Saratov JOURNAL of Medical and Scientific Research

Anisimov A.Yu.

Saratov State Medical University n.a. V. I. Razumovsky, Department of Hospital Surgery of the Therapeutic Faculty, Post-graduate

The role of connective tissue dysplasia in aetiopathogenesis of varicose disease and acute varicothrombophlebitis

Year: 2019, volume 15 Issue: №2 Pages: 302-307
Heading: Surgery Article type: Review
Authors: Tsarev O.A., Anisimov A.Yu., Prokin F.G., Zakharov N.N., Senin A.A., Kulikova A.N.
Organization: Saratov State Medical University
Summary:

The academic literature review presents the analysis of recent publications which focus on the role of connective tissue dysplasia in aetiopathogenesis of lower extremity varicose vein disease (LEVVD) and acute varicothrombophle-bitis (AVTPh). The ways of predicting the variants of LEVVD and AVTPh clinical course on the basis of analyzing the combination of phenotypic characteristics are examined. Key words: varicose disease, varicothrombophlebitis, connective tissue dysplasia.

Acute varicothrombophlebitis: modern approach to the problem

Year: 2018, volume 14 Issue: №1 Pages: 87-94
Heading: Surgery Article type: Review
Authors: Tsarev О.А., Anisimov A.Yu., Prokin F.G., Zakharov A.A., Lobanov A.V., Senin A.A.
Organization: Saratov State Medical University
Summary:

Acute varicothrombophlebitis, or thrombosis of superficial veins (TSV), is a dangerous complication of lower extremity varicose vein disease, as it is a frequent cause for pulmonary artery thromboembolism. The survey states the modern approach to pathogenesis, diagnostics, clinical findings and therapeutic approach to patients with TSV.

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Surgical approach to patients with varicothrombophlebitis with undifferentiated dysplasia of connective tissue

Year: 2016, volume 12 Issue: №1 Pages: 66-70
Heading: Surgery Article type: Original article
Authors: Tsarev О.А., Anisimov A.Yu., Zakharov N.N., Korobov A.V.
Organization: Saratov State Medical University
Summary:

Aim: to study the peculiar features of clinical course of acute varicothrombophlebitis and surgical approach to patients with undifferentiated dysplasia of connective tissue. Material and Methods. The features of undifferentiated dysplasia of connective tissue, character of clinical course of acute varicothrombophlebitis, remote results for 94 patients, who had had Troyanov — Trendelenburg's operation, were studied. Results. 70 patients (74,5%) with acute varicothrombophlebitis demonstrated more than four phenotypic characters which showed the presence of undifferentiated dysplasia of connective tissue. 22 patients (31,4%) with acute varicothrombophlebitis with undifferentiated dysplasia of connective tissue were proved to have the discrepancy between localization of acute varicothrombophlebitis clinical evidences and level of proximal part of thrombus in the lumen of great saphenous vein. During the remote observation period, 66 patients (94,3%) with acute varicothrombophlebitis with undifferentiated dysplasia of connective tissue had pheblectomy, as there was vertical and horizontal pathological venous reflux. Out of 24 patients (25,5%) with acute varicothrombophlebitis without undifferentiated dysplasia of connective tissue, only four patients (16,7%) needed thesecond stage of surgical treatment, because 20 patients (83,3%), in 6 months after Troyanov — Trendelenburg's operation, demonstrated the restoration of functional consistency of valves of great saphenous and perforating veins. Conclusion. When determining the indications for urgent disconnection of saphenofemoral junction for patients with acute varicothrombophlebitis and also when choosing surgical treatment approach during remote observation period, it is reasonable to examine the phenotypic characters of undifferentiated dysplasia of connective tissue.

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Prognosis of complicated clinical course of varicose veins of lower extremities on the basis of analysis of phenotypic characteristics of connective tissue dysplasia

Year: 2015, volume 11 Issue: №4 Pages: 587-591
Heading: Surgery Article type: Original article
Authors: Tsarev О.А., Anisimov A.Yu., Zakharov N.N.
Organization: Saratov State Medical University
Summary:

Aim: to identify the phenotypic characteristics of indeterminate connective tissue dysplasia, which help to predict the progression of varicose veins of lower extremities and disease recurrence after surgery. Material and Methods. The long-term results of surgical treatment of 60 patients with varicose veins of lower extremities in a 5-year period after phlebectomy were analyzed. The phenotypic characteristics of indeterminate connective tissue dysplasia were researched. 24 patients had recurrence of varicose veins of lower extremities associated with disease progression; 36 patients did not have recurrence of varicose veins of lower extremities. Results. All the patients demonstrated the signs of indeterminate connective tissue dysplasia, whereas their frequency was different. There were specified nine phenotypic characteristics of indeterminate connective tissue dysplasia, which were significantly more frequent for patients with recurrence of varicose vein disease of lower extremities: 1) postural abnormality, 2) flat foot, 3) skin pallor, 4) hyperextension of skin, 5) positive "wrist test", 6) positive "pollex test", 7) diastasis recti abdominis, 8) myopia, 9) hematomas which form quickly. Conclusion. The determined sum of phenotypic characters of indeterminate connective tissue dysplasia allows to predict progression of varicose vein disease of lower extremities, and offers new opportunities for improving the results of surgical treatment via developing special therapeutic measures aimed at improving lifestyle and dysplasia treatment.

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