Novosti
Khirurgii

 This journal is
indexed in Scopus
journal cover
android icon Android Applicaion

Year 2013 Vol. 21 No 3

INFORMATION TECHNOLOGIES IN SURGERY

S.A. SUSHKOU, G.D. KOROBOV, O.D. MYADELETS

A METHOD OF DETECTION OF POSTERIOR TIBIAL VENOUS WALL ATROPHY AT VARICOSE DISEASE

EE “Vitebsk State Medical University”
The Republic of Belarus

Objectives. To work out the diagnostic method of atrophy of the posterior tibial veins wall at varicose disease.
Methods. Morphological changes in the wall of the posterior tibial veins at varicose disease were studied in 43 patients (females – 26/60,5%, males – 17/39,5%). The patient’s age varied between 24-66, the average age – 46,9±8,5 years (̱σ). Disease duration oscillated between 1-30 years (the average – 12,7±7,3 ëåò years, ̱σ). The material for histological studies was taken during operations from the posterior tibial veins. The histological preparations were stained with hematoxylin-eosin, examined by Heidenhain and studied by means of light microscopy. Volumetric ratios of tissue components were evaluated by the method of G.G. Avtandilov. The age, duration of disease, character of work activity, body mass index, degree of retrograde flow in the femoral and popliteal veins were considered as the influencing factors. For probabilistic model providing the diagnostics of atrophic processes in the deep veins the discriminant analysis, logistic regression, ROC-analysis have been used as a basis of the most available clinical data.
Results. The simulative probabilistic model permitted to suggest a diagnostic method providing the detection of atrophic processes in the posterior tibial veins on the results basis of available instrumental and clinical studies has been worked out. Verification of the method in the control samples showed that all cases of diseases for which presence of atrophy was revealed by using the expert way (conclusion of a histologist), have been classified correctly with the help of calculated values (there were no false-negative diagnoses). Only in one case among patients without histologically detected arthrophy the calculated value turned out to be false positive which composed 10%. The sensitivity of the worked out method was 88,2%, specificity – 88,5%.
Conclusions. The worked out non-invasive evaluation method of the venous wall of the posterior tibial vein can be used to determine the tactics and choice of treatment of varicose disease.

