Venous stagnation - what is it and how to treat blood stagnation

In the early stages, venous blood stasis may not have noticeable symptoms, but over time, the phenomenon of venous stagnation leads to the development of chronic venous insufficiency. Over time, chronic venous insufficiency leads to severe complications that worsen the quality of life, and can even cause death. In this article we will tell you why venous stasis of blood vessels develops and explain what can happen if the disease is not controlled and treated.

Why does venous stagnation of the lower extremities develop?

The disease is based on increased pressure inside the superficial and deep veins of the legs. Excessive pressure stretches the vascular walls, causing the valves of the veins to begin to leak blood back into the superficial veins of the legs, causing venous stagnation.

Increased distensibility of veins may be associated with: - An increase in circulating blood volume and changes in hormonal balance. This situation occurs during pregnancy, when the volume of circulating blood in the female body increases by 30%, and the vessels begin to stretch due to increased load; — Congenital weakness of the vascular walls, due to which even normal pressure inside the veins leads to stretching of the weakened walls of the venous vessels; - Excess weight, “standing” or “sedentary” work, active sports. In these situations, the veins in the legs become compressed for a long time, which leads to venous stagnation.

Main risk factors for the development of CVI

We have already mentioned the main factor leading to the development of venous insufficiency - prolonged static load on the legs. Other risk factors are:

• heredity
• female
• physical characteristics - increased body weight and tall height
• taking hormonal medications (in particular, contraceptives)
• repeat pregnancies and others

Sometimes old age is considered a risk factor, but nowadays CVI, unfortunately, is getting younger, and it is often diagnosed in people under the age of 25.

Why is venous congestion in the legs dangerous?

1. The risk of developing superficial thrombophlebitis Venous congestion in the legs is accompanied by an increase in blood viscosity. Increased blood clotting and a decrease in the speed of venous blood flow provoke the formation of blood clots (thrombi) on the inner surface of the vascular walls of the veins. Having come off the vein wall and entering the venous bed, the thrombus can clog a superficial vein of small diameter and provoke superficial thrombophlebitis. Blockage of a vein leads to disruption of the blood supply to the skin area. Over time, a difficult-to-treat trophic ulcer forms on the affected area of ​​the skin.

2. Risk of developing varicose veins Stagnation of blood in the legs increases the pressure inside the veins. Under the influence of excess pressure, the veins begin to stretch and appear under the skin, forming a network of dilated veins in the legs. Increased pressure inside the veins “squeezes” the liquid part of the blood through the vascular walls of the veins into the muscles and subcutaneous tissue of the legs. Because of this, severe varicose edema occurs.

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Violation of venous circulation in the brain

The brain is a complex structure, its normal functioning depends on the state of blood circulation. In addition to the need to deliver oxygen and glucose to the nervous tissue, the outflow of venous blood and the removal of toxins with it, the result of cell activity, is important. If this process is disrupted, chronic venous insufficiency of the brain is formed.

A peculiarity of the vessels of the brain is the course of the veins: it does not coincide with the direction of the arteries, and a network is formed that is independent of them. If the outflow of blood through one of the vessels is impaired, venous blood is directed to the other, and compensatory expansion occurs. A prolonged decrease in tone leads to vascular atrophy, they collapse, and the risk of thrombosis increases. Dilated vessels contribute to the development of venous circulation insufficiency, the functioning of the valves is disrupted, they do not close tightly, and the direction of blood flow is disrupted.

Stages of the pathological process

The following stages are distinguished during cerebral venous insufficiency:

• latent: no clinical symptoms, no complaints;
• cerebral venous dystonia: some symptoms are observed: headaches, weakness;
• venous encephalopathy: severe symptoms caused by organic lesions are observed, venous outflow is impaired in all areas of the brain, there is a high risk of hemorrhages from dilated vessels.

Classification

There are chronic and acute variants of venous circulation in the brain. Chronic include venous congestion and venous encephalopathy, acute include venous hemorrhage, thrombosis of the veins and venous sinuses, thrombophlebitis.

Causes and risk factors

Insufficiency of cerebral venous circulation can be caused by diseases or individual characteristics of the patient. The most common causes of pathology:

• neoplasms in brain tissue can cause disruption of venous outflow;
• head injuries that impair blood circulation to the brain;
• injuries during childbirth;
• hematomas formed as a result of stroke, atherosclerosis, bruises and other causes contribute to the formation of tissue edema, which complicates the outflow of blood from the affected area;
• blood clots and embolisms narrow the lumen of the vessel or completely close it, preventing the movement of blood;
• diseases of the spinal column, in which deformed sections of the canals compress the vessels and disrupt blood flow, also cause venous insufficiency;
• vascular features: hereditary predisposition and impaired development of veins can provoke the development of a violation of the outflow of venous blood.

Circulatory disorders can be physiological and occur when coughing, sneezing, or physical strain. Such short-term deviations do not cause significant harm to health.

