scholarly journals Modern views on the development of varicose and post-thrombotic diseases

2020 ◽  
Vol 27 (1) ◽  
pp. 105-125 ◽  
Author(s):  
Ivan N. Shanaev
Keyword(s):  
Chronic Diseases ◽  
Varicose Veins ◽  
Modern Science ◽  
Lower Extremities ◽  
Venous System ◽  
Systemic Hemodynamic ◽  
Thrombotic Disease ◽  
Vein Thrombosis ◽  
Thrombotic Diseases ◽  
Valvular Insufficiency

Chronic diseases of the veins of the lower extremities include vascular pathologies within the venous system and exclude those, in which the veins suffer secondarily (chronic heart failure, iatrogenic damage, tumour occlusion). The main clinical and morphological forms of chronic diseases of the veins of the lower extremities include: varicose veins, post-thrombotic disease and phlebodysplasia. Moreover, according to publications, varicose disease accounts for the main percentage of occurrence, i.e. from about 70 to 86 %. Post-thrombotic disease occurs from 14 to 29 % of cases and develops, as a rule, during the first two years after an episode of deep vein thrombosis of the lower extremities in 20–50 % of patients. These two diseases are the main reason for the development of chronic venous insufficiency with a significant decrease in working capacity and quality of life under the age of 60. Despite the achievements of modern science, the ethiopathogenesis of these diseases is yet to be understood. Instrumental diagnostics allows a pathological retrograde blood fl ow due to the failure of the valves of the venous system of the lower extremities to be determined. However, the issue of what is primary — valvular insufficiency or venous wall deformation — remains open at the present time. This article is devoted to a review of modern theories about the mechanisms underpinning the formation of valvular insufficiency in varicose and post-thrombotic diseases. The review also addresses systemic hemodynamic disorders (heart morphology and hemodynamics) against the background of chronic diseases of the veins of lower extremities.

scholarly journals MRI and CT-venography in the diagnosis of hemodynamic disturbances in patients with chronic lower extremities venous disorders. Part III. Possibilities of CT-investigation in diagnosing of venous hemodynamics violations

2021 ◽  
Vol 25 (4) ◽  
pp. 53-74
Author(s):  
E. V. Shajdakov ◽  
A. B. Sannikov ◽  
V. M. Emelyanenko ◽  
M. A. Rachkov ◽  
L. N. Kryukova ◽  
...  
Keyword(s):  
Lower Extremities ◽  
Scientific Data ◽  
Venous System ◽  
Venous Blood Flow ◽  
Technical Problems ◽  
Ct Venography ◽  
Vein Thrombosis ◽  
Venous Diseases ◽  
The World ◽  
Contrast Ct

As a result of solving a large number of technical problems (increasing the area of anatomical coverage and scanning speed, increasing the signal-to-noise ratio, improving spatial and contrast resolution, building a color image quality in 3D mode, significantly reducing the radiation dose), the method of computed tomography imaging of the vascular system has won a leading position in the world today. However, if CT Angiography is used everywhere and daily in the diagnosis of arterial pathology, this method has not yet received clinical recognition in patients with chronic venous diseases.This review of the literature analyzes the scientific data published in the world on the results of CT Venography. Methods of indirect and direct contrast CT Venography are described. The possibility of using contrast CT Venography in the diagnosis of deep vein thrombosis is shown, where the accuracy, sensitivity and specificity of the method according to foreign authors is up to 97.9%, 96.8% and 100%, respectively. This method acquires particular importance in the diagnosis of pelvic vein thrombosis and inferior Vena cava, where the informative value of USDS is lower. The second clinical direction that is actively developing today is the combined use of CT Venography and CT Angiopulmonography in the diagnosis of a deadly complication of pulmonary embolism. The prospects of these attempts are preferable by the following advantages: the single-time study and the absence of the need for additional administration of contrast agents, the speed of scanning, and obtaining additional information about the state of the peripheral venous system in patients with venous thromboembolism.Another and irreplaceable tool of contrast-enhanced CT Venography can become in the study of the features of the topographic and anatomical structure of the venous bed. Using their own research, the authors demonstrate the possibilities of direct CT Venography in the visualization of the venous system of the lower extremities.The need for more accurate topical diagnostics with 3D visualization of the venous system of the lower extremities and pelvis by CT-Venography is due to the growing interest in recent years of vascular and interventional surgeons to test and more actively implement endovasal methods of correction of venous blood flow in phlebological practice.

scholarly journals Features of venous blood circulation and valve function in the lower extremities according to duplex scanning data and morphofunctional studies

2021 ◽  
Vol 102 (5) ◽  
pp. 597-605
Author(s):  
I M Ignatyev ◽  
V V Evseeva ◽  
S Yu Ahunova ◽  
E G Gradusov
Keyword(s):  
Early Diagnosis ◽  
Blood Circulation ◽  
Prognostic Value ◽  
Varicose Veins ◽  
Venous Blood ◽  
Duplex Ultrasound ◽  
Venous System ◽  
Ultrasound Scanning ◽  
Valve Function ◽  
Valvular Insufficiency

