EXPERIENCE OF MANAGING PATIENTS WITH PRIMARY VARICOSITY

A study was conducted for optimizing management of patients with varicosity by applying differentiated approach. A total 590 patients with primary lower limbs varicosity were included in study. Clinical investigation in all cases include lab tests and Doppler and duplex ultrasound. Approach for surgical management was specified according to revealed blood flow disturbances. Surgical options include external valve support for incompetent femoral vein, high ligation, stripping, local flebectomy, RFA, EVLA, distant occlusion of posterior tibial veins, posterior tibial veins resection, SEPS, Shave-Тherapy, splitted skin grafting, laser debridement of venous ulcer, sclerotherapy of varicose veins. Statistical analyses were performed using Statistica 10.0 software. Study results showed that pathogenetically based surgical interventions directed for ablation of vertical and horizontal reflux allows to achieve good clinical results. Effective management of patients with primary varicosity could be achieved only by applying pathogenetically based interventions to reflux causes removal. In conclusion, management of patients with primary varicosity should be patient-specific, complex, directed for restoration of blood flow disorders, relief of clinical symptoms and trophic disturbances.