What can be long-term consequences?
As a complication of chronic venous insufficiency, bleeding from the varicose veins, for example, can occur. This can be caused by the increased tension due to blood congestion or by an injury or accident. Often veins with a thin wall, which lie just under the skin, are affected.
It then bleeds openly out of the varicose vein or under the skin. In the event of such bleeding, the affected area should be tied off and elevated. Another complication is the inflammation of affected veins.
The expansion of the veins due to blood congestion leads to irritation, which can cause inflammation. This manifests itself as pain, redness and further swelling of the legs. Furthermore, deep vein thrombosis of the legs can be a long-term consequence of chronic venous insufficiency.
Since the veins of the legs are dilated, small tears in the vascular wall may occur. Blood platelets can attach themselves to these areas. In addition, the blood can coagulate due to the congestion and settle there.
This leads to a narrowing of the vessel opening, which is called thrombosis. It is particularly dangerous because the blood clot can detach from the wall, be carried to the lungs and cause a pulmonary embolism. A very important further complication is the leg ulcer.
Ulcus cruris is an ulcer on the lower leg that develops due to chronic venous insufficiency. The upper layers of the skin are no longer supplied with blood properly, for example due to the swelling of the leg. As a result, the cells of the immune system can no longer get there and even the smallest injuries cannot heal, resulting in an ulcer.
The ulcer usually occurs just above the inner ankle, usually does not hurt much and often wets. The affected area should continue to be moved to promote blood flow. The wound should also be treated externally to promote healing. However, even after healing, the affected area should continue to be observed and the underlying disease treated, as ulcers often reappear in the same place.
Therapy of chronic venous insufficiency
The therapy depends on the stage of the disease and the severity of the symptoms. The initial aim is to improve the outflow of blood from the leg veins. This is to ensure that the diseased sections of the vascular system are as functional as possible so that the blood does not back up into other parts of the body and cause permanent damage there.
Initially, a purely conservative therapy with compression stockings or bandages is aimed at. Compression stockings of various strengths can be selected depending on the degree of venous insufficiency. Cold applications from bottom to top can also result in improved blood flow due to a strong contraction of the veins in cold conditions.
Prolonged standing should be avoided, and heat (for example in the sauna) is also harmful. On the other hand, a lot of exercise can improve blood flow. In the case of severe oedema, physical therapy with lymphatic drainage can also be used, in which a physiotherapist attempts to slowly move the fluid with his hands from the feet and lower legs towards the heart.
Horse chestnut extract and butcher’s broom root are suitable herbal remedies for venous insufficiency. In addition, there are some procedures to obliterate vessels and thus prevent further congestion of the blood. For example, a liquid that is toxic for the tissue can be injected into smaller vessels.
In this way, the vessels suffer damage that results in the formation of a scar that closes the vein. The obliteration of large veins is done by means of laser therapy or radiofrequency obliteration. In these two methods, a probe is inserted into the affected vein.
A laser is then activated on this vein, for example, which causes a kind of burn wound in the vein. This is also closed by a scar. This prevents the blood from accumulating in the legs and normal blood flow can be restored.
Another possibility is the surgical removal of some of the affected vein sections. An operation is performed in case of strong symptoms, complications or for cosmetic reasons. Lymphatic drainage is one of the options for treating chronic venous insufficiency.
By compressing the veins and lymph vessels, the accumulated blood should flow out of them. This can be done with the hands (manual lymph drainage), with bandages or compression stockings. In this way the vessels are constricted and “squeezed out”.
Due to this reduction in the diameter of the veins, the blood flows faster and no longer sinks. Lymph drainage is carried out in different phases. First of all, it is about the final congestion of the vessels and then about maintaining the improvement. Good skin care and gymnastics can also be helpful.
