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Informations about varicose and spider veins for patients and health professionals
Informações sobre varizes para pacientes e profissionais de saúde
Information à propos des varices et des télangiectasies pour patients et profissionnelles de la santé
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HTML Text Part 1 - What is varicose and spider veins

HTML Text Part 2 - Complications, preventions and FAQ

HTML Text Part 3 -Treatments

PDF Text

Part 2

The Complications of the Varicose Veins

We call Type 4 or CVD - Complicated Venous Disease all of the situations where complications have already happened. The most frequent complications are Trombophebitis, the Leg Ulcers, Hyper-pigmentations , the Venous Eczema, the Bleeding, Fibrosis, the Ocre Dermatitis, the Infections, the Pain, and the Clot of Lung. They are usually patients who have had this problem for a very long time. 

All these types follow an evolution, but it does not mean that one type will necessarily evolute to the other. The varicose veins always get worse, but each patient will have a different history and it doesn't mean, although it is possible, that the type 1 will turn into type 4. 

Trombophlebitis 

The blood should flow inside of the vases, without interruptions. However, when a bleeding happens as in an accident or caused by some disease, or even a controlled bleeding as the ones of any surgery, the body tries to protect itself and control this situation that causes a risk of death. The most important is the coagulation system. The coagulation then is a good thing, when it happens for protection. But in certain situations this coagulation system can malfunction and cause serious problems. 

When a vein has sick walls, as in the varicose veins, or if the system that makes the blood flow, the venous pump of the calf is working poorly, as in forced rests because of diseases or in long trips, the Venous Thrombosis can happen. 

The Venous Thrombosis can be superficial or deep. The superficial happens in the vases of the surface of the member and the deep in the internal vases of the leg . 

Superficial Trombophlebitis 

The venous thrombosis can have several causes, and among them, the Varicose Veins. When the coagulation of the blood inside the superficial veins happens, it is called Superficial Trombophlebitis. 

When the veins of the members are extensive, as in the varicose veins, the whole process of flow of the blood is in jeopardy. We can say, in a simple way, that when the blood doesn't have a good flow in vein, it tends to coagulate, forming a clot (the thrombus) inside the vein. The superficial thrombophlebitis is one of the complications of the varicose veins. A coagulation inside the vase happens, interrupting the circulation as if it was a cork. 

The patient complains about pain, redness and swelling in the varicose veins. The Superficial Venous Thrombosis has an effective treatment, but the great problem is that, although rarely, the clot can progress through the superficial veins to the deep veins. It can also, starting from the deep veins or through great superficial veins, release small pieces of coagulated blood, the embolus. 

The embolus can, through the circulation, reach the lung. It stops there, impeding the circulation to happen and putting the life in risk. The progression of a Thrombus to the lung is called the Clot of Lung or Pulmonary Embolism. 

Deep Venous Thrombosis 

The Deep Venous Thrombosis, or DVT, is a fearsome occurrence, because it puts in risk the patient's life. Several are its causes, and one of them is the presence of Varicose Veins of Lower Extremities. It is a serious disease that is characterized by the formation of clots inside the deep veins of the leg. One of its main consequences in a short term is the Clot of Lung which can lead to death, prolong or complicate hospitalization after a surgery or even make the individual disabled for certain social activities and work, when it causes sequelae. 

The pos-phlebitic syndrome can happen some years after DVT. It is characterized by swelling, dark coloration and hardening of the skin, eczema (chronic allergy of the skin) and ulcers (wounds) due to the alterations and scars left by DVT in the venous system. Certain people have risk factors for this disease. There are certain situations that can cause the disease; they are the risk situations. The individual factors and risk situations can characterize the patient as being in the risk group for the development of the disease. This risk is called Thromboembolic Risk . 

We can mention as main individual risk factors for DVT, besides the varicose veins: people older than 40 years old, obesity, individuals who have already had thrombosis, the use of contraceptives and therapy of hormonal replacement, neoplasy, pregnancy and puerperal period, individuals with genetic abnormality of the coagulation system, traumatisms, surgeries, immobilization for long periods, hospitalization, diseases of the heart or lungs, and serious infections. 

