A complex minimally invasive approach to the treatment of patients with complicated forms of chronic venous insufficiency
DOI:
https://doi.org/10.11603/2414-4533.2023.3.14145Keywords:
chronic venous insufficiency, endovenous welding, great saphenous vein, trophic ulcer, platelet rich plasmaAbstract
The aim of the work: to determine the effectiveness and results of the clinical application of EVEZ with the local treatment of CVI of complicated TV with the help of PRP; to increase the level of efficiency and safety of treatment of patients with CVI.
Materials and methods. The results of 112 EVEW operations in 93 patients with CVI C5–C6 were analyzed. EVEW of the GSV was performed in 90 cases, SSV in 22. The diameters of the jugular segments of the veins were 5.7–28.4 mm, the area of the VLU was 8–84 cm2. The EVEW device provides electrothermal ablation of veins due to denaturation of the venous wall. The duration and power of EVEW is determined automatically, according to the coefficient of relative resistance. The proposed method of preoperative preparation speeds up the processes of VLU cleaning and regeneration.
Results and Discussion. PP is absent in 74 (66.1%) cases, moderate PP in 38 (33.9 %). After 2 years, fibrosis of target veins in 100 % of cases. Paresthesia lasting up to 14 days in 4.5 %. The proposed algorithm of preoperative preparation led to the clearing of the VLU in (14±7.6) days and healing in (27±4.5) days in 95 % of patients. Automatic EVEW algorithm allows to increase the level of efficiency and safety of surgical treatment of patients with veins of large diameters and their extrafascial location, severe forms of CVI with VLU. The use of a complex of preoperative preparation made it possible to achieve complete clearing of the VLU in 90 % of patients by (14±7.6) days. Injections of PRP in the VLU area and the use of EVEW led to epithelization in (27±4.5) days in 95 % of patients.
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