scholarly journals The choice of the method of surgical treatment of varicose veins of the lower extremities in outpatient clinic

2019 ◽  
Vol 178 (4) ◽  
pp. 47-51
Author(s):  
A. N. Shikhmetov ◽  
N. N. Lebedev ◽  
A. M. Zadikyan ◽  
N. V. Ryazanov
Keyword(s):  
Surgical Treatment ◽  
Outpatient Clinic ◽  
Complex Analysis ◽  
Ultrasound Examination ◽  
Varicose Veins ◽  
Lower Extremities ◽  
Laser Coagulation ◽  
Results Of Treatment ◽  
Minimally Invasive Methods ◽  
Equal Efficacy

The OBJECTIVE was to compare the results of treatment of varicose veins of the lower extremities using minimally invasive methods in outpatient clinic. MATERIAL AND METHODS. The complex analysis of the treatment of 220 patients with varicose veins of the lower extremities was carried out. The approach to the choice of the volume of surgery was based on the data of ultrasound examination. The results of radiofrequency ablation and laser coagulation of subcutaneous veins were compared. RESULTS. CVI phenomena after EVLO were eliminated in 146 (95.4 %) patients, after RFA – in 62 (92.5 %). Differences in the frequency of obliteration were higher in the RFA group compared with EVLO (rxy=(0.772±0.02); p<0.01); differences in the ablation frequency were more significant after EVLO (rxy=(0.712±0.04); p<0.01), and differences in recanalization frequency were insignificant (rxy=(0.341±0.08); p<0.01). Thus, it was proven the equal efficacy of these methods in removing the vertical reflux in the surgical treatment FBVNC. In general, the efficiency estimated by recanalization frequency after EVLO and RFA was 92.7 %. CONCLUSION. Endovasal methods were highly effective and safe, could be successfully used for eliminating both vertical and horizontal pathological reflux in surgical treatment of FBVNC in outpatient clinic.

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 SURGICAL TREATMENT OF CHRONIC VENOUS DEFICIENCY OF LOWER EXTREMITIES

2020 ◽  
pp. 68-73
Author(s):  
I. B. Babynkina ◽  
A. A. Novikova ◽  
G. P. Babynkina
Keyword(s):  
Surgical Treatment ◽  
Lower Extremities ◽  
Outpatient Basis ◽  
Perforating Veins ◽  
Results Of Treatment ◽  
Cosmetic Effect ◽  
Modern Economic ◽  
Surgical Tactics ◽  
Tissue Trauma ◽  
Standard Operations

Summary. The aim. Improving the results of treatment of patients with decompensated forms of chronic venous insufficiency in post-thrombophlebitic and varicose diseases based on the use of differentiated pathogenetically substantiated surgical tactics. Materials and methods. The basis of the work is the study of the results of surgical treatment of 102 patients not previously operated on with postthrombophlebitic disease of the lower extremities in the decompensated stage of CVI. All patients underwent combined surgical treatment, including the elimination of perforating insufficiency and various modifications of the operation on the superficial veins to eliminate vertical reflux. Results and discussion. The combined operation for clipping perforating veins allows the operation to interrupt blood circulation through insolvent perforating veins, including on an outpatient basis, minimizing tissue trauma during puncture rather than sectional access to a vein. The cosmetic effect of the operation is significantly increased, which is especially important in the treatment of women. Since the operation can be performed on an outpatient basis, the number of days of incapacity for work is significantly reduced compared to standard operations on perforating veins, which is a particularly important circumstance in modern economic conditions. Conclusion. Using the proposed method allows to achieve optimal conditions for the restoration of trophism of affected tissues, leading to a decrease in the number of complications and a reduction in hospitalization.

Vein-Sparing and Radical Principles in the Surgical Treatment of Varicose Veins of the Lower Extremities

Flebologiia ◽  
2018 ◽  
Vol 12 (4) ◽  
pp. 300
Author(s):  
A. V. Gavrilenko ◽  
P. E. Vakhrat'yan ◽  
A. Yu. Kotaev ◽  
A. M. Nikolaev ◽  
N. M. Mamedova ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Varicose Veins ◽  
Lower Extremities

scholarly journals Endovenous Laser Ablation of Giacomini Vein in Surgical Treatment of Varicose Veins of Lower Extremities

