter;
white pastries;
legumes (beans, peas, soybeans, lentils);
rosehip, black currant, chokeberry;
bananas and pomegranates;
walnuts.

Useful foods for those with a tendency to develop blood clots include boiled lean meat, fish, cottage cheese and kefir, and vegetable oil. Fresh herbs (dill, parsley, onions), garlic, tomatoes are very useful. You can eat all fruits and berries except those that are prohibited. If the patient does not have diabetes and is not overweight, chocolate is allowed.

In addition to diet, it is very important to maintain a drinking regime. In addition to tea, coffee, juices, compotes and other drinks, you need to drink an average of about 2 liters of plain drinking water per day. A sufficient amount of fluid in the body can have a positive effect on blood viscosity, preventing blood clots from forming.