Pulmonary Embolism

The Lung Clots happens when a piece of the clot that was formed inside the deep veins of the leg is released and reaches the blood vessels of the lungs. Depending on the size of the clot, the person cannot survive. In the case of varicose veins, although it can happen, the Pulmonary Embolism is a rare occurrence. 

Dermatitis Ocre 

The difficulty that the blood has to return to the heart in the cases of varicose veins, ends up in stasis and swelling . The swelling and stasis cause a series of alterations in the lower extremities, mainly in the more distal part. The migration to the skin of elements of the blood happens, and they stay in places where they should not be. The presence of iron, derived of the hemoglobin of the blood, gives the skin of the leg or the ankle a dark and rusty aspect, called "Dermatitis Ocre." 

Eczema 

Blood stasis also causes the inflammation of the skin, resulting in a venous eczema. The skin itches, peels and swells. It is an unpleasant and inconvenient problem caused by the varicose veins. 

Varicose Ulcer

It is a difficult to control complication of the varicose veins. Furthermore, it is an unpleasant condition. The Venous Ulcer appears after a long evolution of the varicose veins. It is a wound, that can have a great extension, reaching a great part of the individual's leg. 

Bleeding

The Bleeding is a serious complication that happens when the varicose vein increases so much of size, that breaks the skin that recovers the vein and perforates it, causing a profuse bleeding. 

Swelling

It is a sign of venous stasis. The individual's lower extremities are swollen, mainly in the end of the day. 

Pain 

Usually the patients with varicose veins complain about pain in the lower extremities associated with the weight and fatigue sensation that gets worse with the heat. Other factors may cause pain, such as sitting or standing for very long periods of time during the day, being, therefore, more intense in the end of the afternoon. In the women those uncomfortable symptoms tend to get worse in the premenstrual period and pregnancy. Associated with these symptoms, people usually complain about itching, tingling, heat, cramps, and the swelling of the ankles and lower extremities. These symptoms are proportional to the amount of varicose veins. 

The order in which the complications appear

In a large number of patients, the varicose veins can be present for many years without complications, but the treatment should not be postponed, because the complications can take many years to appear, When they finally appear in a more advanced age, the effective treatment cannot be established anymore. 

In the beginning of the evolution of the Varicose Veins of lower extremities, it is observed the weight sensation or fatigue in the end of the day. The visible varicose veins of several sizes appear slowly. The edema begins to appear in the end of the day. After there is the pigmentation (dermatitis ocre) and eczemas may appear. In evolution of the disease, Trombophlebitis, ulcers and bleeding may occur . 

Prevention 

We should remind that the varicose veins are a chronic problem that depends on hereditary factors. This tendency will accompany the patient for his lifetime. We cannot speak in cure for varicose veins, but in control. Using the approach of the Continuous Treatment for Varicose Veins, we can promise that the primary varicose veins won't be neither an aesthetic nor a health problem for the patient. Some preventive measures can be used to lessen the tendency of have varicose veins. These measures are going to be described and I'm going to explain how they work.

Elastic stockings: they are the main preventive measure. They act deviating, through the communicating veins, the blood of the superficial veins where the varicose veins are formed, to the deep veins, where varicose veins do not exist. The people with important hereditary tendency and the ones who sit or stand up for a long time for professional reasons should wear elastic stockings. These medicinal stockings, although they seem simple, must be prescribed by a specialist. The correct stockings have to be used, according to the disease presented by each person. We've found many mistakes related to the usage of medicinal stockings without medical orientation. 

Avoid the sun and the heat: The sun, sauna, and very hot and long baths cause the heating of the skin and the flow of a larger amount of blood to the vases of the skin. If a larger amount of blood flows in the superficial vases, they get used to that and dilate. The heat is a factor that favors the emergence of vases in the people that are predisposed to have this problems. 

