Objective: The presentation of cryostripping as an alternative procedure useful in venous insufficiency treatment. Methods: This retrospective study presents the results of 1087 operated patients, including follow-ups. Cryostripping was practised in all mentioned cases. Patient follow-up was performed at one week, one month, and six months postoperatively by clinical examination, Doppler ultrasonography, CIVIQ-20 and r-VCSS questionnaires. Outcomes, complications, surgery and hospitalisation period, and benefits of the method were analysed. Results: Generally, good functional and aesthetic outcomes defined by clinical symptom remission, absence of insufficient veins on Doppler ultrasonography, QoL and r-VCSS improvement (p < 0.001) were obtained. Complications included bruising ⌀ < 2 cm (32.38%), haematoma (8.92%), saphenous nerve injury (3.49%), deep vein thrombosis (0.18%). Recurrence was noted in 2.94% cases. Mean duration of procedure was 42 ± 12.5 min, mean duration of hospitalisation was 1.05 ± 0.36 days. Compared to high ligation and conventional stripping, the postoperative complications were reduced; compared to other minimally invasive procedures, the costs were reduced. Conclusions: Cryostripping seems to combine the radicality and efficacy of the stripping technique with the cosmetic advantage of the endothermal procedures, being an effective therapeutic method perfectly adapted to the economic conditions of middle-income countries health system. It is also suitable as day-case surgery.

Chronic venous disease (CVD) is a common pathology that significantly affects the quality of life (QoL) of patients. Methods: QoL was assessed in 317 patients diagnosed with CVD who underwent surgeries, including cryostripping (n = 113), high ligation and stripping (HL&S, n = 96), and phlebectomies (n = 108). CVD symptoms and QoL were assessed before surgery and 2 weeks after surgery using the following questionnaires: CIVIQ-20, VAS, Eq-5D, PHQ-9 and GAD-9. Results. The results reveal a significant correlation (p < 0.05) between CEAP score and QoL questionnaires performed preoperatively and postoperatively in all three surgical technique groups, with a statistical improvement postoperatively. Phlebectomy had the best postoperative QoL score (r = 0.495) compared to the other two types of procedures. Conclusions: Analyzing patients’ subjective perception following conventional surgery for CVD treatment, an improved QoL is observed both in functional and psychosocial aspects, even early postoperatively. Classical surgical procedures remain an effective and feasible option in CVD treatment.

Chronic venous disease (CVD) is a frequently encountered disease that progresses with age. Although the principal method of evaluation and diagnosis is Doppler ultrasound, routine laboratory tests may be an easier and more accessible way to evaluate CVD progression. The present retrospective study evaluated the laboratory results of 256 patients diagnosed with CVD. According to the Clinical, Etiological, Anatomical and Pathophysiological classification, depending on the CVD stage, patients were stratified into three groups: Group 1 (C2-C3; mild disease), Group 2 (C4; moderate to severe disease) and Group 3 (C5-C6; severe disease). The considered parameters were age, red blood cell count (RBC), white blood cell count (WBC) and platelet count (PLT), percentage of neutrophils and lymphocytes, neutrophil-to-lymphocyte ratio (NLR), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), fibrinogen, prothrombin time (in percentages and seconds), internal normalized ratio, activated partial thromboplastin time, creatine kinase (CK), CK myocardial band, alanine transaminase, aspartate transaminase, total bilirubin and urea. No significant differences among the groups were noted in RBC, WBC, PLT and coagulation factors; on the other hand, inflammatory markers exhibited differences among the groups. Several differences were observed in hepatic, metabolic and muscle tissue markers. Intraluminal thrombus formation in the case of varicose veins (thrombophlebitis) may be due to conditions of turbulent flow, stasis and endothelial inflammation, rather than hypercoagulability. The results of the present study confirmed the implication of inflammatory factors in pathophysiological modifications, including thickening of venous walls and valvular modification, as well as the appearance of intraluminal thrombi and trophic lesions. NLR, ESR, CRP and fibrinogen were increased with CVD progression and may be considered useful markers in evaluating CVD progression. Simple blood tests may provide phlebologists with additional insight for the management of those patients.

Pelvic venous insufficiency (PVI) is frequently associated with symptoms of abdominal pain or discomfort that is overlooked or under-diagnosed in women. Despite the fact that pelvic venous insufficiency in men is very well documented, its occurrence in women needs to be further studied. Patients with pelvic varicose veins undergo a long and inconclusive diagnostic work-up before the exact cause of the symptoms is identified. Gonadal venous insufficiency (GVI) is a condition that can present acutely, leading to diagnostic challenges. We present a case report of a 47-year-old female with acute abdominal pain and GVI, where endovascular embolization was used for successful treatment. The patient was diagnosed with GVI based on imaging findings of an enlarged left ovarian vein with retrograde flow and dilated pelvic veins seen on magnetic resonance imaging (MRI) with contrast material. Due to the severity of her symptoms and imaging findings, endovascular embolization was chosen as the treatment modality. The embolization was successful, and the patient’s symptoms resolved completely. This case highlights the challenge of diagnosing GVI with acute clinical expression and the potential benefits of endovascular embolization as a treatment option. Further studies are needed to determine the optimal management strategies for acute GVI, but endovascular embolization should be considered a safe and effective option. At the same time, we present a short review of the recent literature data related to this topic.