One-time attacks of cerebral circulatory disorders do not cause serious consequences for the body. However, prolonged blood stagnation can contribute to the development of serious consequences. The following risk factors increase the likelihood of cerebral venous insufficiency:

• frequent stress;
• smoking;
• alcohol abuse;
• prolonged dry cough;
• professional singing;
• hypertension;
• heart failure;
• reading in the wrong position
• professional swimming;
• frequent wearing of clothes that compress the neck;
• chronic rhinitis:
• work in high-altitude, underwater, underground professions;
• office work that involves staying in a position with the head tilted or turned;
• frequent physical activity of high intensity

Clinical manifestations

Disturbances of venous circulation, as a rule, are genetically determined. Currently, the role of the initial tone of the veins in the formation of venous discirculation is undeniable. Constitutional and hereditary factors are key for the development of venous dyshemia. Patients with a family “venous” history usually have several typical manifestations of constitutional venous insufficiency - varicose veins or phlebothrombosis of the lower extremities, hemorrhoids, varicocele, impaired venous outflow from the cranial cavity, esophageal varicose veins. Pregnancy is often the trigger.

Typical complaints:

• morning or afternoon headache of varying intensity;
• dizziness, depending on changes in body position;
• noise in the head or ears;
• visual disturbances (decreased visual acuity, photopsia);
• “tight collar” symptom - increased symptoms when wearing tight collars or ties;
• “high pillow” symptom - increased symptoms when sleeping with a low headboard;
• sleep disorders;
• feeling of discomfort, “fatigue” in the eyes in the morning (symptom of “sand in the eyes”);
• pastiness of the face and eyelids in the morning (with a pale, purple-cyanotic tint);
• mild nasal congestion (outside the symptoms of acute respiratory infections);
• darkening of the eyes, fainting;
• numbness of the limbs.

Signs of impaired cerebral venous blood flow are related to weather conditions. Headaches are poorly controlled by analgesics; often some relief is brought only by a change in body position - in a horizontal position, venous blood flow is redirected along collaterals - bypassing the affected vessel.

The patient’s psyche changes in such a way that minor experiences can lead to neuroses. Tearfulness increases, the patient often breaks into a scream. Mania and depression are observed. Severe damage leads to psychosis, accompanied by hallucinations and delusions; this can make the patient dangerous to himself and others.

Diagnostics:

• radiography determines the strengthening of the pattern of the veins of the skull, which indicates the presence of a pathological process;
• angiography is a contrast method for diagnosing blood stagnation, determining the patency of blood vessels;
• computed tomography and magnetic resonance imaging make it possible to accurately determine the presence of a pathological process in the brain, as well as in surrounding tissues;
• ultrasound examination of the veins of the brain and neck;
• rheoencephalography is a functional diagnostic method that assesses the condition of blood vessels;
• An increased level of pressure in the ulnar vein allows one to suspect abnormalities in the vessels of the brain.

Therapy is complex and includes several areas

• drug treatment;
• non-drug treatment: physiotherapy, massage, physical therapy;
• surgery.

Drug therapy

The following drugs are used to normalize cerebral circulation:

• venotonics strengthen the vascular wall, reduce permeability, have an analgesic effect, and eliminate inflammation;
• diuretics to eliminate swelling;
• neuroprotectors improve nutrition and metabolism of the brain;
• anticoagulants to thin the blood and prevent thrombosis;
• vitamin therapy (vitamins B and PP).

Non-drug treatment

There are a number of non-drug therapies that are effective as an additional treatment method and improve vascular tone. However, before treating impaired cerebral venous outflow with their help, it is necessary to assess individual risks and contraindications: in some cases, such procedures can lead to the opposite effect and worsen the patient’s condition.

Applicable:

• head and neck massage;
• oxygen therapy;
• foot baths;
• physical therapy: breathing exercises, neck exercises, yoga classes.

Intern of the ophthalmology department Gurlo A.I.

Head of the department ophthalmological department Rudova

Symptoms of the disease

Let's look at the general symptoms first. It should be remembered that in the initial stages of the disease they appear one at a time and are often “blurred”. The more the disease progresses, the more pronounced the symptoms, and they most often appear in groups. So:

• pain in the legs, feeling of heaviness, fullness;
• spider veins;
• swelling - first passing after rest, then permanent;
• night cramps in the legs;
• dryness, unhealthy shine of the skin, age spots or areas of discoloration;
• trophic ulcers at an advanced stage.

Consultation with a surgeon: when to contact, how is the appointment?

Symptoms of CVI by stage

Symptoms of AHF

Signs of the disease are more pronounced and appear much faster compared to CVI:

• Pain in the legs that increases with movement;
• just below the site of vein blockage there is large swelling;
• difficulties in any physical activity;
• pallor or bluishness of the skin;
• at the site of pathology, skin temperature decreases by 2-3℃;
• body temperature can rise to 40℃;
• increasing pain to unbearable;
• “referring” pain to the groin and pelvis area.

