Automatic regime of endovenous electric welding in treatment of varicose disease of the lower extremities
Objective. To study up the application efficacy of automatic regime in endovenous electric welding (EVEW) in treatment of varicose disease of the lower extremities (VDLE).
Materials and methods. Automatic regime of EVEW was investigated on excised segments of big subcutaneous vein (BSV), registering the temperature, resistance and morphological changes. The results of the method application in 56 patients, suffering VDLE Classes C2 - C5 (in accordance to the CEAP classification were analyzed - clinic, etiology, anatomy, pathogenesis): in 21 men and 35 women ageing 18 - 63 yrs old. Postoperative pain, anatomic result and complications have served as a criteria for the outcome estimation. The intervention was performed under infiltrative anesthesia using 0.125% solution of bupivacaine. The results were determined using ultrasound angioscanning in 14 days, 3 and 6 mo.
Results. During automatic cycle of EVEW (5 - 12 sec) the BSV occlusion in 55 - 75 °C temperature have occurred. The vein alteration on the depth of endothelial and subendothelial layers without damage of endothelial layer and paravasal cellular tissue was determined. Postoperative pain was moderate. Fibrous transformation (FT) of BSV in 6 mo was determined in 55 (98.2%) patients. Ecchimosis and paresthesia were observed in 4 (7.1%) and 2 (3.6%) patients.
Conclusion. Automatic regime of EVEW, which is based on interrelationship of electric parameters of welding and resistance of tissues, providing the BSV occlusion with further FT, is accompanied by low heat of vein and excludes the impact of subjective factors on results of the operation.
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