Endovascular laser coagulation in varicose vein relapses in the lower extremities
A. I. Chernookov,
S. I. Kandyba,
E. S. Silchuk,
S. I. Dolgov,
A. A. Atayan,
Yu. N. Lebedeva,
A. A. Ramazanov https://doi.org/10.37895/2071-8004-2022-26-2-8-14
Abstract
Objective. To study the effectiveness of endovascular laser coagulation in patients with recurrent varicose veins in their lower extremities.
Material and methods. Outcomes after the treatment of 54 patients with varicose vein relapses in the lower extremities were analyzed. Under the tumescent anesthesia, endovascular laser coagulation was made: in 5 patients – stump of the great saphenous vein; in 22 patients – recanalized, residual and preserved subcutaneous venous trunks; in 27 patients – insufficient communicating veins of the thigh and lower leg.
Results and discussion. In average, surgery lasted for 31 ± 0.6 minutes; intensity of the postoperative pain syndrome was 3.4 ± 0.4 points. Early postoperative complications were registered in 1 (1.8 %) patient, side effects in the form of hyperpigmentation and paraesthesia – in 4 (7.4 %). In 12 months, all operated patients demonstrated an improvement in all parameters of their quality of life by 29.2– 40 %; cosmetic outcome after surgery was 7.8 points out of a ten-point scale. The long-term observation revealed the relapse in varicose veins only in 1 (1.8 %) patient.
Conclusion. The justified use of endovasal laser coagulation in patients with relapses of varicose veins in the lower extremities allows to avoid manipulations in the area of scar-altered tissues, to reduce tissue damage and duration of surgery, to improve patients’ quality of life, to avoid additional incisions as well as to improve cosmetic outcomes after surgery.
About the Authors
A. I. Chernookov
Moscow State University of Food Production
Russian Federation
Russian Federation
Alexandr Chernookov – Dr. Sci. (Med.), Professor of Department of Injury Surgery
Moscow
S. I. Kandyba
Branch No 5, N.N. Burdenko Military Hospital
Russian Federation
Russian Federation
Sergey Kandyba – Cand. Sci. (Med.), Head of Surgical Department
Moscow
E. S. Silchuk
Center of Phlebology
Russian Federation
Russian Federation
Evgeny Silchuk – Cand. Sci. (Med.), Head of the Surgical Department
Moscow
S. I. Dolgov
Center of Phlebology
Russian Federation
Russian Federation
Sergey Dolgov – Head of Surgery Department
Moscow
A. A. Atayan
Sechenov Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Andrey Atayan – Cand. Sci. (Med.), Associate Professor, Department of Hospital Surgery
Moscow
Yu. N. Lebedeva
Branch No 5, N.N. Burdenko Military Hospital
Russian Federation
Russian Federation
Yulia Lebedeva – Cand. Sci. (Med.), Associate Professor of Department of Injury Surgery
Moscow
A. A. Ramazanov
Clinical Center for Restorative Medicine and Rehabilitation
Russian Federation
Russian Federation
Arthur Ramazanov – surgeon
Moscow
References
1. Haman S.A.S., Giang J., De Maeseneer M.J.R., NiJsten T.E.C., Van den Bos R.R. Editor´s Choice – five year results of great saphenous vein treatment a metaanalysis. Eur. J. Vasc. Endovasc. Surg. 2017; 54(6): 760–770. DOI:10.1016/j.ejvs.2017.08.034
2. Lukyanenko M.Yu., Starodubtsev V.B., Karpenko A.A., Sergeevichev D.S. Laser technologies in the treatment of chronic venous insufficiency in patients with a wide ostial segment of the main trunks of subcutaneous veins. Angiology and Vascular Surgery 2014; 20(1): 96–100 [In Russ.].
3. Chernookov A.I., Ramishvili V.Sh., Dolgov S.I., Nikolaev A.M., Atayan A.A., Belykh E.N. Modern strategy of treatment of patients with relapses of varicose veins after endovasal interventions. Medical News of Georgia. 2021; 4: 26–33. DOI:10.21518/1995-1477-2021-18-2-124-130
4. Van Groenendael L., Van der Vliet J.A., Fllinkenfl ogel L., Roovers E.A., Van Sterkenburg S., Reijnen M. Treatment of recurrent varices of the great saphenous vein by conventional surgery and endovenous laser ablation. Journal Vascular Surgery. 2009; 50(5): 1106–1113. DOI:10.1016/j.jvs.2009.06.057
5. Duvanskiy V.A., Azizov G.A. Features of regional microcirculation in patients with chronic venous insufficiency stage C6. Lazernaya medicina . 2011; 15(1): 12–15 [In Russ.].
