scholarly journals A perioperative phlebotropic therapy compliance study in patients with varicose veins

2020 ◽  
pp. 81-88
Author(s):  
S. N. Zhabin ◽  
A. A. Shitikov ◽  
A. V. Tsukanov ◽  
E. G. Obedkov ◽  
S. S. Dudchenko ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Lower Extremity ◽  
Varicose Vein ◽  
Conservative Therapy ◽  
Varicose Veins ◽  
Laser Coagulation ◽  
Entire Study ◽  
Wide Range ◽  
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.

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

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.

scholarly journals Ways to improve outpatient phlebological care with “one day” technology

2021 ◽  
Vol 18 (1) ◽  
pp. 30-39
Author(s):  
A. V. Pelevin ◽  
O. N. Guzhkov ◽  
D. L. Mushnikov
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Treatment Options ◽  
Health Sector ◽  
Laser Coagulation ◽  
Personalized Approach

Introduction. Chronic venous insufficiency is one of the most common diseases, so finding the best treatment options is one of the most urgent tasks of surgery. One of the methods of implementing this direction is to apply a personalized approach. The aim of the study is to improve surgical care for patients with VVPC by introducing a personalized approach.Materials and methods. The study was based on clinical observations and special studies in 428 patients with uBVNC in outpatient settings. All of those surveyed were women. The average age of the patients was 42.3 ± 15.5 years. All patients were operated on — endovasal laser coagulation (EVLk) was performed in the traditional way. Clinical examination of patients, as well as special methods of research was carried out. A questionnaire was used to assess the quality of life of patients. The peculiarity of the study was the use of social and hygienic methods: survey, psychological testing, expert. Statistical analysis and mathematical processing of results were carried out with the help of modern computer technologies based on the Statisticala 6 application package.Results. It has been established that over the past five years in the Ivanovo region there has been an increase in the incidence of vessels of the lower extremities. The frequency of varicose veins exceeds 47 per 100 patients examined. The desire to perform surgery in the nonstate health sector is observed in 9.8 cases. In 85.0% of patients with VBNC, received for surgical treatment, have a lack of preparedness. Their information, clinical and psychological level is 65.0–89.0% of the due and direct influence on the formation of an unfavorable result.Conclusion. Thus, the implementation of a personalized approach to the surgical treatment of patients with chronic venous insufficiency by laser coagulation provides on a par with the reliable obliteration of altered veins the fastest clinical recovery of patients, improvement of their quality of life, satisfaction with results, good hemodynamic and cosmetic effects.

scholarly journals Comparison of results of treatment varicose vein disease using a method of endovenous laser oblitetation with radial light guide and combined phlebectomy

2017 ◽  
Vol 16 (1) ◽  
pp. 16-20
Author(s):  
A. N. Galileeva ◽  
M. A. Parikov ◽  
V. B. Karpovich ◽  
A. A. Kotslova ◽  
V. V. Davydenko
Keyword(s):  
Quality Of Life ◽  
Varicose Vein ◽  
Varicose Veins ◽  
Lower Extremities ◽  
Term Efficacy ◽  
Results Of Treatment ◽  
Radial Fiber ◽  
Vein Disease

We compare the short- and long-term efficacy of endovenous laser oblitetation (EVLO) using a radial fiber with radial emission versus combined phlebectomy for the surgical treatment of varicose vein disease of the lower extremities. Participated 58 patients (46 females, 12 males) with ages ranging between 24 and 75 years with varicose vein disease of the lower extremities affecting the great saphenous vein (GSV) were prospectively enrolled in this observational trial. Patients were randomized to receive either combined phlebectomy - first group - 29 patients (33 extremities) or endovenous laser obliteration using a radial fiber-second group - 29 patients (36 extremities). A total of 69 extremities with functional classes C2 - 28 (40.58 %) cases, C3 - 30 (43.48 %) cases and C4 - 11 (15.94 %) cases according to CEAP classification were treated. Post-treatment CIVIQ-2 Questionnaire and VCSS scale, physical examination, duplex angioscan was conducted at 1st day, 1 week, 12 and 36 months later. The frequency of recurrence was assessed at one and three years after the surgery. 2nd group is characterized by higher quality of life in postoperative period. 100 % ablation in group with EVLO and 93.1 % - with combined phlebectomy. The frequency of recurrence presenting with new visible varicose veins was noted through 3 year in 8 patients (9 extremities) (34 %) from first group and in 4 patients (6 extremities) (21 %) from the second of 80 % examined patients. Endovenous laser obliteration has significant advantages in short-term efficacy: lower post-procedure pain, quicker rehabilitation period, possibility to carry out in outpatient settings, higher quality of life in long-term efficacy, lower frequency of recurrence.

