Varicose Veins:

Varicose veins are bulging, and distorted veins (Gawas et al., 2021). This condition can develop anywhere in the body but the most prevalent site is in the legs.

Varicose veins are not a potentially fatal medical condition however, it can be uncomfortable and lead to more serious problems. It usually forms in veins near the skin’s surface and is caused by high blood pressure in the veins (Chang et al., 2018).

Through one-way valves in the veins, blood rushes towards the heart, but when the valves weaken or break, blood can pool up in the veins resulting in the dilation of veins.

Risk Factors:

Varicose veins may be caused by being pregnant. This raises blood body concentration in the legs, causing the developing fetus in the uterus pressurizes the veins.

The good news is that the varicose veins generally dissolve after the baby is born, if the extra pressure is alleviated. The possibility of developing varicose veins is enhanced by taking medicine containing female hormones such birth control tablets and replacement hormones used to treat the symptoms of a menopause (Yun et al., 2018).

The likelihood of varicose veins being overweight or obese is may be the other reason. Increased weight of the body can compress the veins, increasing pressure and tightening the walls and valves.

Weight loss may be of assistance. Long periods of sitting or standing can cause blood to pool up in the leg veins, increasing vein pressure. Veins may stretch as a result of the increased pressure causing a potential damage to the walls of the veins injuring the impending vein valves (Epstein et al., 2018).

Pathophysiology:

The venous wall consists of three layers but is less well defined than in the bloodstream. The intima is narrow with a sleek elastic lamina around it.

The media consists of elastin and layers of muscle bundles organized in various directions. The relative muscle and elastin quantities vary depending on the caliber and working pressure of the brain (Jacobs et al., 2017).

Moreover, adventitia fuses with the peri-venous connective tissue which includes nerve fibers and vasa vasorum and ensures distension of the vessel, a major element of proper venous function.

Any abnormalities were documented in all three layers with increasing age and particularly with the progression of the disease and the structure of the vein wall progressively becomes more disordered.

Typically, the intima is thickened and the elastic fibers are disorientated. The external muscular layer of the medium is hypertrophic and fibrous with dystrophic elastic fibers.

Calf muscle pump failure, such as old age, stroke, neuromuscular disorders, arthritis or trauma is connected with any cause of persistent weakness or immobility (Youn et al., 2019). Lesions limiting or preventing the mobility of the knee have a specific influence on the calf muscle pump.

Failure of a valve shutdown which leads to the valve failure and reflux may impact deep, superficial and main or secondary venous systems.

The loss of the mural elastin and collagen that leads to expansion of and separation of the leaflets of the valve is thought to constitute primary valvar incompetence (PVI). VV development is the most prevalent clinical result of this procedure.

The primary GSV trunk is frequently supported by an investment fascia, which makes tributaries quite varicose (DePopas & Brown, 2018).  PVI may also damage the profound vein system, however the clinical implications of PVI are less evident and clear since other tissues sustain their deep veins

If there are no symptoms, medical attention may not be necessary. Varicose veins, on the other hand, might deteriorate if left untreated.

It is possible that the patient is asked to raise his feet three or four times a day over the heart level about fifteen minutes (Gohel, 2020).  If someone has to sit or stand longer, flexing (bending) the legs might help keep the blood flowing from time to time.

From the body to the heart, veins bring the non-oxygenated blood. In the veins one-way valves are present to prohibit retrograde blood flow.

If these valves do not operate correctly, blood pools raise the pressure inside the veins and stress the walls of the veins. Small vein walls may also play a role in varicose vein straining.

These extended veins can be seen and felt just below the skin surface. No need to confuse varicose veins with spider venous veins which are a smaller variant of varicose veins consisting of red or blue lines that appear like a web or a branch.

While spider veins often have no physical signs, bigger varicose veins are symptomatic and can lead to severe problems of health (Rusinovich, 2020).

Treatment:

To optimize the therapy of the varicose veins, the source of superficial venous incompetence needs to be properly identified.

Further therapy, especially for the abolition of venous reflux, is intended to alleviate symptoms related to superficial venous incompetence, prevention of complications, and if feasible, short time for recovery. Lifting the legs might help lessen the swelling of the leg and other symptoms if the varicose vein is minor to severe.

Varicose veins can also be treated using compression stockings (Chang et al., 2021). These stockings constrict the veins and keep blood from pooling.

Compression stockings can be beneficial if used on a daily basis. Varicose veins can also be treated using lasers or radiofrequency radiation.

The laser or radiofrequency radiation is utilized to provide heat to the varicose vein wall, destroying it. Other treatment options may include surgery and microphlebectomy (Sotiris et al., 2020).

It should also be examined the cost-effectiveness of various treatments. The treatment indications are dependent mostly on the preferences of the patient.

The selection of therapy is also influenced by symptoms of deep venal failure and features, the expense of it, the risk of iatrogenic consequences, accessible medical means, the reimbursement insurance, and medical training (Müller & Alm, 2020).

 In patients with severe discomfort and leg tiredness, ankle edema, chronically deformed veins, aesthetic problems, premature hyperpigmentation, outer bleeding, progressive or painful ulcers or superficial thrombophlebitis, vascular operational procedure may be used for treating venous insufficiency.

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