6. Gavrilenko A.V., Vakhratyan P.E., Oskolkova S.A. Causes of relapse of varicose veins of the lower extremities. Annalikhirurgii. 2013; 1: 41–44 [In Russ.].
7. Potapov M.P., Staver V.E., Dyakiv A.D., Parshchenko A.F. Features of phlebohemodynamics in relapse of varicose veins of the lower extremities. Zdorovie i obrazovanie v XXI veke. 2017; 19(1) pp. 43–46 [In Russ.].
8. Sadriev O.N., Kalmykov E.L., Gaibov A.D., Inoyatov M.S. Relapse of varicose veins after phlebectomy. Rossiyskiy mediko-biologicheskiy vestnik imeni akademika I.P. Pavlova. 2016; 24(1): 86–90. DOI:10.17816/PAVLOVJ2016186–90 [In Russ.].
9. Sushkov S.A. Postoperative relapse of varicose veins of the lower extremities. Novosti khirurgii. 2008; 16(4), issue 2: 163–177 [In Russ.].
10. Theivacumar N.S., Darwood M.J., Gough M.J. Neovascularisation and recurrence 2 years after varicose vein treatment for sapheno-femoral and great saphenous vein reflux: a comparison of surgery and endovenous laser ablation. Eur. J. Vasc. Endovasc. Surg. 2009; 38(2): 203–207. DOI:10.1016/j.ejvs.2009.03.031
11. Zolotukhin I.A., Seliverstvov E.I., Zakharova E.A., Kiriyenko A.I. Isolated removal of tributaries of the insolvent great saphenous vein leads to functional restoration of its valves. Phlebologia. 2016; 10(1): 8–16. [In Russ.] DOI:10.17116/flebo20161018-16
12. Raskin V.V., Semenov A.Yu., Kurginyan H.M. Endovenous laser obliteration in prevention of varicose vein recurrences in the basin of the anterior accessory saphenous vein. Profilakticheskaya medizina. 2020; 23(3): 98–103 [In Russ.] DOI:10.17116/profmed20202303198
13. Abud B., Kunt A.G. Midterm varicose vein recurrence rates after endovenous laser ablation: comparison of radial fibre and bare fibre tips. Interactasc. Cardiovasc. Thorac. Surg. 2021; 32(1): 77–82. DOI:10.1093/icvts/ivaa219
14. Hinchliffe R.J. et al. A prospective randomized controlled trial of VNUS closure versus surgery for the treatment of recurrent long saphenous varicose veins. Eur. J. Vasc. Endovasc. Surg. 2006; 31(2): 212–218. DOI:10.1016/j.ejvs.2005.07.005
15. Cavallini A., Marcer D., Ruffino S. Endovenous laser treatment of groin and popliteal varicose veins recurrence. Phlebology. 2018; 33(3): 195–205. DOI:10.1177/0268355516687865
16. Gaibov A.D., Nematzoda O., Burieva Sh.M., Kalmykov E.L. Experience in mechanochemical scleroobliteration in the treatment of varicose vein relapses in lower extremities. Rossiyskiy mediko–biologicheskiy vestnik imeni akademika I.P. Pavlova. 2020; 28(1): 57–66. [In Russ.] DOI:10.23888/PAVLOVJ202028157–66
17. Pavei P. Ferini M., Spreafi co G., Nosadini A. Ultrasound guided foam sclerotherapy of recurrent varices of the great and small saphenous vein: 5-year follow up. Veins and Lymphatics. 2014; 3: 46–55. DOI:10.4081/vl.2014.4655
18. O’Donnell T.F., Balk E.M., Dermody M., Tangney E., Iafrati M.D. Recurrence of varicose veins after endovenous ablation of the great saphenous vein in randomized trials. J. Vasc. Surg: Venous and Lym. Dis. 2016; 97(4): 97–105. DOI:10.1016/j.jvsv.2014.11.004
Review
For citations:
Chernookov A.I., Kandyba S.I., Silchuk E.S., Dolgov S.I., Atayan A.A., Lebedeva Yu.N., Ramazanov A.A. Endovascular laser coagulation in varicose vein relapses in the lower extremities. Laser Medicine. 2022;26(2):8-14. (In Russ.) https://doi.org/10.37895/2071-8004-2022-26-2-8-14
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