Varicose Veins in Pregnancy: A Health Professional's Questionnaire

2001 ◽  
Vol 16 (4) ◽  
pp. 164-166
Author(s):  
L. B. Coughlin ◽  
R. Gandy ◽  
S. Rosser ◽  
L. de Cossart
Keyword(s):  
Surgical Treatment ◽  
Family History ◽  
Pregnant Women ◽  
Varicose Vein ◽  
Health Professionals ◽  
Varicose Veins ◽  
Postal Questionnaire ◽  
Factors Associated ◽  
Vein Disease ◽  
In Pregnancy

Objective: To acertain the knowledge of varicose vein disease amongst health professionals dealing with pregnant women. Method: Postal questionnaire survey. Results: General practitioners (GPs) and midwives estimated an incidence of varicose veins in pregnancy of 20-50%. Factors associated with varicose veins included second and subsequent pregnancies, thrombophlebitis, family history and obesity, although obesity was thought to be less of an association by the vascular surgeons (57%). Half the respondents linked varicose veins to deep venous thrombosis. Support hosiery is the main management, with 10% of obstetricians asking for a vascular surgeon's opinion, but never vice versa. Surgical treatment was recommended on family completion but 38% of vascular surgeons will consider surgery between pregnancies. Eighty per cent of GPs and 91% of midwives would welcome guidelines. Fifty-seven per cent of vascular surgeons stated that they already have guidelines although these are the professionals least likely to deal with pregnant women. Conclusion: Knowledge amongst health professionals of varicose vein disease in pregnancy is generally good. However, guidelines would be welcomed.

scholarly journals OPTIMIZATION OF SURGICAL TREATMENT OF PATIENTS WITH A VARICOSE VEIN DISEASE OF THE LOWER EXTREMITIES

2020 ◽  
pp. 99-101
Author(s):  
K. Y. Parkhomenko ◽  
K. E. Payunov ◽  
S. M. Diahiliev ◽  
A. G. Drozdova ◽  
V. P. Kolesnik ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Varicose Vein ◽  
Comparison Group ◽  
Varicose Veins ◽  
Lower Extremities ◽  
Invasive Technique ◽  
Duration Of Treatment ◽  
Surgical Department ◽  
Commercial Enterprise ◽  
Vein Disease

Summary. The aim of the study — to improve the results of surgical treatment of patients with a varicose vein disease of the lower extremities by using a minimally invasive technique such as endovasal endowelding. Matherials and Methods of the study. The results of surgical treatment of 82 patients with varicose veins of the lower extremities who were treated in the surgical department of the Municipal non-commercial enterprise of the Kharkov regional council «Regional Clinical Hospital», from 2015 to 2020 were analyzed. All patients were divided into two groups: the main (43 patients) and the comparison group (39 patients). The main group consisted of patients, in the treatment of which the method of endovasal endowelding was used. These patients were treated in 2017–2020. The comparison group consisted of patients who were operated on by performing a combined venectomy in 2015–2017. Results of the study. In patients treated with the endovasal endowelding technique, there is a decrease in the frequency of postoperative complications and the duration of treatment in the surgical department. Conclusions. The study proves the feasibility of using endovasal endowelding in the surgical treatment of patients with varicose veins of the lower extremities.

