[Genesis of great saphenous vein obliteration and its clinical manifestations after endovenous laser coagulation combined with crossectomy during the varicose vein treatment].

An analysis of results of the endovenous laser coagulation combined with crossectomy was made in 170 patients with varicose veins of lower extremities (C(VI), C(II)-C(V)). Clinical and ultrasonic data were investigated during a period of 3-5 days (45 lower extremities) and followed up in 1-3 years after operation (194 lower extremities). Three years later the absence of reflux was observed in 95.9% of cases. In 51.1% of cases, 1-2 zones of parietal and segmental hemodynamical insignificant bloodstream were detected. A recanalization of the great saphenous vein along the whole length was revealed in 8 cases out of 194 (4.1%) patients. The bloodstream was provided by affluxes in the area of a shin and a wellhead afflux of the stump of the great suphenous vein. The ultrasonic picture of recanalization was similar to that observed in post-thrombophlebitic occlusion.

[Features of using endovascular laser coagulation in complex treatment of varicose disease].

The investigation was performed in 41 patients who were given laser coagulation of the subcutaneous vein trunks. The technique of laser coagulation as a stage of combined phlebectomy and the results of morphological investigation of the venous wall after laser coagulation depending on the parameters of coagulation are described. An analysis of the nearest and long-term results of the treatment using clinical and ultrasonic methods of investigation suggests that it is possible to use laser coagulation of the subcutaneous veins in patients with symptoms of chronic venous insufficiency of the II-V stages by CEAP classification.

[Staged treatment of patients with lymphedema of the lower extremities]. / Etapnoe lechenie bolnykh limfedemoi nizhnikh konechnostei.

At examination of 120 patients with lymphedema of the lower extremities, in 70% of them, structure and function of lymphangion were preserved. State of lymphangion is of great importance in substantiation of the tactics of treatment. In preserved morphofunctional properties of lymphangion, the operation of lymphovenous shunting is effective in 83% of the patients. Stimulation of contractile activity of the lymphatic vessels at the stages of in-patient, out-patient treatment and that in sanatoria and health resorts contributes to improvement of a result of treatment of the patients.

[Late results of combined surgery of the veins and lymphatic vessels in patients with chronic lymphovenous insufficiency of the leg]. / Otdalennye rezul'taty sochetannykh operatsii na venakh i limfaticheskikh sosudakh u bol'nykh s khronicheskoi limfovenoznoi nedostatochnost'iu nizhnykh konechnostei.

An analysis of long-term results of treatment of 1258 patients with chronic lymphovenous insufficiency of lower extremities has shown the necessity of differentiated approach to different categories of the patients. A substantial improvement of results of the treatment of patients with complicated forms of varicose disease is observed in combination of operations on the venous and lymphatic systems. The character of these operations (lymphovenous anastomoses, lymphonodovenous anastomoses) must be determined strictly individually on the basis of an analysis of clinical course of the disease, data of lympho- and phlebography.

[Causes of relapses in varicous veins of the lower extremities and their treatment]. / O prichinakh retsidivov varikoznogo rasshireniia ven nizhnikh konechnostei i ikh lechenie.

The article analyzes the causes of relapses of varicose veins of lower extremities in 60 patients: in 38 patients after preceding surgery and in 22 patients after phlebo-sclerosing treatment. Of 60 patients 52 were operated upon. The operation in case of recurrence of the disease after surgery must include careful revision of the sapheno-femoral anastomosis, removal of the remaining trunks and segments of veins, detection and ligation of communicating veins with deficient valves.