Diagnostics and Treatment of Varicose Veins of Lower Extremities in Children and Adolescents

Author Name(s): A.L. Mirolyubov, I.N. Nurmeev, L.M. Mirolyubov, N.N. Nurmeev
Author Email: public.mail@ksu.ru

Abstract

Experience of diagnostics and treatment of varicose vein disease in 242 children and adolescents is presented in the article. The aim of the work is to study the experience of use of endovascular and laser technologies in treatment of varicose veins in children and adolescents.

CEAP classification was used in diagnostics. Authors applied open surgery, sclerotherapy, laser coagulation of varicose veins. All results were satisfactory good. There were no complications. Conclusions of the work: the treatment of varicose veins in children and adolescents always required individual approach; timely beginning conservative treatment allows to achieve recovery in a large group of patients; so such tactics are justified as starting in all patients; the use of compression sclerotherapy and endovascular laser obliteration allows to get recovery with best post-operative cosmetic results.

Introduction

Varicose veins of lower extremities are an important medical, social and economic problem. In recent years, there has been a general increase in the incidence of disease, usually in the group of people of working age; the number of complicated forms increases with the outcome of permanent disability. In many cases, the disease occurs already in childhood [8]. Annually, a high increase in new cases is noted [1, 4]. In the second half of the 20th century, significant progress was made in the diagnosis and treatment of varicose veins, but the improvement of therapeutic and diagnostic measures remains an urgent task at the present time.

In the treatment program, there is the trend of the transition from classical surgical interventions to minimally invasive and cosmetically satisfactory methods, such as laser and chemical methods of veins removal. Such a transition was impossible without perfect ultrasound technology.

Among modern methods of treatment of varicose veins, sclerosing treatment (compression sclerotherapy) can be singled out. It is performed by the administration of liquid and foam preparations into the lumen of the vein with its subsequent obliteration [7]. Such treatment is characterized by minimal invasiveness, does not require general anesthesia, allows to avoid temporary incapacity for work. However, the use of the sclerotherapy method is accompanied by a potential risk of developing deep vein thrombophlebitis, in case of accidental penetration of the sclerosing substance in them [2]. Sclerosing treatment of varicose veins in children’s surgical practice has not been worked out. Separately, it should be noted the lack of permission for use of sclerosing drugs in children, in the annotations to this drug.

The methods of percutaneous and endovasal laser coagulation of veins, which are chronologically younger, rapidly spread around the world. This is connected with their acceptable therapeutic and aesthetic results [3, 5]. In adult surgical practice, the issue of endovasal laser removal of veins has been worked out in detail, while the possibilities and peculiarities of treating adolescent patients in the literature has not been covered [6].

OBJECTIVE: To study the possibilities and generalize the experience of using intravascular and laser technologies in the treatment of varicose veins in children and adolescents.

Performing of conservative treatment program is more effective in the adolescent group of patients, where the stabilization of the disease occurs more often by 4.25 times than in adult patients, and in 13.6% complete cure is achieved. In the treatment of adolescent patients, EVLA provides an effective and safe occlusion of varicose veins.

The introduction of new method of stem sclerotherapy of varicose veins and the optimization of the use of endovenous laser ablation allow to achieve recovery with a reliable improvement in the quality of patients’ life.

The research was prepared in the framework of the grant of the President of the Russian Federation MD-809.2013.7

 

Acknowledgements

The work is performed according to the Russian Government Program of Competitive Growth of Kazan Federal University.

 

References

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