Duplex Power Phlebography (DPP): Guideline in Management of Varicose Vein Disease

Introduction: Lower extremity varicose vein disease is one of the common problems in vascular surgery. Clinically, this disease is accompanied by a wide range of complaints and external symptoms, which eventually lead to a worse patients’ quality of life. The integrated approach is being applied to the disease treatment, which involves the use of various phlebotropic drugs as conservative therapy along with minimally invasive surgical correction and sclerotherapy.Objective: to improve the quality of phlebotropic therapy for patients with lower extremity varicose vein disease, based on the study of factors that shape the patient’s compliance with the effective treatment of clinical symptoms. The term «compliance» means the precise and informed implementation of the doctor’s recommendations during the treatment by the patient. Most often, «compliance» is assessed by the drug use index, which is the quotient of dividing the number of days on which the full dose of the drug was taken by the duration of the entire study period. Materials and methods: The analysis of 368 + 111 patients with lower extremity varicose vein disease was carried out. Of these, 111 patients turned out to be beyond the correct study of compliance (a phlebectomy was performed in a hospital). 368 patients were divided into the following groups: Group 1: the patients, who were assigned modern surgical treatment of varicose veins (endovenous laser coagulation, scleroobliteration); Group 2: the patients, who withdrew from assigned interventions. As it turned out, the different groups of patients differed in compliance.Results. The patients who were shown and performed surgical treatment – 320 (86.9%), can be considered highly compliant with the prescribed conservative therapy – the average value of the compliance index is 0.83, compared to the representatives who refused to perform the recommended surgical procedures recommended by them – 48 (13.1%), the compliance index is 0.78.In the course of the investigation, the factors shaping compliance with phlebotropic drugs were identified, a comparative assessment was carried out on the main indicators of the effectiveness of phlebotropic drugs.Conclusion. Thus, the compliance of the patients suffering from LEVVV during the treatment with phlebotropic drugs varies depending on the multiplicity and convenience of the form of the drug, on the effectiveness of the proposed phlebotropic therapy according to the influence on the complaints and symptoms, on the psychological readiness of the patient to entrust the result of the final treatment of the disease to the surgeon.

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DNA methylation and gene expression profiling reveal MFAP5 as a regulatory driver of extracellular matrix remodeling in varicose vein disease

Epigenomics ◽

10.2217/epi-2018-0001 ◽

2018 ◽

Vol 10 (8) ◽

pp. 1103-1119 ◽

Cited By ~ 7

Author(s):

Mariya A Smetanina ◽

Alexander E Kel ◽

Ksenia S Sevost'ianova ◽

Igor V Maiborodin ◽

Andrey I Shevela ◽

...

Keyword(s):

Gene Expression ◽

Dna Methylation ◽

Extracellular Matrix ◽

Gene Expression Profiling ◽

Varicose Vein ◽

Expression Profiling ◽

Extracellular Matrix Remodeling ◽

Matrix Remodeling ◽

Vein Disease

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Molecular Genetics of Primary Varicose Vein Disease

Encyclopedia of Life Sciences ◽

10.1002/9780470015902.a0025031 ◽

2013 ◽

Author(s):

KN Adesina-Georgiadis ◽

MA Anwar ◽

AH Davies

Keyword(s):

Molecular Genetics ◽

Varicose Vein ◽

Vein Disease

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Ways of Improvement of Safety and Efficiency of Endovenous Laser Coagulation in Treatment of Lower Limb Varicose Vein Disease

Galician Medical Journal ◽

10.21802/gmj.2016.3.33 ◽

2016 ◽

Vol 23 (3) ◽

Author(s):

Roman Kohan ◽

Volodymyr Goshchynsky

Keyword(s):

