scholarly journals HISTORICAL AND MODERN ASPECTS OF TREATMENT OF LOWER LIMB VARICOSE VEIN DISEASE (THE LITERATURE REVIEW)

2021 ◽  
Vol 20 (1) ◽  
pp. 56-69
Author(s):  
Oleksandr Gumenchuk ◽  
Olena Shevchenko ◽  
Oleksandr Kobzar
Keyword(s):  
Conservative Management ◽  
Varicose Vein ◽  
Lower Limb ◽  
Developed Countries ◽  
Ct Angiogram ◽  
Minimal Trauma ◽  
Surgical Methods ◽  
Venous Diseases ◽  
Wide Range ◽  
Vein Disease

In developed countries, lower limb varicose vein (LLVV) is determined in 25% of the adult population. The high prevalence of varicose vein disease and the likelihood of severe complications developments determine the socio- economic importance of fi nding the eff ective methods of treatment this pathology. Age, height, female gender, overweight and heredity are well known traditional risk factors. The pathogenesis of LLVV is a complex and multifactorial process.The aff ected of endothelial cells is the main pathogenetic link in the LLVV development, that leads to a violation of their antithrombogenic properties. In the future, other membranes of the vein wall are involved in the pathological process. The development of LLVV is associated with a violation of the venous valves and their damage as well. The main method for diagnostic LLVV is ultrasound CT angiogram, that allows you to simultaneously visualize the researched vessel, determine the direction of blood fl ow and its parameters, its individual anatomical features. There are conservative and surgical methods of LLVV treatment. The fi rst attempts of the conservative management for this disease were wrapping the aff ected leg, as evidenced by the rock paintings that had been found in the Sahara Desert. The current analogue is the compression therapy, which plays a major role in the conservative management of venous diseases. Before the conservative method of treatment of LLVV the drug therapy is used as well. The use of various herbs for the management of blood vessels was common in ancient India. Currently, there is the wide range of modern pleotropic drugs. Aulus Cornelius Celsus removed varicose veins with a tiny hook, which is an extremely early version of a varicose vein treatment performed today. In the following centuries, the methods of surgical treatment of this disease were constantly have been improved. Nowadays, the most frequently used methods of varicose vein obliteration are based on endovasal thermal damage of the venous wall, that leads to the occlusive fi brosis and transformation of the vein into a connective tissue cord. The main advantages of these interventions are minimal trauma, speedy rehabilitation, and good cosmetic result. 

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.

Differentially Expressed Genes in Lower Limb Varicose Vein Disease

Flebologiia ◽  
2020 ◽  
Vol 14 (2) ◽  
pp. 122
Author(s):  
M.A. Smetanina ◽  
F.A. Sipin ◽  
E.I. Seliverstov ◽  
I.A. Zolotukhin ◽  
M.L. Filipenko
Keyword(s):  
Differentially Expressed Genes ◽  
Varicose Vein ◽  
Lower Limb ◽  
Differentially Expressed ◽  
Vein Disease

scholarly journals Study of the Clinical Profile of Varicose Vein Disease

2021 ◽  
Vol 11 (8) ◽  
pp. 6-10
Author(s):  
Raunak Kumar Gupta ◽  
Dilip Kumar Acharya ◽  
Sanjay .M . Datey
Keyword(s):  
Varicose Vein ◽  
Varicose Veins ◽  
Clinical Profile ◽  
Lower Limbs ◽  
Economic Losses ◽  
Western World ◽  
Medical College ◽  
Long Saphenous Vein ◽  
Venous Diseases ◽  
Vein Disease

Introduction: Varicose veins are part of the spectrum of chronic venous diseases and include dilated, tortuous veins of lower limbs, spider telangiectasia and reticular veins. Varicose vein disease is a very common problem of the western world and mostly their patients come for treatment because of cosmetic reasons. Indian scenario is different as mostly patients from lower socioeconomic strata of the society come for complications like ulceration, dermatitis etc. of varicose veins come for treatment. This problem sometimes results in chronic absenteeism from work, economic losses and change of occupation in many individuals. Methods: This observational study was carried out from 1st January 2017 to 30th June 2018 in Sri Aurobindo Medical College and Postgraduate Institute, Indore. Clinical profile of 52 patients of varicose vein disease was studied. All the patients were thoroughly examined and the pertaining data recorded. This data was tabulated and compared with the available literature on this subject. Results: Fifty two cases of varicose vein disease were studied. The commonest age group affected with the disease was between 41 to 50 years. Male patients were more and comprised of 84.6% of total number. Sapheno femoral junction valve was incompetent in 73.1 % cases as compared to saphenopopliteal junction[34.6%].Obesity was an important factor in causation of varicose vein disease. Flush ligation at SFJ with stripping was the commonest surgical procedure carried out our center. Conclusion: It is found that varicose vein disease with its associated sequelae brings the patient for treatment in our scenario. Long saphenous vein is the commonly affected part of the superficial venous system because of incompetency of the valve at SFJ. Although various etiological factors can be attributed to varicose vein disease but occupation and obesity remain the main factors. Accurate assessment of problem and adequate surgery will prevent recurrence. Key words: Varicose veins, venous ulcers, recurrent varicose veins.

