Modern approaches to the comprehensive treatment of chronic venous insufficiency of the lower limbs in the stage of trophic disorders
Abstract
Objective. Evaluate the clinical effectiveness of minimally invasive treatment methods for chronic venous insufficiency (CVI) of the lower extremities at the stage of trophic disorders (C6 according to the CEAP classification). Materials and methods. A prospective study included 80 patients, divided into two groups: the main group (n = 40) underwent endovenous laser coagulation (EVLC), radiofrequency ablation (RFA), and perforator vein correction, while the control group (n = 40) received conservative therapy. Results. It was shown that in the main group, complete ulcer healing was achieved in 90 % of patients within 12 weeks, whereas in the control group this figure was 55 % (p 0.01). The recurrence rate during the year was significantly lower with the use of minimally invasive surgery. Thus, minimally invasive treatment methods demonstrate high clinical effectiveness, promote faster ulcer healing and reduce recurrence rates, and may also be considered the preferred therapeutic approach for C6 stage chronic venous insufficiency. Conclusions. The conducted prospective study confirmed the high clinical effectiveness of minimally invasive treatment methods for chronic venous insufficiency of the lower extremities at the stage of trophic disorders (C6 according to the CEAP classification). The use of endovenous laser coagulation and radiofrequency ablation in combination with correction of perforator reflux made it possible to achieve stable healing of trophic ulcers in 90 % of patients within 12 weeks, whereas with conservative therapy alone this indicator was 55 %. Minimally invasive interventions not only accelerate epithelialization of the ulcerative defect, but also significantly reduce recurrence rates, decrease pain, improve venous hemodynamics, and enhance patients’ quality of life. Their safety and suitability for outpatient use make these methods preferable in clinical practice for managing patients with C6-stage chronic venous insufficiency.