Aim. To study the mechanisms of venous return and the functioning features of lower extremity venous valves in horizontal and vertical positions. Methods. The study, conducted from April 2019 to December 2020, included 100 people. The study participants were divided into 2 groups. The first group was represented by 44 patients (88 limbs) with varicose veins, whose venous system was examined by duplex ultrasound scanning during inpatient rehabilitation. The second (control) group consisted of 56 healthy individuals (92 limbs) without visible signs of venous pathology who underwent an outpatient examination of the venous system. The average age of the patients in the two groups was 49.22.4 and 51.11 years, respectively; women predominated in both groups. The qualitative and quantitative parameters of venous blood flow were studied in the study. Venous valvular insufficiency was assessed by using reflux duration and the Psatakis index. A morphometric study was conducted on 140 limbs of 48 human corpses, from which venous fragments were taken for biomechanical studies of the valves. The clinical characteristics of patients are presented by descriptive statistics, quantitative parameters are reported as the mean value (M) and standard deviation (SD). The differences were tested for significance by using the Student's t-test. Results. In the study, we introduced the concept of the valve index, the aspect ratio of the ellipse, the shape of which has a venous valve in cross-section. Duplex ultrasound scanning, as well as a morphofunctional examination of the valves, made it possible to establish that the valve index is significantly higher in the presence of signs of varicose veins, which indicates dilation and incipient varicose vein, which leads to valvular insufficiency. The elasticity index defined by us, as the indicator of change in the venous lumen size, measured by the ratio of its diameters, also significantly (p=0.034) differed in the studied groups: the elasticity index in the group of healthy people was 1.370.11, in the group of patients with varicose veins 1.560.17. The studied factors allowed us to develop a test that has an important prognostic value for the early diagnosis of varicose veins as well as the implementation of preventive health measures. Conclusion. The features of venous blood circulation and valve function studied in the study not only have prognostic value for the early diagnosis of varicose veins but are also of practical interest for developing methods of surgical correction of venous valvular insufficiency.

PATHOPHYSIOLOGICAL AND PATHOMORPHOLOGICAL ASPECTS OF RELAPSE OF VARICOSE VEINS AFTER ENDOVASCULAR LASER VEIN COAGULATION

2020 ◽  
Vol 73 (11) ◽  
pp. 2468-2475
Author(s):  
Volodymyr B. Goshchynsky ◽  
Bogdan O. Migenko ◽  
Svitlana S. Riabokon
Keyword(s):  
Endothelial Dysfunction ◽  
Postoperative Period ◽  
Varicose Vein ◽  
Varicose Veins ◽  
Lower Extremities ◽  
Venous System ◽  
Circulating Endothelial Cells ◽  
Electron Microscopic ◽  
Deep Venous System ◽  
Vein Disease

The aim: With the help of biochemical and morphological methods of investigation to identify the causes of a false postoperative recurrence of varicose veins after the EVLC. Materials and methods: In 173 patients with varicose veins of the lower extremities, the level of markers of endothelial dysfunction was determined: P-selectin, E-selectin, tissue plasminogen activator, endothelin-1, adhesion molecules of type 1 vascular endothelium (sVCAM-1-soluble vascularcellularmolecula), circulating endothelial cells (CEC) before surgery (EVLC), on the 10th and 60th day of the postoperative period.At the same time, a morphological and electron microscopic examination of the state of the deep venous system in 31 patients with varicose vein disease of the lower extremities who died from acute heart failure, was performed. Results: Increased values of markers of endothelial dysfunction in patients with varicose veins of the lower extremitiesbefore surgery of EVLC were established. We found that, despite the operation, the parameters of endothelial dysfunction decrease, but in the remote postoperative period do not come to the norm. Morphological and electron microscopic studies of the deep vein wall revealed pathomorphological changes in all of their layers, especially the endothelial layer. At the heart of the development of endothelial dysfunction in the postoperative period, the leading role belongs to changes in mitochondria. Conclusions: 1. Based on our research, we can state that there are significant pathomorphological and pathophysiological changes in the deep venous system of the lower extremities in conditions of varicose vein disease. 2. The initiator of postoperative relapse of varicose veins are structural changes in the wall of deep veins with a violation of the integrity of the endothelial lining, contributing to the absorption of plasma and leukocyte contents from the blood stream in the interstitium, with the following pathological changes in the layers of deep veins.Such changes are the basis for the manifestations of endothelial dysfunction in the postoperative period.

scholarly journals Comparative analysis of short-term outcomes after surgical treatment of varicose disease with endovasal laser obliteration and short stripping

2021 ◽  
Vol 25 (2) ◽  
pp. 55-62
Author(s):  
A. V. Gavrilenko ◽  
M. V. Ananeva ◽  
P. E. Vakhratyan ◽  
A. N. Kosenkov ◽  
M. M. Musaev
Keyword(s):  
Postoperative Pain ◽  
Saphenous Vein ◽  
Varicose Veins ◽  
Clinical Manifestations ◽  
Lower Extremities ◽  
Clinical Severity ◽  
Vein Thrombosis ◽  
Venous Clinical Severity Score ◽  
Ultrasound Findings ◽  
Deep Vein

