YOU DEFEND AND CURE YOUR VEINS
Edited by Leonardo Corcos and Lanfranco Scaramuzzino

During the medical visit and the successive talk, escape many of the questions to which the patients would want one answer. The anxiety of the visit makes to often forget a lot how much us had been proposed to ask; then in returning to house come back the questions and the doubts. To get worse the situation they contribute many common places, often wrong, of one old flebology. The development of the not invasive diagnostic techniques has contributed to clear in the last years the operation of the venous circle and has allowed a sharpening of the cure methods rendering them more aimed to you, selective, effective and stable in the time, with a remarkable improvement of the clinic and aesthetic results . This publication does not have the pretension to replace itself to a flebologia text, but to only clear the more frequent doubts that the patient has bearer of one disease of the veins.

What is the varicose veins?
The varice term means expansion. The varix is therefore an expansion of the vein that subsequently stretches to assume a tortuous aspect. Varices more classic, are the so-called ones " varices tronculari" are formed in correspondence of the famous veins safene and above all of their collaterals, but a lot often varices forms one true and own peripheral net, from which the definition " reticular varices". These are situated above all on the superficial posterior external of thighs and legs and can be introduced in shape circumscribed or diffused to the greater part of the surface of the thigh and the leg. Reticular varices , for how much of usual only considered an aesthetic problem, can be cause of disturbs typical of the venous insufficiency to the par of varices tronculari. The varicose veins are more or less visible in relationship to one they more or less superficial localization and is hit some approximately half (50%) of the general population!

1. the expansion of the venous wall prevents the corrected operation of the valves; the blood circulates in opposite direction, that is towards the periphery (reflux) increasing the expansion of the wall. A progressive vicious circle is determined therefore that amplifies the disease in the time.
2. The alteration of the valves represents the first event that comes followed from the successive exhaust of the wall and from the described vicious circle.
3. The third hypothesis is represented from the combination of the two previous mechanisms and seems to take place itself in the greater part of the cases.

Are they hereditary?
A true and own heredity is not demonstrated but the studies and the experience confirm without doubt the importance of the familiarity in the appearance and the progression of these diseases. Also in this case the tendency appears more enunciated in the feminine sex. As an example: a woman, daughter of parents both bearers of varicose veins, has one probability to develop the same disease of 95%. If one of the parents is only sick, the probability comes down to 65%. The percentages in the male are respective of 65% and 25%.

How are they manifested?
In the phase it begins them of the disease perceives sense of weight to the legs and the ankles, heat and fatigue that are attenuated walking. Nocturnal cramps to the feet appear and to the calf that is introduced with long intervals and, in it makes more advances, the swelling up of the legs and the feet. These annoyances stretch to emphasize themselves in spring-summer and, for the greater part of the women, in the premenstrual period. Generally the varicose and the capillaries appear subsequently when the clinical picture stretches to get worse. But this is not a fixed rule. In fact the cases are not rare that they introduce voluminose accompanied varicose veins from disturbs to minimums or absent quite. Complications like the thrombophlebitises, often accompanied or continuations from ipodermiti (the inflammation of woven subcutaneous) or from the lymphangitises can then be verified. When the disease and the patient are abandoned, are introduced in the time damages more serious of the venous circulation until the ulcerations, that they represent the extreme manifestation of the chronic venous insufficiency.

What is the chronic venous insufficiency?
It is a  complex disease that   interests 12% of the population and is caused from the contemporary dysfunction of the deep and superficial veins. The disease often comes confused with simple varix   that  represent however the most frequent manifestation, but can in some cases seem  without  varicose veins or visible capillary. It is however able to evolve in the time and carrying the legs of the patients until the extreme degrees of the disease with venose ulcere chronic rebels to any medical and physical treatment. These patients commonly are defined "incurable" for the difficulty to do the diagnosis and cure of cases complex.

What is the "capillaries"?
Telangiectasia, is the scientific term that identifies a sick capillary. It is thin red vein, and is situated in the thickness of the skin. It is often called "broken capillary ". In truth it is a capillary dilated and therefore much more visible and unaesthetic. The breach of the small vein appears instead as the appearance of "bruise"  and has been caused from an emphasized vasale brittleness that represents a different disease that often is associated to other diseases generates them. This problem regards exclusively the feminine sex nearly; in approximately 40% of the cases they are localizes  to thighs; in little cases they only can give   pruritus, above all in the premenstrual period.

Which is the cause of the "capillaries"?
In the greater part of the cases they appear without one very precise cause  in absence of circulatory problems and often in absence of varicose veins. It has been observed that exists a sure familiar predisposition to the problem.The pregnancy and the "pill"  favor the appearance and that they can appear after post-trauma, also light, that it has been involved the inferior limbs. In one small percentage of persons (15%) the telangiectasias is only associated to the tronculari varicose veins, but at least in a third party of the cases it is possible to characterize, through medical examinations, an insufficiency of the superficial or internal veins not still clinically assured . More often, nearly in two thirds party of the cases, instead they are associated to reticular varices. In truth many of they depend on the circulatory  alteration of reticular varices that they must be eliminated for first. Their treatment allows to reduce much  the capillaries . The more serious and extended  reticular varices  and the telangiectasias can   provoke disturbs and complications like venous eczemas and small haemorrhages.

How they are cured?
First of all eliminating an eventual venous insufficiency and the nutrix veins (reticular varices) by the  sclero-therapy  and the laser-therapy. The red telangiectasias, that they are thinnest and resistant, are most difficult to deal and is possible to optimize the results with complementary therapies and the laser-therapy.