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Vascular Surgery 2019
Journal of Vascular and Endovascular Therapy
ISSN: 2573-4482
Page 39
March 28-29, 2019
Rome, Italy
Vascular Surgery
4
th
Edition of World Congress & Exhibition on
“Two-level” varicose veins: myth or reality?
Chernukha L M, Guch A A, Kondratyuk V A, Vlasenko E A
and
Bobrova A O
National Institute of Surgery and Transplantology, Ukraine
Chernukha L M et al., J Vasc Endovasc Therapy 2019, Volume 4
DOI: 10.21767/2573-4482-C1-005
Aims:
The main principle of treatment in patients with
varicose veins (VV) of the lower limbs is the elimination of
pathological venous reflux. In typical cases, reflux forms
in saphenofemoral and/or safenopopliteal junction. The
aim of the study was to identify the possibility of using
minimally invasive interventions in patients with VV of the
lower limbs to eliminate pathological venous reflux formed
above the level of saphenofemoral junction.
Materials & Methods:
Examination of the blood flow in
the ovarian and internal iliac veins in 27 women with VV
of the thigh’ posteromedial surface and gluteal region
was carried out. Color duplex scanning with Valsalva test
was performed for the pelvic and subcutaneous veins
reflux detection. Phlebography and computed tomography
were performed to exclude patients with May-Turner and
nutcracker syndrome.
Results:
Ultrasound signs of pelvic venous insufficiency
were dilated veins of myometrium >4 mm, ovarian veins >8
mm, reverse blood flow during the Valsalva test. Varicose
veins of the perineum were noted in 23 (85.18%) patients,
in 18 (66.66%) VV on the thigh’ medial and posteromedial
surface were observed. The blood reflux on the left ovarian
vein was recorded in 19 (70.37%) cases, on the right - in 7
(25.92%). Analysis of the data led us to the idea of a “two-
level” varicose disease, in which isolated correction of the
pathological venous reflux distal to the inguinal ligament
inevitably led to a recurrence of VV. Endovascular methods
of correction of pathological venous reflux in ovarian veins
were used in 10 patients (37.03%), in 7 of them(70.0%) laser
ablation with 2 ring radial fiber, in 3 (30.0%) - radiofrequency
ablation.
Conclusions:
Elimination of the pathological venous
reflux in ovarian veins may be suggested as the method
of prevention of VV recurrence caused by pelvic venous
insufficiency.
Recent Publications
1. Chernukha L et al. (2016) Epidemiological
aspects of comorbidity of lower limbs chronic
venous disease (CVD) and haemorrhoids: the
results of detect-duo. Іnt Angіol. 35(1-2):83.
2. L M Chernukha, O V Kashyrova, A O Guch, G
G Vlaykov, O A Vlasenko, V A Kondratuk and
I V Gomolyako (2017) Congenital vascular
malformations: features of diagnosis and
treatment (2017) The Hungerian Journal of
Vascular Diseases XXIV(3):17-18.
3. Chernukha L, Kashyrova O, Vlaykov G, Guch A,
Vlasenko O and Kondratyuk V (2018) The main
aspects of diagnostics and treatment of diffuse
arteriovenous forms of congenital vascular
malformations of extremities with the presence
of microfistulas. Acta Phlebologica. 19(2):49-
55..