Tactics of treatment of varicose disease, complicated by thrombosis, using miniinvasive methods

Keywords: varicothrombophlebitis; thrombosis of stem and deep veins of the shin; endovenous laser coagulation; radiofrequency ablation

Abstract

Objective. To determine the treatment tactics for varicose dilation of veins, complicated by thrombosis of subcutaneous veins and the shin deep veins, using miniinvasive methods.

Маterals and methods. The results of treatment in the IGUS named after V. Т. Zaytsev NAMS of Ukraine in 2015 - 2017 yrs of 80 patients, suffering varicothrombophlebitis, were analyzed. The patients were divided into two groups. In Group I 38 patients, suffering varicothrombophlebitis and/or the shin deep vein thrombosis (DVT), were included, who were treated in accordance to the algorithm proposed. In Group II 42 patients with the same pathology were included, to them a standard treatment was conducted.

Results. Immediately after the operation in the Group I patients a severe morbidity, connected with the operation technique (DVT, pulmonary thromboembolism, hemorrhage) were absent. Rate of cutaneous neurological disorders in distal parts of the extremities in patients, to whom endovenous laser coagulation was performed, have constituted 5.2%, and in radiofrequency ablation (RFA) – 2.6%. Due to differentiated approach applied for determination of the operative intervention volume for varicose dilation of veins, complicated by varicothrombophlebitis and/or DVTH of the shin, it became possible to perform operative intervention of lesser traumaticity and to achieve good immediate result in majority of the patients.

In Group II in 1 patient postoperative period have complicated by DVT. Of the local complications lymphorrhea was observed in 5% patients, and in 2 patients – the extended femoral hematomas.

Conclusion. Operative treatment in the RFA volume or endovenous laser coagulation of the stem on the level of reflux with ligature/ablation of perforant veins after conduction of anticoagulant therapy on stage of total recanalization are indicated in patients, suffering thrombosis of the big subcutaneous vein or small subcutaneous vein and deep veins of the shin. In the patients, suffering thrombosis of stem, the deep shin veins after conduction of operative treatment it is mandatory to administer anticoagulant therapy in the treatment dosage during 7 - 14 days, depending on indices of soluble complexes of the fibrin monomers and/or D-dimer.

Author Biographies

V. V. Boyko, Zaytsev Institute of General and Urgent Surgery, Kharkov

Valeriy Boyko – MD, PhD, full professor,
Director of V.T. Zaycev Institute of General and Urgent Surgery
61018, Ukraine, Kharkov, v’ezd Balakireva, 1.
Tel.: 057-349-41-25.
https://orcid.org/0000-0002-9274-2153

Е. G. Cherkasheninov, Kharkоv National Medical University

Evgen Cherkasheninov- graduate student
Khakov National Medical University,
61018, Ukraine, Kharkov, v’ezd Balakireva, 1.
Tel.: 057-349-41-25.
echerk@gmail.com

V. А. Prasol, Zaytsev Institute of General and Urgent Surgery, Kharkov,

Vitaliy Prasol– MD, PhD,
Head of the Department of acute diseases of vessels
V.T. Zaycev Institute of General and Urgent Surgery
61018, Ukraine, Kharkov, v’ezd Balakireva, 1.
Tel.: 057-349-41-71.
ORCID: https://orcid.org/0000-0002-0556-6981

Yu. V. V. Ivanova, Zaytsev Institute of General and Urgent Surgery, Kharkov,

Yulia Ivanova – MD, PhD,
Principal Research Scientist of the Department of surgical infections
V.T. Zaycev Institute of General and Urgent Surgery
61018, Ukraine, Kharkov, v’ezd Balakireva, 1. Tel.: 057-349-41-94.
E-mail: guionxnamnu@mail.ru
https://orcid.org/0000-0001-8773-6827

S. А. Аndreyeshchev, Shupyk National Medical Academy of Postgraduate Education, Kyiv

Sergey Andreyeshchev, MD, PhD, Assistant Professor,
assistant professor Department of Surgery and Transplantology,
Shupyk National Medical Academy of Postgraduate Education.
30 Heroiv Sevastopolia Str., 03680, Kyiv, Ukraina,
Tel: +38 (044) 408-18-11
e-mail: info@hirurgiya.com.ua
ORCID: http://orcid.org/0000-0002-2281-1803

I. S. Pulyaeva, Zaytsev Institute of General and Urgent Surgery, Kharkov,

Inna Pulyaeva – PhD,
Senior Research Scientist of the Department of Acute Vascular Diseases Surgery
V.T. Zaycev Institute of General and Urgent Surgery
61018, Ukraine, Kharkov, v’ezd Balakireva, 1. Tel.: 057-349-41-50.
E-mail: pulyaeva.inna@gmail.com
ORCID: https://orcid.org/0000-0002-6824-7232

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Published
2018-07-26
How to Cite
Boyko, V. V., CherkasheninovЕ. G., PrasolV. А., V. Ivanova, Y. V., АndreyeshchevS. А., & Pulyaeva, I. S. (2018). Tactics of treatment of varicose disease, complicated by thrombosis, using miniinvasive methods. Klinicheskaia Khirurgiia, 85(7), 43-46. https://doi.org/10.26779/2522-1396.2018.07.43
Section
General Problems of Surgery