Effective measures include avoiding sauna, very hot and long baths, and the sun on the beach. When exposed to the heat of the beach or in the swimming pool, people have to be sure to enter the water every 15 or 20 minutes to avoid the heating of the leg. Sunbathing should be avoided and never happen after 10 o'clock a.m., when the harmful sun beams are more frequent. 

Avoid overweight: The weight excess overloads the circulation and causes varicose veins. To have good nutritional habits is healthy for the whole body. The weight excess also causes cellulite, which is associated with the microvarices and telangiectasies (spider veins). 

Do exercises: The exercises improve the muscular strengthen of the leg and, therefore they improve the return circulation. The best ones are walking, running and swimming. 

Avoid the use of hormonal contraceptives: The feminine hormones (pills, menopause treatment, hormonal replacement) keep liquids and they increase the pressure inside of the veins. They also soften the walls of the vases and they are some of the main factors that cause varicose veins. 

Avoid sitting or standing for a long time: As already seen, the varicose veins appear when people stand or sit and they don't appear when people are laying or in movement. When, for professional or social reasons it is necessary to be sit or stand for a long time (at work, in parties, in long trips), we should move the feet, as if we were accelerating a car. This movement of the ankle, called back-flexing, makes the musculature of the calf to contract rhythmically, putting the "outlying heart" in action. That makes the circulation work and avoids varicose veins. 

High heels : there was a myth that high heels were harmful. But recent researches carried out by the State University of Campinas showed that high heels are not only not harmful, but can be beneficial. 

Varicose veins of lower extremities are a very frequent problem, that affects most of the women and many men too. Maybe it is one of the diseases that, although it is common, is the most ignored by the people. The lack of information and the prejudice against the disease is evident: from the confusion in relation to the heart surgery, where the "bypass operation" is confused with Saphenectomy, that is a type of varicose veins surgery, until the wrong concept that it is not worth to treat the varicose veins, because varicose veins will appear after some time again.

Questions and answers about varicose veins 

Do internal varicose veins exist? 

They don't exist. The internal or deep veins are protected by the musculature that impedes their dilation. What really exists are other serious diseases that affect the internal veins, but not the varicose veins. Even though the superficial veins are inside the fat tissue, that doesn't protect them and that's where the varicose veins appear. 

Can the varicose veins, the microvarices and the telangiectasies happen altogether? 

Yes. They are signs of the same disease. In short: it is the increased pressure inside the veins, caused by alterations in the valves, resulting in an inverted blood flow, causing the dilation of the superficial veins. This happens due to a hereditary tendency and it is worsened by several factors. The veins are present in the lower extremities since the birth, but they don't get attention. When the dilation happens as a result of the disease, they become visible and unaesthetic.

Do varicose veins appear again after some time?

No. Other varicose veins may appear and they should be treated. A person who has the vesicle or the appendix operated will never have problems in these places again because there is only one appendix and only one vesicle. The veins, on the other hand, will always exist. It is not possible to remove all of them. A vein that was normal in the moment of a treatment can become sick later, because the hereditary tendency will exist during all the lifetime. This fact doesn't invalidate the treatments, because if the varicose veins are not treated, they can lead to serious complications in the future. For this reason, the Continuous Treatment of Varicose veins was designed to control the aesthetic problem and the disease as they appear.

Can the superficial veins be removed without causing problems? 

Yes. The veins that really matter are the deep veins, they are the responsible for the venous circulation. The superficial veins can be treated or removed without any consequence for the body.

Is there a "cure" for the varicose veins of the lower extremities? 

The varicose veins of the lower extremities are a chronic disease that depends on a hereditary tendency and on aggravating factors. Since it's linked to the hereditariness, we cannot speak about "curing" the varicose veins, because the tendency will always be present and new varicose veins may appear during the life of the individual. However, this disease may be controlled and the people can live their life without the health and aesthetic problem of varicose veins. We can say that, nowadays, only the people who want to have varicose veins will have them. The medicine has modern and simple techniques that control the problem with great functional results.

HTML Text Part 1 - What is varicose and spider veins

HTML Text Part 2 - Complications, preventions and FAQ

HTML Text Part 3 -Treatments

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