FACTORS INFLUENCING THE EFFECTIVENESS OF ENDOVASAL CHEMICAL ABLATION OF VEINS IN VARICOSE VEINS DISEASE WITH COMORBID DIABETES MELLITUS TYPE 2

Authors

DOI:

https://doi.org/10.11603/2414-4533.2024.1.14641

Keywords:

varicose veins, diabetes mellitus, microelements, carbohydrates, chemical ablation

Abstract

The aim of the work: to evaluate the effectiveness of endovasal chemical vein ablation in the treatment of VVD with comorbid DM-2; determine the factors likely to affect the effectiveness of treatment; to determine the dynamics of the microelements (ME) level, which take part in carbohydrate metabolism in this category of patients; identify prognostic criteries.

Material and Methods. An analysis of the treatment of 99 patients with VVD was carried out (17.2 % men and 82.8 %, average age 48 years). C4-C6 classes (CEAP) were observed in 67.7 % of cases. Comorbid DM-2 was diagnosed in 12.1 % of patients. The ratio of mild, moderate, and severe diabetes was 1:3:2, and the phases of compensation, subcompensation, and decompensation were 1:6:5. Polidocanol (Lauromacrogol 400) in a concentration of 1-3% in the form of a foam was used for EVCA.

Results. One month after endovasal chemical ablation (EVCA), significant improvement was noted in 11.8 % of cases in men and 41.5 % of women. Also, the effectiveness of the treatment after 1 month is influenced by the age of the patients, initial blood pressure values, systolic volume, peripheral vascular resistance and vascular autonomic index, degree of venous insufficiency, past phlebothrombosis, use of rivaroxaban, vein diameter (DV). Simultaneous direct variance-correlation relationships of treatment effectiveness at the first follow-up stage relate to baseline INSl/s, and negative relationships to CPl/s and FAl/s. An unfavorable factor is a high initial value of CPl/s (where INS-insulin, CP-C-peptide, FA-fructosamine, l/s is the ratio of the indicator in the varicose and ulnar veins). 6 months after the performed EVCA, compared to the control group and initial concentrations, chromium content increases (by 8 %) in patients, and in comparison with the initial values, Se and Zn levels increase by 2 % and 9 % in patients with VVD.

The results of EVCA in female patients are better, there are fewer complications, which depend on the state of systemic hemodynamics, the degree of venous insufficiency, past phlebothrombosis and the diameter of the varicose vein, parameters in the blood from it INS, CP and FA, and from the ulnar vein – associated with carbohydrate metabolism of trace elements (Cr, Mn, Zn). Prognostic criteria were identified, while an increase in the levels of Cr, Se, and Zn was recorded in patients who underwent EVCA.

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Published

2024-03-04

How to Cite

SHAPRINSKIY, V. O., ZHARIKOV, S. O., PYLYPENKO, R. V., & TAHEIEV, V. R. (2024). FACTORS INFLUENCING THE EFFECTIVENESS OF ENDOVASAL CHEMICAL ABLATION OF VEINS IN VARICOSE VEINS DISEASE WITH COMORBID DIABETES MELLITUS TYPE 2. Hospital Surgery. Journal Named by L.Ya. Kovalchuk, (1), 27–34. https://doi.org/10.11603/2414-4533.2024.1.14641

Issue

No. 1 (2024)

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ORIGINAL INVESTIGATIONS

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Copyright (c) 2024 В. О. ШАПРИНСЬКИЙ, С. О. ЖАРІКОВ, Р. В. ПИЛИПЕНКО, В. Р. ТАГЕЄВ

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