Year 2014 Vol. 22 No 5

GENERAL AND SPECIAL SURGERY

B.S. SUKOVATUKH, M.B. SUKOVATUKH

THE APPROACH TO THE TREATMENT OF INCOMPETENT PERFORATING VEINS IN PATIENTS WIH THE LOWER LIMB VARICOSE VEINS

SBEE HPE Kursk State Medical University,
The Russian Federation

Objectives. To study the correlation of the blood refluxes and on its basis to substantiate the approaches in treatment of incompetent perforating veins in patients with the lower limb varicose disease.
Methods. The analysis of the integrated examination and treatment of 181 patients suffering from varicose veins (CEAP class C3-C6) has been conducted. All patients were divided into two groups. 106 (58,6%) patients with class C3 were enrolled into the first group. The second group included 75 (41,4%) patients with class C4-C6. Duplex ultrasound is being performed to determine localization, intensity and extension of blood refluxes in the venous system of the affected limb.
Results. In 75,5% of patients with class C3 (the 1st group) the moderate intensive superficial blood reflux along the great saphenous vein in the thigh and upper third of the leg resulted to the incompetence of solitary perforating veins has been revealed. In 88% of patients with class C4-C6 (the 2nd group) a superficial blood reflux of high intensity extended from the groin until the malleolus. The reflux was considered to be responsible for the multiple perforating incompetence. Deep venous reflux in the 1st group of patients was noticed only in 10,4%.
It was of low intensity without any negative impact on perforating veins. Incompetence of deep vein valves in the 2nd group was detected in 36% of patients. It was clear that in 22,7% of patients a deep reflux was of high intensity caused the multiple incompetence of perforating veins.
Conclusion. The incidence of the venous reflux in perforating veins is considered to be directly depended on the intensity of blood reflux in superficial and deep veins. The higher occurrence of reflux expression, the more incidences of incompetent perforating veins has revealed.

Keywords: varicose veins, blood refluxes, perforating incompetence, surgical treatment
p. 553-559 of the original issue
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Address for correspondence:
305041, Rossiyskaya Federatsiya,
g. Kursk ul. K. Marksa 3,
GBOU VPO Kurskiy gosudarstvennyiy meditsinskiy universitet,
kafedra obschey khirurgii,
tel.: (4712) 52-98-62,
e-mail: SukovatykhBS@kursksmu.net,
Sukovatykh Boris Semenovich
Information about the authors:
Sukovatykh B.S. MD, professor, a head of the general surgery chair of SBEE HPE Kursk State Medical University.
Sukovatykh B.S. PhD, an associate professor of the general surgery chair of SBEE HPE Kursk State Medical University.
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