Mathematical Model ◽

Laser Radiation ◽

Varicose Vein ◽

Lower Limb ◽

Linear Density ◽

Varicose Veins ◽

Laser Coagulation ◽

Light Pipe ◽

The Mathematical Model ◽

Vein Disease

Nowadays endovenous laser coagulation is the priority method of treatment of lower limb varicose vein disease. However, there are a number of specific complications that reduce efficiency of its usage.The objective of the research was to decrease specific postoperative complications after endovenous laser coagulation due to the introduction of its mathematical design.Materials and methods. The study included 168 patients with lower limb varicose vein disease. Prior to surgery the mathematical calculation of the basic parameters of laser coagulation such as density of laser irradiation and rate of reverse movement of the light pipe depending on the diameter of varicose veins was made. The control group consisted of 146 patients with varicose vein disease; the aforementioned parameters were established according to the instruction of using a laser device.Results. The analysis of complications such as induration of skin over coagulase great or small saphenous vein, phlebitis in the projection of the great or small saphenous vein, ecchymosis or dermatomelasma in the early postoperative period, pain syndrome showed the reduction in the number of complications while applying the mathematical model of calculation of linear density of laser radiation and the speed of reverse traction of the light pipe with its transfer to the graphic image.Conclusions. The application of the mathematical model of calculation of linear density of laser radiation and the speed of reverse traction of the light pipe with its transfer to the graphic image allows us to improve the results of endovenous laser coagulation for varicose veins due to the reduction in specific complications.

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Selection of Treatment Techniques for Lower Extremity Varicose Vein Disease

Galician Medical Journal ◽

10.21802/gmj.2016.3.36 ◽

2016 ◽

Vol 23 (3) ◽

Author(s):

Vasyl Mykhailovych Krysa ◽

Bohdan Vasylovych Krysa

Keyword(s):

Varicose Vein ◽

Medical Center ◽

Laser Coagulation ◽

Treatment Technique ◽

Treatment Techniques ◽

Clinical Observations ◽

Vascular Ultrasonography ◽

Rehabilitation Period ◽

Short Time ◽

Vein Disease

The article deals with available literature analysis, as well as authors’ own clinical observations concerning treatment of varicose vein disease. The article presents traditional surgery and endovascular methods of treatment and emphasizes that no technique has been recognized as universally applicable. The issue of reducing postoperative trauma, as well as shortening hospitalization and rehabilitation periods remains topical. Vein removal or any other way of excluding it from blood circulation has to be aimed only at areas with abnormalities in the area with venous reflux confirmed by ultrasonography. Such approach enables preserving autograft, indispensable in cardiovascular surgery. Nowadays, classical combined phlebectomy is replaced by endovascular techniques. The reason is that it is less traumatic, has a good aesthetic effect and a shorter rehabilitation period. Laser coagulation proves to become a priority trend in treating varicose vein disease, as an instrument of so-called “office surgery” when patients can leave the medical center on their own and proceed with their usual activities in a short time. All known treatment techniques should not be considered as rivals. Combination of various treatment techniques with consideration to their peculiarities makes it possible to achieve better clinic results than when aiming at a single technique. The main criterion to choose a treatment technique is preoperative vascular ultrasonography, which determines anatomic and morphological peculiarities of varicose vein disease, special features of hemodynamic disorders and helps select an optimal treatment option.

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Varicose veins: A critical review of the definition and the therapeutical options

VASA ◽

10.1024/0301-1526/a000131 ◽

2011 ◽

Vol 40 (5) ◽

pp. 344-358 ◽

Cited By ~ 5

Author(s):

Jeanneret ◽

Karatolios

Keyword(s):

Varicose Vein ◽

Varicose Veins ◽

Treatment Modalities ◽

Therapeutic Approaches ◽

New Techniques ◽

Definition Of ◽

Vein Disease ◽

Therapeutical Options ◽

Long Term Studies

This review intends to give an overview of the present therapeutic options for varicose vein disease. The definition of varicose vein disease and its recurrence are made and discussed with new aspects including duplexsonography assessment. All therapeutic approaches have developed and refined their treatment modalities, the open surgical as well as the endovenous techniques. In particular the new endovenous techniques are described with regard to safety and outcome, the published literature in this respect is summarized. The studies comparing the different techniques are listed, the prospective long term studies comparing the new techniques with the so called gold standard (open surgery) shall decide on the fate of the different techniques.

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