2017 ◽  
Vol 25 (6) ◽  
pp. 583-588
Author(s):  
V.A. Yanushko ◽  
◽  
N.A. Rogovoy ◽  
D.V. Turliuk ◽  
I.P. Klimchuk ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Laser Ablation ◽  
Varicose Veins ◽  
Lower Extremities ◽  
Endovenous Laser Ablation

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 THE USE OF VARIOUS TECHNOLOGIES IN THE SURGICAL TREATMENT OF DECOMPENSATED FORMS OF VARICOSE VEINS OF THE LOWER EXTREMITIES WITH UNILATERAL VALVULAR INCOMPETENCE OF THE GREAT SAPHENOUS AND ANTERIOR ACCESSORY SAPHENOUS VEIN

2021 ◽  
Vol 48 (1) ◽  
Author(s):  
O. V. Sokolov
Keyword(s):  
Surgical Treatment ◽  
Radiofrequency Ablation ◽  
Varicose Veins ◽  
Pain Syndrome ◽  
Ulcer Recurrence ◽  
Average Area ◽  
Results Of Treatment ◽  
Group I ◽  
Group Ii ◽  
One Year

Abstract Purpose of the study. Comparative evaluation of the results of treatment of patients with varicose veins (VVs) in stage C6, with the valve incompetence of the trunks of GSV and ASSV in one lower limb, by traditional venectomy and radiofrequency ablation (RFA). Materials and methods. The study was conducted on the basis of MI «RCH n.a. І.І. Mechnikov», MNE «CCH №16» DCC and MC «JMC Menorah» from 2010 to 2020 yy. Included 43 patients: women – 29 (67,4%), men – 14 (32,6%). Age - from 29 to 74 years (average – 52,7 ± 10,8 years). Patients are divided into 2 groups. The I group (n = 22) included patients who underwent traditional venectomy of GSV and ASSV, the II group (n = 21) – patients who underwent RFA under local anestesia. The observation lasted 12 months. Results. The average area of ulcers ranged from 1 to 12 cm2. The average area of ulcers in group I was 6,3 ± 3,1 cm2, in group II – 6,2 ± 2,7 cm2. Complete epithelialization of ulcers occurred faster with the use of RFA (group II) – 38,1 ± 5,7 days against 44,7 ± 6,2 days in group I. After 3 months. the number of healed ulcers in group I. was 20 (83,3%), in II – 24 (96,0%). Ulcer recurrence one year after surgery occurred in 4 (5,6%) patients of group I, in group II there were no recurrences. After 6 months the difference between the severity of CVI (VSS) was 10,5 ± 2,8 points in group I and 13,9 ± 2,2 points in group II. Conclusions. 1. Surgical treatment of VVs at unilateral defeat of GSV and ASSV with use of RFA differs in the better profile of a postoperative pain syndrome, less traumatism, has the best indicators of recovery in comparison with a traditional venectomy. 2. Treatment with RFA in comparison with traditional phlebectomy one year after surgery had an advantage in the number of recurrences of trophic ulcers Keywords: varicose veins, venectomy, radiofrequency ablation, trophic ulcers.

Clinical and duplex ultrasound evaluation of lower extremities varicose veins – a practical guideline

VASA ◽  
2017 ◽  
Vol 46 (5) ◽  
pp. 325-336 ◽  
Author(s):  
Luca Spinedi ◽  
Pavel Broz ◽  
Rolf Peter Engelberger ◽  
Daniel Staub ◽  
Heiko Uthoff
Keyword(s):  
Ultrasound Examination ◽  
Varicose Veins ◽  
Lower Extremities ◽  
Duplex Ultrasound ◽  
International Consensus ◽  
Venous Ulceration ◽  
Ultrasound Evaluation ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

Abstract. Lower extremities varicose veins are among the most frequent diseases in the general population. They can cause complaints with a deterioration of the quality of life and are associated with potentially threatening clinical conditions such as chronic venous ulceration, haemorrhage from ruptured varicose veins, and venous thromboembolism. An accurate diagnostic work-up is crucial to confirm the presence and the extension of the venous problem, in order to obtain an optimal management of the condition. In the past years, great efforts have been made to reach an international consensus on the terminology, the symptomatology, the classification, and the duplex ultrasound examination of lower extremities varicose veins. Mainly guided by these consensus documents, the present article describes the diagnostic work-up of lower extremities varicose veins, based on a careful medical history, physical examination, and duplex ultrasound examination.

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.

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