Minimally invasive management of chronic venous insufficiency: A case report on combined radiofrequency ablation and sclerotherapy in an obese patient

International Journal of Surgery Case Reports, Journal Year: 2025, Volume and Issue: 130, P. 111290 - 111290

Published: April 12, 2025

Chronic venous insufficiency (CVI) affects a significant portion of the population, particularly impacting those with obesity. This condition leads to various symptoms, including leg discomfort and edema, contributing work absenteeism. Traditional surgical procedures, like saphenous vein stripping phebectomy, are increasingly supplanted by minimally invasive techniques, such as radiofrequency ablation (RFA) sclerotherapy, which reduce invasiveness associated complications, beneficial for high-risk patients, A 22-year-old male patient BMI 41, suffering from severe varicose veins, hypertension, diabetes, obstructive sleep apnea. The underwent simultaneous RFA sclerotherapy after imaging confirmed incompetence but ruled out deep thrombosis. procedure, performed under spinal anesthesia, resulted in successful obliteration great vein, no postoperative complications. literature highlights advantages endovascular techniques over traditional open surgery, patients comorbidities that elevate risks. Studies support efficacy combining showing improved outcomes reduced recurrence rates. combined approach minimizes complications provides quicker recovery, making it suitable option patients. Our experience findings suggest paired is an effective treatment modality managing CVI,

Language: Английский

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A Systematic Review of Endothelial Dysfunction in Chronic Venous Disease—Inflammation, Oxidative Stress, and Shear Stress

International Journal of Molecular Sciences, Journal Year: 2025, Volume and Issue: 26(8), P. 3660 - 3660

Published: April 12, 2025

Chronic venous disease (CVD) is among the most common diseases in industrialized countries and has a significant socioeconomic impact. The diversity of clinical symptoms manifestations CVD pose major challenges routine diagnosis treatment. Despite high prevalence huge number surgical interventions performed every day, substantial proportion etiopathogenesis remains unclear. There are several widely advocated generally valid theories “peri-capillary fibrin cuffs” “white cell trapping hypothesis”, which consider role reflux/obstruction, inflammation, vascular remodeling, hemodynamic changes, genetic social risk factors. specific provoking factors for development reflux: incompetence valve system, inflammation wall, hypertension. Over past few years, increasing scientific data demonstrated link between oxidative stress, endothelial dysfunction, inflammation. High levels oxidants persistent can cause cumulative changes hemodynamics, resulting permanent irreversible damage to microcirculation cells. Production reactive oxygen species expression inflammatory cytokines adhesion molecules involved vicious cycle wall remodeling. interaction ROS, particular, superoxide anion radical, with nitric oxide leads decrease NO bioavailability, followed by initiation prolonged vasoconstriction hypoxia impairment tone. This review addresses ED, oxidative, stress mediation. Based on predefined inclusion exclusion criteria, we conducted systematic published articles using PubMed, PMC Europe, Scopus, WoS, MEDLINE, Google Scholar databases interval from 24 April 2002 1 2025. current included studies (n = 197) articles, including new reviews, updates, grey literature, were evaluated according eligibility criteria. selection process was standardized form PRISMA rules, manual search databases, double-check ensure transparent complete reporting reviews. Studies had report quantitative assessments relationship shear chronic disease.

Language: Английский

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Transpersonal aspects of venous disease, an opportunity to improve its management

Acta Phlebologica, Journal Year: 2025, Volume and Issue: 26(1)

Published: April 1, 2025

Language: Английский

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Fixed-dose ruscus extract combination and its place in current clinical guidelines for the treatment of chronic venous diseases

Ambulatornaya khirurgiya = Ambulatory Surgery (Russia), Journal Year: 2025, Volume and Issue: unknown

Published: April 15, 2025

Chronic venous diseases (CVD) is the most common lower extremity vascular pathology. Various vein-specific symptoms and syndromes associated with CVD negatively affect all components of quality life in modern society. The appearance development have been proven to be C-nociceptor irritation evoked by so-called algogens – biologically active substances occurred due inflammation endothelial dysfunction along local temperature elevation intravenous pressure. Endothelial mainly phlebostasis a decrease shear stress, leading hypoxia cells. Further, multi-stage mechanism leukocyte-endothelial interaction activated, which results microangiopathy at microcirculatory level, as well valve apparatus injury varicose transformation principal superficial veins macrocirculatory level. It evident that suppression inflammatory reaction not only leads reduction or relief symptoms, but also prevents macro- disorders. In this regard, phlebotropic, venoactive, pharmacological drugs targeting different pathogenetic mechanisms progression present great interest. case, despite group phleboprotective effect, specific for achieving it may significant differences various venoactive agents. review, we discuss main indications instructions use phlebotropic patients CVD, drawing on established international Russian clinical guidelines.

Language: Английский

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Local and Systemic Endothelial Damage in Patients with CEAP C2 Chronic Venous Insufficiency: Role of Mesoglycan

International Journal of Molecular Sciences, Journal Year: 2025, Volume and Issue: 26(9), P. 4046 - 4046

Published: April 24, 2025

Chronic venous disease (CVD) involves complex pathophysiological mechanisms, particularly an imbalance between matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs), contributing to remodeling varicosities. Elevated MMP-2 MMP-9 levels are commonly found in tissues affected by ulcers. Inflammation plays a central role CVD, with higher of pro-inflammatory markers present varicose veins compared healthy ones. Syndecans, key components the endothelial glycocalyx, involved inflammatory responses. Alterations glycocalyx structure associated vascular damage both arterial diseases. This study aimed investigate changes CVD patients, focusing on therapeutic mesoglycan, glycosaminoglycan-based drug. A prospective, monocentric included 23 patients C2 clinical–etiological–anatomical–pathological (CEAP) CVD. Serum samples were collected before after mesoglycan treatment. Results showed significantly elevated VCAM-1, MMP-2, MMP-9, SDC-1, IL-6, IL-8 blood from versus systemic circulation. Patients received 50 mg orally every 12 h for 90 days. After treatment, notable reduction was observed. These results support hypothesis that may alleviate local inflammation, providing insights into new strategies management.

Language: Английский

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