The purpose of this study was to compare outcomes (within six months) after short stripping (SS) and endovenous laser obliteration (EVLO) in patients with varicose veins when analyzing ultrasound findings, postoperative complications, level of postoperative pain, clinical manifestations, and duration of rehabilitation after the intervention. Patients with varicose veins of lower extremities and insufficiency of large saphenous vein valves had either EVLO or SS with miniflebectomy. All patients were examined before surgery and then in 5 days, 10 days and in 1, 3 and 6 months after it. The patients also had clinical examination, ultrasound duplex scanning of their lower extremity veins; Venous Clinical Severity Score (VCSS) was also used for the trial. Pain was assessed during the first 10 days after the surgery using a 10-point pain assessment scale. 156 patients (177 lower extremities) were followed-up for 6 months. As the results of our study showed, endovenous laser obliteration and short stripping were equally effective in eliminating the reflux of the great saphenous vein (GSV). After 6 months of follow-up, the reflux along the medial inflow was noted in one case in SS group; partial GSV recanalization was noted in one case in EVLO group in 3 months, in 3 cases – in 6 months. Besides, despite LMH preventive doses one patient from EVLO group had EHIT II deep vein thrombosis. The obtained outcomes have demonstrated that EVLO and SS have similar effectiveness and safety. No difference has been found between these two types of treatment, except more pronounced postoperative pain and bruising in SS group. Performed care was equally safe and effective in eliminating GSV reflux, in relieving symptoms and eliminating varicose veins as well as in improving the quality of life. Long-term outcomes, especially the rate of relapses depending on the type of intervention, are to be investigated in future trials.

Leech Therapy - A unique treatment in Ayurveda

2019 ◽  
Vol 4 (02) ◽  
Author(s):  
Prasadshakti G. Gannur
Keyword(s):  
Blood Circulation ◽  
Skin Diseases ◽  
Varicose Veins ◽  
Blood Stream ◽  
Blood Capillaries ◽  
Analgesic Property ◽  
Vein Thrombosis ◽  
Leech Therapy ◽  
Medicinal Leeches ◽  
Deep Vein

As mentioned in Ayurveda, Rakta itself is life for human being. If it get vitiated (impure) by means of unhealthy food habits and seasonal change is going to induce many disease. There is a unique worm - Leech which is used therapeutically to treat certain diseases induced by impure blood. Medicinal leeches are used for therapeutic purpose; these will suck only impure blood and relieve the symptoms. While sucking leaches leave saliva into the blood stream, which contain many medicinal properties. Out of which Hirudin is the main content which is having very effective anti-coagulant and analgesic property, because of this analgesic property, the process of sucking is painless. Leaches are mainly used in skin diseases as acne, Kusta, Visarpa, recurrent abscess along with these certain diseases which involve impairment of the blood circulation such as varicose veins deep vein thrombosis non healing ulcers and necrosis are also get benefited by leech therapy which improve the blood circulation by stimulating blood capillaries. Hence in this paper the uses of leech therapy are mentioned for the society to get benefited.

Prophylaxis of Venous Thromboembolism Following Orthopedic Surgery: Mechanical and Pharmacological Approaches and the Need for Extended Prophylaxis

1999 ◽  
Vol 82 (08) ◽  
pp. 918-924 ◽  
Author(s):  
R.D. Hull ◽  
G.F Pineo
Keyword(s):  
Clinical Trials ◽  
Venous Thromboembolism ◽  
Orthopedic Surgery ◽  
Total Joint Replacement ◽  
Case Series ◽  
Pharmacological Agents ◽  
Thrombotic Disease ◽  
Vein Thrombosis ◽  
Major Orthopedic Surgery ◽  
Mechanical Devices

IntroductionMajor orthopedic surgery, particularly total joint replacement or hip fracture, represents a high risk of future development of postoperative venous thromboembolism and warrants the routine use of prophylaxis with either mechanical devices or pharmacological agents. The aim of prophylaxis is to prevent fatal pulmonary embolism (PE) and the morbidity of deep vein thrombosis (DVT), particularly the development of post-thrombotic syndrome. Patterns of clinical practice, with respect to the prevention of venous thromboembolism and the appropriate use of anticoagulants for the treatment of thrombotic disease, have been strongly influenced by recent consensus conferences.1,2 Rules of evidence for assessing the literature have been applied to all recommendations regarding the prevention and treatment of thrombotic disease. These results were extrapolated using evidence gleaned from major clinical disorders and are based only on nonrandomized clinical trials or case series.1-3 Data from a large number of Level I clinical trials in patients undergoing orthopedic surgery have provided answers to many of the questions regarding prophylaxis of venous thromboembolism. In this review, we will discuss the prevention of venous thromboembolism following orthopedic surgery and discuss some of the controversial issues where further studies are required.

Sign in / Sign up

Export Citation Format

Share Document