Meeting of the school of phlebologists "Peculiarities of approach to early stages of chronic diseases of veins".
22 October, the Hilton Leningradskaya Hotel hosted a meeting of the phlebology school led by Vadim Y. Bogachev, MD, professor, head of the Department of Angiology and Vascular Surgery, Research Institute of Clinical Surgery. The subject of the meeting was "The peculiarity of the approach to the early stages of chronic diseases of the veins".
Speaker Professor, MD. Bogachev V.Yu.
Specialist, phlebologist of the phlebology center "MIFTS" Alexey Malakhov took part in the seminar.
Certificate of Dr. Malakhov A.M.
Patients with the initial forms of chronic heart disease are frequent guests at the reception of phlebologists and surgeons. Appearance of a feeling of heaviness in the legs, vascular sprouts, swelling in the evening lead to an appointment with a doctor.
First of all, let's see what the initial forms of varicose veins are. The most authoritative, accepted worldwide classification of vein diseases is CEAP. According to this classification:
C0 - absence of symptoms of the disease in a clinical examination, but with subjective complaints from the patient (so-called phlebopathy);
C1 - the presence of telangiectasias (vascular sprouts) and visible reticular veins (diameter 1-3 mm). It should be noted that these small wreaths, although visible to the eye, but do not carry any risk to human health, that is, they represent a cosmetic defect. Aesthetic phlebology in Russia, although massively and inferior to the advanced Western market of medical services, but in the VIP segment offers the same technology and service. The quality is often not inferior to the most fashionable clinics in Europe and the United States. The choice remains for the patient, there will be this sclerotherapy, thermal contact electrocoagulation, laser transcutaneous exposure. In experienced hands, perhaps the safest technique, allowing without a trace and complications to irretrievably remove the smallest vessels, is sclerotherapy. Thermal techniques are bribed by the lack of the use of compression knitwear, but there is a risk of permanent skin pigmentation and only the finest telangiectasias can really be corrected. There are also restrictions on skin types.
A much more difficult task is to slow the transition of the disease to the next stages, which already carry quite serious risks and clinical consequences.
The main causes of progression of varicose veins are: heredity, unbalanced motor load, nutrition. We live in a post-industrial era of smart gadgets, automated production, genetic engineering. The development of technology in many ways simplified the way of life, increased the comfort of human life for some decades. The reverse side of the coin, our bodies are no longer subject to the usual physical activity. If we talk about the lower extremities, then they are "lucky", perhaps least. Human feet are not the fastest in the animal kingdom, but they are among the hardiest. They can overcome many kilometers distances. As an example, a short epic from the era when a person enjoyed evolutionary advantages. Even now, in the savannah of Africa, tribes enjoying a primitive mode of hunting have survived. They are chasing an antelope until it falls from physical exhaustion. This example shows the possibilities, and the legs of the Masai of Kenya, the inhabitants of Moscow and the indigenous peoples of Chukotka are arranged, plus or minus the same.
Thus, even periodically visiting the gym, often, we do not satisfy our need for motor activity. To this can be added a long static position, people of many professions, spend so a few hours a day. Less harmful to the venous wall, but also not physiological, long to sit.
Heredity also contributes its significant contribution to the prevalence of varicose pathology. Gene mutations (weakness of connective tissue including) with the development of agriculture, industry and, paradoxically, medicine, grow in the human population in a geometric progression.
Participants of the seminar "The peculiarity of the approach to early stages of chronic diseases of veins"
At the moment, medical science offers a number of measures to prevent the development of CVI and transition to the next stages. In the first place is a correction of the way of life (motor mode, nutrition, exclusion of bad habits). Next is the preventive use of compression linen (classes "A" and 1-th) for certain loads and the use of phlebotrophic drugs. Qualitative compression knitwear is guaranteed to protect your veins while you are in it. The optimal price-quality ratio is offered by Medi. The market of phlebotonics in Russia is quite a wide choice of drugs from different manufacturers. And now the doctors of polyclinics are widely prescribed preparations of troxerutin. This is due to its good performance, availability and popularity among doctors of the "old guard". But now in the arsenal of doctors there are more effective drugs. The molecule of diosmina, perhaps for today, is most effective for strengthening the venous wall. The best quality preparations based on it are produced by the French companies Servier (Detralex) and INNOTERA (Flebodei 600). The choice between them is based both on the individual preferences of physicians and on some clinical aspects (for example, in miniature patients it is more appropriate to use phlebodia, in large ones it is detralex).
Professor Bogachev V.Yu. and Dr. Malakhov A.M. after the workshop
Summarizing, it is worth noting that any treatment is effective in a complex, it is necessary to take into account all aspects of both the development of the disease and the life of a particular patient. Only with this approach your legs in good tone will overcome the main test, time.