Comparative evaluation of modern approaches to treatment of varicose veins of the lower extremities
https://doi.org/10.51922/2074-5044.2025.2.79
Abstract
The article presents an overview of modern approaches aimed at treating varicose veins of the lower extremities. A comparative analysis of the effectiveness of their use is carried out. An assessment of the advantages and disadvantages of individual treatment methods is carried out, based on the observations of various foreign and domestic authors.
About the Author
A. N. BuzinBelarus
References
1. Baeshko, A. A., Tihon, S. N., Kryzhova, E. V., Markaucan, P. V., Vartanyan, V. F., Dechko, V. M., Kovalevich, K. M., Shestak, N. G. «Pennaya skleroterapiya: istoriya razvitiya i sovremennye dannye». Novosti hirurgii, 2012, vyp. 20, № 4, str. 101–110.
2. Burleva, E. P., Peshkov, A. V., Tyurin, S. A., Belencov, S. M., Matveeva, M. A., Onohina, M. E., Oseev, I. O. «Recidivy varikoznoj bolezni nizhnih konechnostej: struktura i takticheskie resheniya (startovoe issledovanie)». Novosti hirurgii, vyp. 20, № 1, 2012.
3. Kurginyan, H. M., Raskin, V. V., Markin, S. M. Rannie rezul’taty primeneniya sistemy mekhanohimicheskoj obliteracii varikoznyh ven dlya lecheniya varikoznoj bolezni. Ambulatornaya hirurgiya. 2021; 18(2):32–36.
4. O. Ne’matzoda, D. D. Sultanov, A. D. Gaibov, B. G. Muminzoda, O. F. Soliev , H. A. Yunusov «Mesto skleroterapii v lechenii varikoznoj bolezni». Zdravoohranenie Tadzhikistana, № 2 (357), 2023 77–85.
5. Pervye klinicheskie rezul’taty primeneniya lazera s dlinoj volny 1940 nm Semenov Artem Yur’evich. Sovremennaya medicina. № 2 (18) 2020 g. 82–86.
6. Stojko, Yu., Ignat’eva, N., Zaharkina, O., Gulieva, V., Mazajshvili, K., Cyplyashchuk, A., Yаshkin, M., Akimov, S., Bagratashvili, V., Haritonova, S. Eksperimental’noe obosnovanie rezhimov radiochastotnoj termoobliteracii. Flebologiya. 2015;9(2):12–17.
7. Shajdakov, E. V., Ilyuhin, E. A., Petuhov, A. V., Grigoryan, A. G., Rosuhovskij, D. A., SHajdakov, E. V., Ilyuhin, E. A., Petuhov, A. M., Grigoryan, A. G., Rosuchovskij D. A. Radiochastotnaya oblit eraciya ClosureFAST i endovazal’naya lazernaya obliteraciya 1470 nm: mnogocentrovoe prospektivnoe nerandomizirovannoe issledovanie. Flebologiya. 2012;6(3): 20–27.
8. Hitar’yan, A. G., Gusarev, D. A., Pryadko, S. N., Veliev, K. S., Vatolina, T. V. «Sravnitel’nyj analiz tekhnicheskih osobennostej i rezul’tatov endovazal’noj lazernoj koagulyacii s pomoshch’yu lazerov s dlinoj volny 980 nm, 1479 nm i metoda radiochastotnoj ablacii s tekhnologiej Closure Fast.» Annaly hirurgii, 2015, vol. 2, pp. 24–30.
9. Yаnushko, V. A., Rogovoj, N. A., Turlyuk, D. V., Klimchuk, I. P., Kalinin, S. S. «Endovenoznaya lazernaya koagulyaciya podkozhnyh ven nizhnih konechnostej (1470 nm i 1560 nm) v kompleksnom lechenii varikoznoj bolezni». Voennaya medicina, no. 4, 2017, pp. 74–78.
10. Alozai, T., Huizing, E., Schreve, M., van Vlijmen, C. J., Wisselink, W., Ünlü, Ç. A systematic review and meta-analysis of mechanochemical endovenous ablation using Flebogrif for varicose veins: A summary of evidence. J Vasc Surg Venous Lymphat Disord. 2021.
11. Ammollo, R. P., Petrone, A., Giribono, A. M., Ferrante, L., Del Guercio, L, Bracale, U. M. Early Results of Mechanochemical Ablation with Flebogrif in great Saphenous Vein Insufficiency: does Polidocanol Concentration Affect Outcome? Transl Med UniSa. 2020; 21:47–51.
12. Bradbury, A. W., Bate, G., Pang, K., et al. Ultrasound-guided foam sclerotherapy is a safe and clinically effective treatment for superficial venous reflux. J Vasc Surg. 2010;52:939–945.
13. Carradice, D, Leung, C, Chetter, I. Laser; best practice techniques and evidence. Phlebology. 2015;30(2 suppl):36–41.
14. Dekiwadia, D. Sclerotherapy for Varicose Veins. Indian J Surg. 2023;85(Suppl 1):77–85.
15. Epstein, D., Bootun R, Diop M, Ortega-Ortega M, Lane, T. R. A., Davis A. H. Cost-effectiveness analysis of current varicose veins treatments. J Vasc Surg: Venous and Lym Dis. 2022;10(2):504–513.
16. Evidence summary of combined saphenous ablation and treatment of varicosities versus staged phlebectomy Hager, Eric S. et al. Journal of Vascular Surgery: Venous and Lymphatic Disorders, Volume 5, Issue 1, 134–137.
17. Franceschi, C. Théorie et pratique de la cure conservatrice et hémodynamique de l’insuffisance veineuse en ambulatoire [CHIVA]. Precy-sous-Thil, France: Editions de l’Armançon; 1988.