Keywords: primary varicose veins, condition of deep veins, morphological changes of the venous wall, diagnostics
p. 90 – 102 of the original issue
References
  1. Zhukov BN, Katorkin SE. Innovatsionnye tekhnologii v diagnostike, lechenii i meditsinskoi reabilitatsii bol'nykh khronicheskoi venoznoi nedostatochnost'iu nizhnikh konechnostei [Innovative technologies in diagnosis, treatment and rehabilitation of patients with chronic venous insufficiency of the lower limbs]. Samara, RF: Litfond 2010; 383 p.
  2. Mironiuc A, Palcau L, Andercou O, Rogojan L, Todoran M, Gordan G. Clinico-histopathological correlations of venous wall modifications in chronic venous insufficiency. Chirurgia (Bucur). 2008 May-Jun;103(3):309–12.
  3. Lim CS, Davies AH. Pathogenesis of primary varicose veins. Br J Surg. 2009 Nov;96(11):1231–42. doi: 10.1002/bjs.6798.
  4. Budd TW, Meenaghan MA, Wirth J, Taheri SA. Histopathology of veins and venous valves of patients with venous insufficiency syndrome: ultrastructure. J Med. 1990;21(3-4):181–99.
  5. Fuchs U, Petter O. Morphologic studies of the conductive veins of the leg in superficial varicose veins. Z Gesamte Inn Med. 1990 Feb 15;45(4):121–3.
  6. Leu HJ, Vogt M, Pfrunder H, Odermatt BF. Phlebosclerosis: disorder or disease? Vasa. 1991;20(3):230–6.
  7. Bogachev VIu, Golovanova OV., Kuznetsov AN, Shekoian AO. Bioflavonoidy i ikh znachenie v angiologii. Fokus na diosmin [Bioflavonoids and their role in angiology. Focus on diosmin]. Angiologiia i Sosudistaia Khirurgiia. 2013;19( 1): 73–81.
  8. Perrin M, Ramelet AA. Pharmacological treatment of primary chronic venous disease: rationale, results and unanswered questions. Eur J Vasc Endovasc Surg. 2011 Jan;41(1):117–25.
  9. Kirienko AI, Bogachev VIu, Zolotukhin, IA, Panina NG. Vliiaet li ekstravazal'naia korrektsiia klapanov bedrennoi veny na techenie varikoznoi bolezni? [Does extravasal correction of femoral vein valves influence on varicose disease?]. Angiologiia i Sosud Khirurgiia. 2002;8(2): 39–44.
  10. Gavrilenko AV, Sandrikov VA, Vakhrat'ian PE, Dutikova EF, Fateeva IE. Rol' klapannoi nedostatochnosti bedrennoi veny v techenii i retsidivirovanii varikoznoi bolezni nizhnikh konechnostei [The role of valvular insufficiency of the femoral vein in the course and recurrence of varicose veins of the lower extremities]. Angiologiia i Sosudistaia Khirurgiia. 2006;12(3): 61–6.
  11. Lane RJ, Cuzzilla ML, McMahon CG. Intermediate to long-term results of repairing incompetent multiple deep venous valves using external valvular stenting. ANZ J Surg. 2003 May;73(5):267–74.
  12. Wang SM, Hu ZJ, Li SQ, Huang XL, Ye CS. Effect of external valvuloplasty of the deep vein in the treatment of chronic venous insufficiency of the lower extremity. J Vasc Surg. 2006 Dec;44(6):1296–300.
  13. 13 Rosales A, Slagsvold CE, Kroese AJ, Stranden E, Risum O, Jorgensen JJ. External venous valve plasty (EVVP) in patients with primary chronic venous insufficiency (PCVI). Eur J Vasc Endovasc Surg. 2006 Nov;32(5):570–6. Epub 2006 Aug 21.
  14. Zhukov BN, Katorkin SE, Zhukov AA, Kravtsov PF, Isaeva ES. Kliniko-funktsional'nyi analiz variantov operativnykh vmeshatel'stv pri oslozhnennykh formakh khronicheskoi venoznoi nedostatochnosti s pozitsii dokazatel'noi meditsiny [Clinical and functional analysis of the options for surgery in complicated forms of chronic venous insufficiency in terms of evidence based medicine]. Khirurg, 2012(7):45–51
  15. Sushkov SA, Miadelets OD, Samsonova IV, Nebylitsin IuS, Sushkova OS, Kugaev MI. Morfologicheskie izmeneniia v stenke zadnikh bol'shebertsovykh ven pri varikoznoi bolezni nizhnikh konechnostei [Morphological changes in the posterior tibial vein wall with varicose disease of the lower extremities]. Vestn VGMU. 2006;.5(2):73–9.
  16. Sushkov SA, Miadelets OD, Korobov GD. Sravnitel'nyi analiz morfologicheskikh izmenenii v glubokikh venakh pri raznykh formakh varikoznoi bolezni [Comparative analysis of morphological changes in the deep veins of various forms of varicose disease]. Flebologiia. 2012;.6(3): 46-51.
Address for correspondence:
210023, Respublika Belarus', g. Vitebsk, pr. Frunze, d. 27, UO "Vitebskii gosudarstvennyi meditsinskii universitet", kafedra obshchei khirurgii,
e-mail: sergery@nm.ru,
Sushkou Sergei Al'bertovich
Information about the authors:
Sushkou S.A. PhD, associate professor, vice-rector on scientific research work of EE “Vitebsk State Medical University”.
Korobov G.D. PhD, associate professor of public health and public health care of EE “Vitebsk State Medical University”.
Myadelets O.D. MD, professor, a head of histology, cytology and embryology chair of EE “Vitebsk State Medical University”.
Contacts | ©Vitebsk State Medical University, 2007-2023