Elimination of perforating reflux in patients with postthrombotic syndrome

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The symptoms of post-thrombotic disease are known to develop in a large number of the patients who underwent deep venous thrombosis of the lower extremities. In the majority of such cases the disease begins within one or two years after acute thrombosis and becomes progressively more severe in the course of time. Trophic ulcers occur in most patients in the absence of special treatment. Perforating vein reflux is considered to be one of the causes of the development of trophic complications. The present article presents an overview of the methods for the management of perforating vein reflux in the patients with post-thrombotic disease. At present, there is no universal opinion concerning the effectiveness of endovasal techniques for the treatment of perforating vein reflux associated with post-thrombotic disease. Both direct and endoscopic variants of perforant vein dissection are currently recognized to be only of historical interest due to their injuriousness and low effectiveness as regards relief of clinical symptoms, in the first place trophic ulcers. As far as the endovasal methods for the treatment of perforating vein reflux are concerned, only their technical aspects may be currently regarded as being fairly well developed. The results of the application of both phlebosclerosing therapy of compromised perforant veins and thermal (laser or radiofrequency) ablation as well as the possibility of using these modalities for the treatment of the patients with open and healed trophic ulcers during post-thrombotic disease were analyzed in a small number of studies and await further careful assessment.

Keywords:

postthrombotic syndrome

perforating vein

incompetence

dissection

laser ablation

radiofrequency ablation

Authors:

Khabazova K.R.

Kafedra fakul'tetskoĭ khirurgii #1 lechebnogo fakul'teta Rossiĭskogo natsional'nogo issledovatel'skogo meditsinskogo universiteta im. N.I. Pirogova

Smirnova E.S.

Kafedra fakul'tetskoĭ khirurgii #1 lechebnogo fakul'teta Rossiĭskogo natsional'nogo issledovatel'skogo meditsinskogo universiteta im. N.I. Pirogova

Lobanov V.N.

First Phlebology Center, Moscow, Russia

Seliverstov E.I.

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

SPIN RSCI: 9011-1989
Scopus AuthorID: 24332884500
ORCID: 0000-0002-9726-4250

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