18. Gale, S. S., Lee, J. N., Walsh, M. E., Wojnarowski, D. L., Comerota, A. J. A randomized, controlled trial of endovenous thermal ablation using the 810-nm wavelength laser and the ClosurePLUS radiofrequency ablation methods for superficial venous insufficiency of the great saphenous vein. J Vasc Surg. 2010;52(3):645–650.
19. Goode, S. D., Chowdhary, A., Crokett, M, Beech, A., Simpson, R., Richards, T., Braithwaite, B. D. Laser and radiofrequency ablation study (LARA study): a randomized study comparing radiofrequency ablation and endovenous laser ablation (810). Eur J Vasc Endovasc Surg. 2010;40(2):246–253.
20. Kuligod, R., Nangare, N. A Comparative Study Between Sclerotherapy and Endovenous Ablation Therapy in Management of Varicose Veins. European Journal of Molecular and Clinical Medicine. 2022; 9(7):53–55.
21. Lawaetz, M., Serup, J., Lawaetz, B., Bjoern, L., Blemings, A., Eklof, B., Rasmussen, L. Comparison of endovenous ablation techniques, foam sclerotherapy and surgical stripping for great saphenous varicose veins. Extended 5-year follow-up of a RCT. Int Angiol. 2017;36(3):281–88.
22. Lim S. Y., Tan J. X., D’Cruz R. T., Syn N., Chong T. T., Tang T. Y. Catheter-directed foam sclerotherapy, an alternative to ultrasound-guided foam sclerotherapy for varicose vein treatment: A systematic review and meta-analysis. Phlebology. 2020; 35(6):369–383.
23. Nordon, I. M., Hinchliffe, R. J., Brar, R., Moxey, P, Black, S. A., Thompson, MM, Loftus, I. M. A Prospective Double-Blind Randomized Controlled Trial of Radiofrequency Versus Laser Treatment of the Great Saphenous Vein in Patients With Varicose Veins. Ann Surg. 2011;254(6):876–881.
24. Nwaejike, N., Srodon, P. D, Kyriakides, C. Endovenous laser ablation for the treatment of recurrent varicose vein disease--a single center experience. Int J Surg. 2010;8(4):299–301.
25. Rasmussen, L., Lawaetz, M., Serup, J., Bjoern L., Vennits, B., Blemings, A., Eklof, B. Randomized clinical trial comparing endovenous laser ablation, radiofrequency ablation, foam sclerotherapy, and surgical stripping for great saphenous varicose veins with 3-year follow-up. J Vasc Surg Venous Lymphat Disord. 2013 Oct;1(4):349–56.
26. Same Site Recurrence is More Frequent After Endovenous Laser Ablation Compared with High Ligation and Stripping of the Great Saphenous Vein: 5 year Results of a Randomized Clinical Trial (RELACS Study). K. Rass, N. Frings, P. Glowacki, S. Gräber, W. Tilgen, T. Vogt. Eur J Vasc Endovasc Surg. 2015;50:648–656.
27. Schoonover, JP, King, JT, Gray, C, Campbell, K, Sherman, C. 3 alternatives to standard varicose vein treatment. J Fam Pr. 2009;58(10):522–526.
28. S. K. van der Velden, A. A. M. Biemans, M. G. R. De Maeseneer, M. A. Kockaert, P. W. Cuypers, L. M. Hollestein, H. A. M. Neumann, T. Nijsten, R. R. van den Bos Five-year results of a randomized clinical trial of conventional surgery, endovenous laser ablation and ultrasound-guided foam sclerotherapy in patients with great saphenous varicose veins British Journal of Surgery, Volume 102, Issue 10, September 2015, Pages 1184–1194,
29. Shadid, N., Ceulen, R., Nelemans, P., Dirksen, C., Veraart, J., Schurink, G. W., et al. Randomized clinical trial of ultrasound-guided foam sclerotherapy versus surgery for the incompetent great saphenous vein. Br J Surg. 2012;99(8):1062–1070.
30. Shaidakov, E. V., Grigoryan, A. G., Korzhevskii, D. E., Ilyukhin, E.A., Rosukhovski, D. A., Bulatov, V. L, Tsarev, O.I. Morphologic changes in the vein after different numbers of radiofrequency ablation cycles. J Vasc Surg Venous Lymphat Disord. 2015; 3(4):358–363.
31. Vuylsteke, M. E., Klitfod, L., Mansilha, A. Endovenous ablation. Int Angiol. 2019;38(1):22–38.
32. Zollmann, M., Zollmann, C., Zollmann, P., Veltman J., Cramer, P., Stuecker, M. Recurrence types 3 years after endovenous thermal ablation in insufficient saphenofemoral junctions. J Vasc Surg Venous Lymphat Disord. 2021;9(1):137–145.
33. Elganzoury, Mahmoud A., et al. «Mechanochemical ablation versus thermal ablation as a management modality for primary great saphenous varicose veins.» Journal of Medicine in Scientific Research, vol. 2, no. 1, Jan.-Mar. 2019, p. 83.
34. Tawfik, A. M., Sorour, W. A., El-Laboudy, M. E. Laser ablation versus mechanochemical ablation in the treatment of primary varicose veins: A randomized clinical trial. J Vasc Surg Venous Lymphat Disord. 2020;8(2):211–215.
Review
For citations:
Buzin A.N. Comparative evaluation of modern approaches to treatment of varicose veins of the lower extremities. Military Medicine. 2025;(2):79-87. (In Russ.) https://doi.org/10.51922/2074-5044.2025.2.79
JATS XML