Diagnostics and Treatment of Superficial Trombophlebitis. Guidelines of the Russian PhlebologicalAssociation

Стойко, Ю М; Кириенко, А. И.; Илюхин, Е. А.; Lobastov, Kirill; Chabbarov, R.G.; Париков, М. А.; Хорев, Н. Г.; Золотухин, И. А.; Андрияшкин, В. В.; Карпенко, А. А.; Фокин, А. А.; Сушков, С. А.; Сапелкин, С В; Suchkov, I.А.; Крылов, А. Ю.; Ignat'ev, I M

doi:10.17116/flebo20191302178

Cited by 25 publications

(9 citation statements)

References 106 publications

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“…Выдержка из Российских клинических рекомендаций по диагностике и лечению хронических заболеваний вен [1]. Схожая градация представлена в клинических рекомендациях по диагностике и лечению тромбофлебита поверхностных вен конечностей [4]:…”

Section: что дает врачам-флебологам работа по стандартам и правиламunclassified

“…диагностика и лечение тромбофлебита поверхностных вен конечностей. рекомендации ассоциации флебологов россии (2019) [4].…”

Section: клинические рекомендации «варикозное расширение вен нижних конечностей без хронической венозной недостаточности» утвержденные асunclassified

“…соответственно, нет нарушения рекомендации из первого приведенного документа [3]. Касательно второго документа [4] необходимо отметить, что в нем говорится о том, что «на сегодняшний день недостаточно данных для вывода о целесообразности использования термооблитерации в целях предотвращения перехода тромботического процесса в глубокую венозную систему. В связи с этим нет оснований считать тФПв показанием к выполнению эндовазальной термооблитерации».…”

Section: !!! учитывая то что рекомендации по тромбофлебиту [4] и по лечению хронических заболеваний вен [1] вышли из одной организации (мunclassified

“…то есть прямой запрет на леЧение варикоЗной БолеЗни у пациентов с острым тромбофлебитом отсутствует. С другой стороны, в рекомендациях по тромбофлебиту сказано [4]: полномасштабные вмешательства, направленные на ликвидацию патологических рефлюксов и варикозно измененных поверхностных вен, РЕКО-МЕНДуЕТСя проводить в период СТИХШЕГО тромбофлебита, в то время как вмешательства, направленные на снижение риска распространения тромбоза по магистральным поверхностным венам или их тромбоза после отмены антикоагулянтов (например, термооблитерация нетромбированного несостоятельного сегмента магистральной поверхностной вены), ЦЕЛЕСООбРАЗНО выполнять в период СТИХАЮЩЕГО ИЛИ СТИХШЕГО тромбофлебита. Имеющиеся данные в согласительных документах ставят рядового врача в относительно затруднительное положение.…”

“…3 Профилактика венозных тромбоэмболических осложнений при вмешательствах на периферической венозной системе 3. 4 Диаметр вен для термооблитерации 3. 5 Термооблитерация ЭКСТРАФАСЦИАЛЬНЫХ поверхностных вен 3.…”

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Standards and regulations of a self-regulating organization "The National College of Phlebology (Russia)"

Редакционная¹

2020

Ambulatornaya khirurgiya

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Section: что дает врачам-флебологам работа по стандартам и правиламunclassified

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Standards and regulations of a self-regulating organization "The National College of Phlebology (Russia)"

Редакционная¹

2020

Ambulatornaya khirurgiya

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Effect of undifferentiated connective tissue dysplasia on clinical course of varicose disease and thrombophlebitis of varicose veins after crossectomy

