EVLT and Foam-form Sclerotherapy as a C6 Stage Varicose Treatment.

Abstract

Introduction: The issue of treating varicose veins in C6 stages are becoming more and more significant in medical community. This condition is one of the most common lesions of peripheral vessels. Treatment of varicose veins compounds of various therapeutic measures, including: conservative therapy, surgical treatment and sclerotherapy. As of right now, the methods introduced above cannot completely rid the patient of varicose veins problems, as they do not meet all the pathogenetic principles of treatment, and therefore cannot be considered universal. Objective.To evaluate the efficiency of step-by-step treatment in patients with varicose veins at C6 stage. Methods: A prospective complex step-by-step treatment analysis of 58 patients with decompensated forms of varicose veins at stage C6. The average age of the patients was 59±5.6 years.There were 15 men and 43 women.Etiologic factor in the development of venous ulcers in 36 patients had reflux on the trunk of the great saphenous vein in 12 patients with reflux on the trunk of the SSF, and in 10 patients reflux perforating veins of the lower leg and thigh.After ultrasound duplex scanning, all patients underwent a stage of conservative treatment for 1 month, which included: constant wearing of compression stockings, Diosmin 600 mg per day, Sulodexide 250 LSU (25 mg)2 times per day, and aseptic dressings of trophic ulcers.The next stage consisted of endovenous laser treatment (EVLT) of varicose veins. After one week, sclerotherapy of separately expanded varicose inflows and perforators in induration zones was given to minimize operational injury. Results: During the step-by-step treatment, 25 (43.1%) patients managed to fully trophic ulcers epithelize before EVLT and sclerotherapy, at the stage of conservative treatment. In 50 (86,2%) patients, complete healing of ulcers was noted at the stage of EVLT (pic.1). And only in 8 (13,7%)patients, who had extensive, circular varicose ulcers, markedly complete healing in a 3-6 months after EVLT and stage sclerotherapy. It should be noted that varicose disease C6 step-by-step treatment is not only effective in the compound of treatment measures but also positively affects the patients’ emotional background. At the first stage of treatment, patients noted reduction of pain syndrome, swelling and fatigue in the legs. After EVLT, none of the patients complained about having pain in trophic ulcers area . During the step-by-step treatment of varicose at C6 stage, not a single patient experienced worsening of ulcers, erysipelas or inflammation at the sites of puncture or sclerosant introduction. Conclusion: Step-by-step treatment in patients with varicose disease at C 6 stage using compression therapy, drug treatment, EVLT and sclerotherapy, is a pathogenetically substantiated and effective treatment method achieves satisfactory results in a short period of time. Further observations are needed to compare standard surgeries and minimally invasive methods as treatment for stage C6 varicose veins.