Features progressive surgical treatment of varicose veins of the lower extremity in pregnancy

2016 ◽  
pp. 68-74
Author(s):  
V.N. Antonuk-Kissel ◽  
◽  
V.N. Yenikeyeva ◽  
S.I. Lichner ◽  
V.M. Lipniy ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Lower Extremity ◽  
Varicose Veins ◽  
In Pregnancy

Varicose Veins: optimum compression after surgery and sclerotherapy

1990 ◽  
Vol 76 (2) ◽  
pp. 101-104
Author(s):  
P. J. Shouler ◽  
P. C. Runchman
Keyword(s):  
Surgical Treatment ◽  
Varicose Vein ◽  
Varicose Veins ◽  
Compression Stocking ◽  
Compression Stockings ◽  
Varicose Vein Surgery ◽  
High Compression ◽  
Graduated Compression Stockings ◽  
Non Surgical Treatment

SummaryGraduated compression stockings are used in both surgical and non-surgical treatment of varicose veins. In a trial of high versus low compression stockings (40mmHg vs 15mmHg at ankle) after varicose vein surgery, both were equally effective in controlling bruising and thrombophlebitis, but low compression stockings proved to be more comfortable.In a further trial after sclerotherapy, high compression stockings alone produced comparable results to Elastocrepe® bandages with stockings. It is concluded that after varicose vein surgery low compression stockings provide adequate support for the leg and that after sclerotherapy, bandaging is not required if a high compression stocking is used.

Cost-effectiveness analysis: role and implications

2013 ◽  
Vol 28 (1_suppl) ◽  
pp. 135-140 ◽  
Author(s):  
G Marsden ◽  
D Wonderling
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Cost Effectiveness ◽  
Varicose Vein ◽  
Varicose Veins ◽  
Health Gain ◽  
Cost Effectiveness Analysis ◽  
Effectiveness Analysis ◽  
The Cost

Background: Cost-effectiveness analysis (CEA) is often misperceived to be a cost-cutting exercise. The intention of CEA is not to identify and implement cheap technologies, but rather those which offer maximum health gain, subject to available funds. Such analysis is crucial for decision making in health care, as tight budget constraints mean spending in one area of healthcare displaces spending elsewhere. Therefore in order to achieve the greatest health gain for the overall population, treatments must be selected which provide the greatest health gain within the available funds. Summary: The relevance of CEA in health care systems is explained, using varicose vein treatment in the UK NHS as an example. Treatment for varicose veins is often not commissioned to at a local level, most likely because it is misperceived to be a cosmetic problem. However, this view does not take into account the impact of quality of life. CEA balances costs against a quantitative measure of health related quality of life, and could therefore be used to determine whether it is cost-effective to provide varicose vein treatment. The current literature on the cost-effectiveness of varicose vein treatment is reviewed, and an overview of cost-effectiveness principles is provided. Concepts such as economic modelling, incremental cost-effectiveness ratios (ICERs), net monetary benefit (NMB) and sensitivity analysis are explained, using examples relevant to varicose veins where appropriate. Conclusion: This article explains how, far from cutting costs and sacrificing patient health, CEA provides a useful tool to maximise the health of the population in the face of ever tightening budget constraints. CEA could be used to compare the cost-effectiveness of the various treatment options for varicose veins, and efficiencies realised.

scholarly journals Review on effect of long term standing posture on varicose veins and its management

2019 ◽  
Vol 7 (01) ◽  
Author(s):  
Prashant Kumar Sing
Keyword(s):  
Varicose Vein ◽  
Varicose Veins ◽  
Early Stage ◽  
Signs And Symptoms ◽  
Lifestyle Changes ◽  
Physiological Changes ◽  
Standing Posture ◽  
Prolonged Standing

The lifestyle changes, obesity, the occupational pattern of prolonged standing and pregnancy are considered to be significantly contributing to this situation known as Varicose veins wherein veins become enlarged and twisted. Incidence of varicose vein is more in people belonging to the occupation that involved prolonged standing. Varicose vein can be co-related to Sirajgranthi as described in Ayurvedic texts. Ayurved formulations are said to be effective in the management of Sirajgranthi (Varicose veins) Sirajgranthi, treated at an early stage or allows proper maintenance of signs and symptoms reduces the complications and support a better quality of life. In this article we have tried to analyse the anatomical and physiological changes due to long term standing.

scholarly journals Selection of Treatment Techniques for Lower Extremity Varicose Vein Disease

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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