Tsarev,

Zakharov,

Senin

et al. 2022

Saratov Med J

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Objective: to analyze the features of clinical course of lower limb varicose vein disease and acute thrombophlebitis of varicose veins for the patients with undifferentiated connective tissue dysplasia (UCTD) after crossectomy. Materials and Methods. The prospective clinical cohort study involved 132 female patients with varicose disease who underwent crossectomy, of which 67 patients with dysplasia were included into the main group, whereas patients without dysplasia were included into the control group. Examination of patients and ultrasound scanning of leg veins were conducted in 3, 6, 12, and 36 months. The Cox regression analysis was used to assess the effect of dysplasia on the risk of developing thrombophlebitis of varicose veins. Results. The progress of varicose disease clinical manifestations of after crossectomy was detected in 57 (85.1%) female patients with dysplasia and in 14 (21.5%) without it (р=0.002), which resulted in phlebectomy. The recurrent thrombophlebitis of varicose veins was found in 22 (32.8%) female patients with dysplasia vs. 5 (7.7%) without it (р=0.002). Cox regression model Exp (B), which characterizes the predicted change of risks for dysplasia, was 4.216 (95% CI 1.595-11.147). Conclusion. The clinical course of varicose disease in patients with UCTD is characterized by the progression of clinical manifestations of chronic venous insufficiency of a lower limb. UCTD results in over 4.2-fold risk of developing the recurrent thrombophlebitis of varicose veins after crossectomy.

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Comparison of endovenous laser ablation and conservative treatment in acute thrombophlebitis of the varicose great saphenous vein: rationale, design and first results of clinical trial

Kaperiz

Rastatueva

Yavelov

et al. 2023

Cardiovasc Ther Prev

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Thrombophlebitis of the superficial lower limb veins is one of the most common complications of chronic vein disease. Nowadays a long-term (at least 45 days) subcutaneous injection of fondaparinux sodium or heparin in combination with elastic compression of the limb is recommended for treatment of superficial vein thrombosis with a moderate risk of thrombus propagation to deep venous system. However, long-term use of anticoagulants is not always possible and sometimes contraindicated. Endovenous laser ablation (EVLA) around thrombus-free junction of great or small saphenous veins without subsequent long-term use of anticoagulants seems to be a promising intervention for treatment of acute thrombophlebitis of varicose superficial veins.The prospective single-center randomized open-label clinical trial was dedicated for comparison the efficacy and safety of three following treatments options for patients with acute thrombosis of the varicose great saphenous vein and location of thrombi in the trunk and/ or its large inflows: EVLA close to saphenous vein junction without anticoagulation, EVLA and 7 days of anticoagulation and noninvasive treatment with anticoagulation for 45 days (subcutaneous injections of the fondaparinux 2,5 mg). Class 2 compression stockings are used in all patients. Adverse outcomes are recorded at 7, 45 and 90 days after randomization. These include the progression of superficial vein thrombosis, recurrent superficial vein thrombosis, thrombosis involvement of the superficial segment of the perforating vein up to the fascia, deep vein thrombosis according to compression ultrasound, and pulmonary embolism with symptoms. Bleedings according to the World Society of Thrombosis and Hemostasis and the Academic Research Consortium classification as well other complications are also recorded. The first 30 patients included in the study have a low incidence of venous thrombosis risk factors and localization of the thrombus relatively far from the saphenofemoral junction. EVLA resulted in persistent cessation of venous blood flow at the intervention site. New episodes of venous thrombosis were noted only in the group of medical treatment — deep vein thrombosis of the contralateral tibia 5 days after stopping of 45-day treatment with fondaparinux and thrombus in the recanalized inflow of the great saphenous vein without involving its trunk at the 21st day after stopping of 45-day injection of fondaparinux. There were no complications in the area of intervention and bleedings.

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Diagnostics and Treatment of Superficial Trombophlebitis. Guidelines of the Russian PhlebologicalAssociation

Cited by 25 publications

References 106 publications

Standards and regulations of a self-regulating organization "The National College of Phlebology (Russia)"

Standards and regulations of a self-regulating organization "The National College of Phlebology (Russia)"

Effect of undifferentiated connective tissue dysplasia on clinical course of varicose disease and thrombophlebitis of varicose veins after crossectomy

Comparison of endovenous laser ablation and conservative treatment in acute thrombophlebitis of the varicose great saphenous vein: rationale, design and first results of clinical trial

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