Important! To reduce the likelihood of a blood clot breaking off with subsequent thromboembolism, the patient needs to limit movement. Bed rest is recommended for up to 10 days; the affected leg should be higher than the body.

Causes of CVI

Most often, venous insufficiency occurs with varicose veins, as well as against the background of such diseases and pathological conditions as:

• congenital pathology of the venous system;
• congenital aplasia and hypoaplasia of the deep veins;
• congenital arteriovenous fistulas;
• congenital osteohypertrophic nevus with varicose veins;
• suffered acute thrombosis of the main veins;
• Klippel-Trenaunay syndrome;
• previous phlebothrombosis.

In recent years, a new cause for the development of chronic venous insufficiency has emerged, which is increasingly being identified - phlebopathy. This name refers to the state of venous stagnation in the absence of clinical signs of pathology. In rare cases, CVI begins to develop after a trauma (bruise, rupture, deep burns or hypothermia).

Diagnosis and treatment of CVI

At an appointment with a phlebologist at the Ambulatory Surgery Center, the patient is diagnosed based on the medical history, the patient’s complaints, and the results of the study. The main method of instrumental examination is duplex ultrasound scanning. In our clinic, functional diagnostic doctors during the study not only confirm the presence of CVI, but also help surgeons determine the extent of damage to the venous system and the choice of tactics for further action. In some cases, the attending physician may prescribe a duplex angioscan or X-ray contrast study (phlebography).

Treatment of chronic venous insufficiency is a set of measures, the purpose of which is to restore the functionality of the venous and lymphatic systems, eliminate the pathologies that arise from them and prevent relapses. The method of therapy is selected individually for each patient, taking into account the degree of pathological changes, medical history, age and concomitant diseases.

Conservative treatment

A course of treatment is prescribed, lasting on average 2 - 3 months, then after a certain period it is resumed. The course usually includes:

• medicines (phlebotrobic drugs);
• local use of antiseptic ointments;
• corticosteroid drugs;
• elastic compression (bandages and compression hosiery);
• treatment of associated secondary infections;
• elevated position of the legs when lying down.

In some cases, antibiotics and diuretics are prescribed to reduce swelling. The greatest role in the routine treatment of CVI is played by elastic compression, including hardware, pneumatic, and leg elevation. Compression is indicated for all patients, even those with ulcers. In this case, I use elastic bandaging, and then wear special stockings. They should create a distal pressure of 20–30 mm Hg. for patients of the first stage, 30–40 mm Hg. – second and up to 60 mm Hg. at the third.

The effectiveness of therapy directly depends on the active participation of the patient. He needs to strictly follow the doctor’s recommendations and build his life in such a way that conditions that aggravate the course of the disease are not created.

Surgery

Surgery is performed only in 10% of patients with:

• severe concomitant diseases;
• trophic disorders;
• transformed tributaries of the great (small) saphenous veins;
• relapse of varicose veins and in other similar cases.

For this purpose, a minimally invasive surgery technique is chosen - miniphlebectomy.

. The operation is performed under local anesthesia. Through small punctures, the vascular surgeon gains access to the affected areas of the veins to perform ligation (vessel ligation), vein removal, and valve reconstruction. The tasks of a vascular surgeon include eliminating pathological blood discharge and truncation of varicose veins. After the operation, an hour later, the patient can go home; a hospital stay is not required.

Prevention of venous insufficiency

Preventive measures:

• refusal of high-heeled shoes;
• wearing comfortable clothes that do not constrict the body;
• moderate tan;
• extremely rare visits to the sauna, bathhouse;
• maintaining normal body weight;
• proper nutrition;
• drink plenty of fluids (1.5-2 liters of water, unsweetened tea per day);
• giving up alcohol and smoking;
• active lifestyle;
• regular gymnastics during sedentary or standing work;
• when working sedentarily, place your feet on a not very high stand.

Make an appointment with a phlebologist at SM-Clinic on the website or by phone. Prices for services are indicated on the website.

What are the causes of venous insufficiency?

All causes of the disease can be divided into groups:

• Negative heredity. These include structural features of blood vessels, insufficiency of the vascular wall and valve apparatus.
• Blood flow disorders: varicose veins, thrombosis, consequences of injuries, postthrombophlebitis syndrome, constantly high pressure in the lower extremities, phlebitis, pregnancy.
• Lifestyle: obesity, lack of physical activity, excessive strength loads (both uncontrolled lifting of weights in the gym and, for example, working as a loader), sedentary lifestyle or standing work.
• Hormonal status: women suffer from venous insufficiency more often than men, this also includes taking OCs (oral contraceptives) and hormonal therapy.
• Age factor: the older the patient, the higher the likelihood of the disease.