Endothelium-dependent factors of pathogenesis of a relapse of varicose disease: a diagnostic concept and treatment policy

Shevchenko Yu.L., Stoiko Yu.M., Gudymovich V.G., Nikitina A.M.

Russian National Research Medical University named after N.I. Pirogov, Moscow, Russia

A relapse of lower-limb varicose disease (LLVD), despite the development of surgical achievements in surgical technologies is currently an important problem of present-day phlebology. A considerable factor of its pathogenesis is endothelial dysfunction (ED). The results of clinical studies of “false” relapses (n=32) and the control group were indicative of pronounced ED. Studying the level of leukocytes confirmed a hypothesis on a “leukocytic” trap at the level of the varicose veins of lower extremities. The authors analysed the dynamics of certain markers of ED (CECs, VCAM-1, P-selectin, E-selectin t-RA, endothelin-1), suggestive of the degree of ED severity, revealing a tendency towards normalization of the ED markers on the background of phlebotrophic therapy (Antistax). The carried out study also makes it possible to conclude that the level of endothelemia and biochemical indices of ED may serve as an evaluating marker of the activity of processes of varicose transformation of veins in patients with a relapse of the disease.

KEY WORDS: relapse of varicose disease, markers of endothelial dysfunction, phlebotrophic therapy.

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