Features of recurrence of varicose disease of the lower limb and its surgical correction

Abstract

Despite the rapid development and rapid spread of minimally invasive techniques in the surgical treatment of chronic venous diseases in recent years, the relapse rate, taking into account the postoperative period, continues to remain high. Currently, there is no unified algorithm for surgical treatment of patients with recurrent varicose veins of the lower extremities. Therefore, discussion of surgical tactics taking into account the individual clinical and anatomical form of disease relapse is an urgent problem. The article provides a review of modern domestic and foreign literature on the incidence, etiology, pathogenesis, diagnosis and surgical treatment options for recurrent varicose veins of the lower extremities. The modern classifications REVAS and PREVAIT, used to assess the recurrence of varicose veins of the lower extremities, are presented. Modern hypotheses about the main reasons leading to its occurrence are reflected in detail. An analysis of the relapse rate after the use of various methods of surgical correction of the primary disease was carried out. The review provides characteristics of both classical and modern methods for correcting recurrent varicose veins of the lower extremities. The role of ultrasound duplex angioscanning of the veins of the lower extremities is emphasized as an optimal diagnostic method that makes it possible to accurately identify the main pathomorphological and hemodynamic causes of the development of relapse of the disease. Surgical interventions for relapse should be performed only in specialized departments and by highly qualified surgeons. When surgically treating recurrent varicose veins of the lower extremities, it is necessary to correct the venous blood flow in all parts of the muscular-venous pump, and not be limited to simple removal of varicose veins.