Comparison of Endovasal Laser and Radiofrequency Ablation of Great Saphenous Vein in the Complex Treatment of Lower Limb Varicose Vein Disease

Flebologiia ◽  
2020 ◽  
Vol 14 (2) ◽  
pp. 91
Author(s):  
A.S. Volkov ◽  
M.D. Dibirov ◽  
A.I. Shimanko ◽  
R.U. Gadzhimuradov ◽  
S.V. Tsuranov ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Saphenous Vein ◽  
Varicose Vein ◽  
Lower Limb ◽  
Great Saphenous Vein ◽  
Complex Treatment ◽  
Vein Disease

Drug-induced Cholelithiasis

2020 ◽  
Vol 15 ◽  
Author(s):  
Štefan Alušík ◽  
Zoltán Paluch
Keyword(s):  
Reference Lists ◽  
Developed Countries ◽  
Somatostatin Analogues ◽  
Direct Reference ◽  
Google Scholar ◽  
Drug Induced ◽  
Therapy Initiation ◽  
Wide Range

Background: The prevalence of cholelithiasis in developed countries is high and its cause multifactorial, with a negligible proportion of drug-induced cholelithiasis. Methods: Relevant studies were identified by PubMed, Google Scholar and Science Direct. Reference lists of retrieved articles were also reviewed. The most relevant and up-to-date information was incorporated. Results: There is a wide range of drugs that can induce lithiasis. While the risk of developing lithiasis is high with some drugs (ceftriaxone, atazanavir, somatostatin analogues), it is lower or even questionable with others. Some drugs precipitate in the bile and may account for up to 100% of weight of the stone. Conclusion: Cholelithiasis can be induced by a wide range of drugs with different mechanisms of action.The aim of the article is to draw attention to this lesser known fact and the need to take into account the risk of developing lithiasis prior to therapy initiation.

scholarly journals Kinematic Analysis of Lower Limb Joint Asymmetry during Gait in People with Multiple Sclerosis

Symmetry ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 598
Author(s):  
Massimiliano Pau ◽  
Bruno Leban ◽  
Michela Deidda ◽  
Federica Putzolu ◽  
Micaela Porta ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Lower Limb ◽  
Sagittal Plane ◽  
Cross Sectional Study ◽  
Camera Motion ◽  
Cross Sectional ◽  
Temporal Parameters ◽  
Wide Range ◽  
Edss Score ◽  
Spatio Temporal

The majority of people with Multiple Sclerosis (pwMS), report lower limb motor dysfunctions, which may relevantly affect postural control, gait and a wide range of activities of daily living. While it is quite common to observe a different impact of the disease on the two limbs (i.e., one of them is more affected), less clear are the effects of such asymmetry on gait performance. The present retrospective cross-sectional study aimed to characterize the magnitude of interlimb asymmetry in pwMS, particularly as regards the joint kinematics, using parameters derived from angle-angle diagrams. To this end, we analyzed gait patterns of 101 pwMS (55 women, 46 men, mean age 46.3, average Expanded Disability Status Scale (EDSS) score 3.5, range 1–6.5) and 81 unaffected individuals age- and sex-matched who underwent 3D computerized gait analysis carried out using an eight-camera motion capture system. Spatio-temporal parameters and kinematics in the sagittal plane at hip, knee and ankle joints were considered for the analysis. The angular trends of left and right sides were processed to build synchronized angle–angle diagrams (cyclograms) for each joint, and symmetry was assessed by computing several geometrical features such as area, orientation and Trend Symmetry. Based on cyclogram orientation and Trend Symmetry, the results show that pwMS exhibit significantly greater asymmetry in all three joints with respect to unaffected individuals. In particular, orientation values were as follows: 5.1 of pwMS vs. 1.6 of unaffected individuals at hip joint, 7.0 vs. 1.5 at knee and 6.4 vs. 3.0 at ankle (p < 0.001 in all cases), while for Trend Symmetry we obtained at hip 1.7 of pwMS vs. 0.3 of unaffected individuals, 4.2 vs. 0.5 at knee and 8.5 vs. 1.5 at ankle (p < 0.001 in all cases). Moreover, the same parameters were sensitive enough to discriminate individuals of different disability levels. With few exceptions, all the calculated symmetry parameters were found significantly correlated with the main spatio-temporal parameters of gait and the EDSS score. In particular, large correlations were detected between Trend Symmetry and gait speed (with rho values in the range of –0.58 to –0.63 depending on the considered joint, p < 0.001) and between Trend Symmetry and EDSS score (rho = 0.62 to 0.69, p < 0.001). Such results suggest not only that MS is associated with significantly marked interlimb asymmetry during gait but also that such asymmetry worsens as the disease progresses and that it has a relevant impact on gait performances.

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