Endovenous obliteration in the combined treatment of chronic venous diseases

Abstract

The modern approach to the treatment of chronic venous insufficiency and varicose veins utilizes physical techniques for endovasal obliteration. It is characterized by significantly fewer side effects and opens new possibilities for the treatment of patients with varicose disease. Purpose: To evaluate the effectiveness of radiofrequency obliteration of varicose veins and puncture laser obliteration of perforant veins in the combined treatment of patients with varicose disease (VD). Material and methods. Outcomes of treatment of 528 patients with VD in the pool of the great saphenous vein (GSV) or small saphenous vein (SSV) have been analyzed. These patients had the combined treatment, which included radiofrequency obliteration of GSV and SSV trunk and / or Giacomini vein. Of these, 335 patients had also ECHO Foam-Form sclero-obliteration of GSV and SSV inflows and perforant veins on the thigh and / or ankle. In 266 patients, their treatment was combined with miniphlebectomy of GSV and SSV inflows and perforant veins on the thigh and / or ankle; and in 55 patients – with puncture laser obliteration of perforant veins. Results. The assessment of curative outcomes have has shown that postoperative pain intensity (VAS) was 3.1 + 0.5. Transient paresthesias were seen in 14 (3.4%) cases. Local ecchymoses – in 18 (4.3%) cases. Consequences of tumescent anesthesia: local ecchymoses and hyposthesia passed after 3–5 days. Skin pigmentation was noted in 1 case and lasted up to 3 months. Thrombosis was registered in 2 cases as a parietal thrombus in the great saphenous vein at the level of the middle third of the thigh; and in 2 cases as a thrombotic clot prolapse.