In the modern healthcare system, all diseases are grouped according to certain symptoms, severity, and other symptoms. Pathologies of the lower extremities are no exception. In our article, we will consider what classification of vein diseases exists.
Why encrypt the diagnosis?
Many ordinary people find it unclear why to introduce a classification at all? Looking at their medical records, patients see solid codes there. Whether it was the case before, doctors wrote down all the main and accompanying diagnoses of their patients in black and white, which could be easily read at any time. So, why did modern healthcare introduce coded designations for various pathologies?
- The encrypted names of diseases can only be read by a specialist, which is very important for maintaining information that is not subject to disclosure.
- With the advent of computer technology, most of the information for the convenience of their systematization, and in addition, analysis is entered into programs in the form of alphanumeric codes.
- The system of international unification, along with the standardization of disease codes, makes it possible to decipher the diagnosis, even if it was made in another country.
The classification of diseases can be international or accepted as part of the health care of a particular country.
Use of the medical document ICD-10
The main document used by doctors around the world is the so-called ICD-10, which is the latest revised and updated version of the classification system of diseases of various kinds. The figure "10" suggests that the World Health Organization has reviewed and revised the version already ten times.
According to this document, vein diseases are included in the ninth grade under the name: “Circulatory system pathologies”. This list contains the widest list of diagnoses with various complications and without, which can be diagnosed with the appearance of varicose veins. For example, varicose diseases of the lower extremities can be found under the number 183:
- Code 183.9 means varicose vein disease that goes away without complications in the form of trophic ulcers or inflammatory processes.
- Code 183.1 suggests varicose pathology of the legs with the development of the inflammatory process.
- The designation 183.2 speaks of a varicose disease with the presence of necrotic trophic ulcers and inflammatory processes.
- Code 183.0 reports varicose veins associated with trophic ulcers.
Thus, the diagnosis according to the ICD-10 classification greatly facilitates the determination of clarifying information about the disease of the veins of the lower extremities. As part of this, more serious complications are encrypted under other codes:
- Classification code 180.0 reports complications in the form of phlebitis, and, in addition, thrombophlebitis, which are localized in certain areas.
- Code 181 indicates the development of a patient's embolism and thrombosis of blood vessels.
- 184.0 suggests the presence of various types of hemorrhoids with concomitant complications and thrombosis.
- Code 186.2 implies varicose veins of the pelvic and perineal veins.
Thrombophlebitis
What can be leg vein diseases? A significant part of varicose complications is represented by all kinds of deep vein lesions, especially thrombophlebitis. This stage is accompanied, as a rule, by inflammatory processes of the venous walls, as a result of which blockages are formed in the lumen of the vessels. Of course, this greatly affects blood flow. In this regard, thrombophlebitis is a condition threatening the separation of a blood clot, which can lead to blockage of blood vessels that are extremely important for life.
To diagnose thrombophlebitis, a cipher is used, which makes it possible to clarify the nuances of the ongoing processes, for example, the area of localization, the presence of flotation and the severity of the course. Thus, the classification of thrombophlebitis is performed according to the following criteria:
- The type of pathological process, for example: acute (up to one month), subacute form (up to three months), chronic. Chronic thrombophlebitis is diagnosed after three months from the onset of the first symptoms of venous disease.
- The type of origin of the pathological process, for example, varicose veins began against the background of complications associated with pregnancy, childbirth, hormonal failure, allergies or an infection.
- Localization of chronic vein disease is a process that captures the superficial or deep veins of the legs and small pelvis.
- The nature of the course. According to this criterion, the course of the disease can be non-purulent or purulent.
All listed classification types are included in the ICD-10 document under digital codes from 100 to 199. These values are included in the category under the general name “Circulatory system pathologies”. On the basis of alphanumeric encryption in the healthcare system, other classifications of ailments were created.
Form classification
In addition to the international classification, there are also special ones that have been developed and are used by physicians from different countries. For example, Russia has created its own qualifying classification of diseases of the veins directly in their form. This method includes the following several stages of development of pathologies associated with veins:
- The formation of segmental varicose veins without reflux.
- The development of segmental varicose vascular disease with pathological discharge of fluid, which occurs along the superficial, and, in addition, communicative veins.
- The appearance of severe varicose veins with pathological discharge of fluid that occurs through deep veins.
The presented classification makes it possible to clarify how the pathology develops; in addition, a characteristic of the diseases of the veins of the lower extremities and blood vessels, as well as pathological blood flow disorders, is given.
The degree of venous insufficiency
According to the same classification, there are four following degrees of chronic venous insufficiency :
- Zero degree reports the absence of chronic venous insufficiency.
- The second degree indicates the presence of heaviness in the legs, which turns into swelling.
- The third degree of venous disease of the lower extremities indicates stable and persistent edema, sclerosis of the vascular walls, and in addition, hyperpigmentation of the skin and dermatitis.
- The fourth degree implies the appearance of trophic tissue changes and ulcers.
