Journal «Angiology and Vascular Surgery» • 

2004 • VOLUME 10 • №4

THE TREATMENT OF VARICOSITY ASSOCIATED WITH PERSISTENT EDEMA OF THE LOWER LIMBS

A.Sh. Serazhetdinov, A.A. Fokin, L.A. Orekhova
Chelyabinsk State Medical Academy. Chelyabinsk Regional Clinical Hospital, Center of Vascular Surgery,
Chelyabinsk, Russia

From February 1998 to September 2002, 36 patients suffering from varicosity of the saphenous veins of the lower limbs associated with edema were operated on. All of them were provided different variants of intraoperative sclerotherapy (IOST). By the character of venous disorders the patients were divided into 2 groups. The first group (n=19) comprised patients with stages 2 and 3 varicosity according to the clinical classification of the CEAP. The maximal diameter of the varicose greater saphenous vein (GSV) in these patients did not exceed 1 cm, with no trophic disorders. The second group (n=17) included patients suffering from stages 2-4 varicosity according to the clinical classification of the CEAP. In these patients, the diameter of the varicose GSV on the thigh exceeded 1 cm and there were trophic disorders on the leg in the form of pigmentation and/or skin induration. The first group patients underwent crossectomy and IOST of the GSV over the whole length. The second group patients were provided combined intervention: crossectomy, GSV stripping on the thigh and IOST: of the GSV on the leg. To define the effectiveness of the surgical treatment using sclerotherapy, the reference group including 38 persons with varicosity also complicated by edema of the lower limbs was under our observation. This group underwent surgical intervention which consisted in radical venectomy according to Babcock and excision of the lateral venous branches according to Narat.

Analysis of the immediate results has demonstrated that in the basic group, the complications occurred in 5.6% of patients versus 29% in the reference group; the postoperative bed day in the basic group was 1.8 times less. Evaluation of the edematous syndrome carried out in the long-term period (after 2 years) showed its complete absence in 96,4% of the basic group patients versus 72.4% of the reference group patients.

So, the use of different variants of IOST in the treatment of patients suffering from varicosity complicated by edema evidences the advantages of the treatment tactics offered by us as compared to the routine surgical techniques.

KEY WORDS: lower limb varicosity complicated by persistent edema; intraoperative sclerotherapy (IOST).

P. 119

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