Year 2016 Vol. 24 No 6

EXXHANGE OF EXPERIENCE

N. TORMA 1, I. KOPOLOVETS 2, M. FRANKOVIČOVÁ 3,4, Z. TORMOVÁ 3,4, V. LACKOVÁ 1, G. KOPOLOVETS 1, A. OLOS 2

MINIMALLY INVASIVE TREATMENT OF LOWER LIMB VARICOSITY OF C5-C6 CLASSES (CEAP)

Vascular Center "IMEA СС" 1, Kosice,
The Slovak Republic,
DSME "Uzhgorod National University" 2, Uzhgorod,
Ukraine,
East Slovak Institute of Cardiovascular Diseases “VUSCH “ 3, Kosice
P.I.Safarik University 4, Kosice,
The Slovak Republic

Objectives. To evaluate the results of minimally invasive methods for treatment of chronic venous insufficiency in patients with trophic ulcers.
Methods. In 2015 79 patients with chronic venous insufficiency (CVI) stages C5-C6 according to the CEAP classification had been treated. All the patients were divided into 2 groups. Group I included 45 (60.7%) patients with CVI according to CEAP class C5 (healed venous ulcer). Group II included 34 (39.3%) patients with CVI according to CEAP clinical stage C6 (active venous ulcer). Two types of thermal obliteration procedures: radiofrequency obliteration (VNUS ClosureFast) and endovenous laser obliteration (ELVES – 1470 nm) were used. In general, thermal obliteration of the venous trunks was performed in 69.6% of studied patients. Recrossectomy for recurrent varicose veins was performed in 6.3% of patients; mini-phlebectomy was carried out in 25.3% of cases. 16.5% of patients with incompetent perforating veins underwent sclerotherapy; surgical ligation of incompetent perforating veins was performed in 11.4% of patients.
Results. In the postoperative period within 4-6 months the complete healing of trophic ulcer was observed in 26 (76.5%) patients of group II (CEAP stage C6). In 3-4 months after surgery the reduction of the trophic ulcer area by more than 50% was observed in 3 patients with a large circular defect. Transfascial sclerotherapy of tibial perforating veins due to recurrent ulcer 5 and 7 months after radiofrequency obliteration was performed in 4 patients.
Conclusion. Endovenous methods of treatment of lower extremity varicose vein in patients with trophic ulcers allow to achieve good postoperative results. Complete healing of trophic ulcer was observed in 76.5% of patients. The performance of the local treatment of wounds and adequate compression therapy allowing to achieve the positive results and to eliminate the venous reflux for patients with active ulcer.

Keywords: chronic venous insufficiency, varicose vein disease, venous reflux, radiofrequency obliteration, trophic ulcers, compression therapy, complete healing
p. 623-626 of the original issue
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Address for correspondence:
88000, Ukraine, Uzhgorod,
Universitetskaya st., 10,
VGUZ "Uzhhorod National University".
Tel.: +380 50 558-82-11
E-mail: i.kopolovets@gmail.com
Kopolovets Ivan Ivanovich
Information about the authors:
Torma N. PhD, Vascular Surgeon, "IMEA СС", Kosice, the Slovak Republic.
Kopolovets I. PhD, Researcher of DSME "Uzhgorod National University", Uzhgorod, Ukraine.
Frankovičová M. PhD, Professor, Head of Vascular Surgery Clinic, East Slovak Institute of Cardiovascular Diseases "VUSCH", P.I.Safarik University, medical faculty, Kosice, the Slovak Republic.
Tormová Z. Angiologist, East Slovak Institute of Cardiovascular Disease "VUSCH", Kosice, the Slovak Republic.
Lacková V. Angiologist, Vascular Center "IMEA СС", Kosice, the Slovak Republic.
Kopolovets G. Angiologist, Vascular Center "IMEA СС", Kosice, the Slovak Republic.
Olos A. Surgeon, DSME "Uzhgorod National University", Uzhgorod, Ukraine.
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