It is customary to add certain complications to the diagnosis during therapy. For example, complications in the form of various bleeding from veins, the appearance of blood clots, inflammatory processes of the lymph nodes, bacterial infections, necrosis, trophic changes in adjacent tissues, eczema and so on.
Saveliev classification
The system of classification according to Savelyev, which characterizes the degree of blood flow disturbance in the extremities, is quite popular among domestic doctors today:
- Compensation stage, which is characterized by an almost complete absence of disease symptoms, with the exception of discomfort in the area of vein damage.
- The stage of subcompensation, which is the time during which the symptoms of the disease intensify, visually appearing in the form of a reticular pattern, and symptomatically in the form of edema along with tingling, itching, heaviness, convulsions and other phenomena of varicose limb pathology. At the same time, stagnation in the tissues is very intensified, and normal blood circulation is disturbed.
- The stage of decompensation is marked by the appearance of a serious violation of blood flow, which is accompanied by hyperpigmentation and inflammatory processes of adjacent tissues. Symptoms at this time may worsen and develop into regular pain. The appearance of necrotic tissue lesions and trophic ulcers is not ruled out.
Anatomical localization
There is a classification system for the anatomical location of the affected limb veins, which is extremely important when making the correct diagnosis:
- The process of varicose vessels of the great saphenous vein.
- The process of varicose vessels of the small saphenous vein.
- The process of varicose vessels of the large and small saphenous veins.
- The process of varicose veins of the lateral vein.
CEAP Classes
There is an international classification of vein diseases, which is based on the symptoms and signs of the manifestation of pathology. It is called CEAP, where:
- “C” refers to the clinical picture of the disease.
- "E" reports the etiology of the disease.
- "A" carries information about the anatomy of the position of the affected veins.
- "P" refers to the mechanisms of development of varicose veins.
Clinicians most often use section "C", which, in turn, is divided into classes from zero to six. Thus, each stage of the clinical picture of leg vein disease has its own class:
- The zero class carries information about the absence of any obvious manifestations of varicose veins of the extremities. But at the same time, patients may complain of heaviness and fatigue of the legs.
- The first class implies that you can notice the appearance of a reticular pattern (asterisks, meshes). In this case, patients suffer from night cramps.
- The second class indicates the appearance of obvious expansion of veins and blood vessels, which can be clearly distinguished by the eye.
- The third class reports that patients suffer from edema of the extremities, tissue pastiness and other symptoms of varicose veins that do not disappear after rest.
- The fourth class indicates pronounced varicose nodes and veins, and in addition, hyperpigmentation and inflammation of the adjacent integument of the skin.
- Fifth grade is marked by the occurrence of ulcerative lesions, and in addition, symptoms of thrombophlebitis and necrotic changes.
- Sixth grade is accompanied by the formation of non-healing necrosis. In addition, patients may experience deep trophic ulcers.
Through the classification of sections "E" and "A", you can establish a diagnosis against the background of lesions of the deep and superficial veins, as well as clarify the etiology of the disease. Section "P", in turn, makes it possible to clarify the presence of various refluxes in the affected areas of the venous channel.
Disability Scale
In the framework of the diagnosis of the disease, the expansion of the veins is important to consider the number of ulcerative changes, the size and time during which the pathology exists. The presence of relapses and their total number is also taken into account. Among other things, information should be clarified on the ability to work of patients suffering from varicose veins, which is carried out on a scale of disability:
- “Zero” refers to the asymptomatic course of limb vein disease, which does not require a limitation of performance.
- "Unit" implies a symptomatology of the disease that does not require restrictions on disability.
- "Two" reports the presence of symptoms of the disease that prevent the patient from working for more than eight hours, with corrective therapy being mandatory.
- "Three" indicates complete disability.
So, thanks to the classification, it is possible to clarify the state of the disease at a certain point in time, especially in those cases when it progresses or, on the contrary, does not manifest itself in any way. The existing classification system makes it possible to more fully formulate the diagnosis of a patient, specifying the presence of various kinds of complications, and so on.
The presented CEAP system characterizes vein diseases in sufficient detail, but differs by a large number of different points, which, in turn, is reflected in the final code. Thus, any classification of problems with veins is, first of all, a list of the corresponding diseases, which makes it possible to most accurately not only determine, but make a diagnosis.
Vein Disease Treatment
Therapy with these pathologies is different, depending on the degree of development.
Sclerotherapy is used to remove small nodes or extensions.
As a traditional treatment, patients are recommended special stockings with high elasticity, as well as special exercises with high legs. This will be effective for varicose veins, as well as for chronic venous disease.
Surgery is indicated if there is no proper effect from the previous methods, various complications arise during the illness (ulcers or severe bleeding).
Medications may also be needed, especially if this is an advanced form of the disease or the development of complications.
To minimize the risks, you need to spend time on your legs and their health. You should regularly warm up your legs, do alcohol compresses, use herbal decoctions, and perform a special set of physical exercises.