Saratov JOURNAL of Medical and Scientific Research

The effect of undifferentiated connective tissue dysplasia on the clinical course of varicose disease and thrombophlebitis of varicose veins after crossectomy

Year: 2022, volume 18 Issue: №1 Pages: 38-41
Heading: Surgery Article type: Original article
Authors: Tsarev О.А., Zakharov А.А., Senin А.А., Korchakov N.V.
Organization: Saratov State Medical University

Objective: to analyze the features of clinical course of lower extremity varicose vein disease and acute thrombophlebitis of varicose veins for the patients with undifferentiated connective tissue dysplasia after crossectomy. Material and methods. The prospective clinical cohort study covered 132 female patients with varicose disease who underwent crossectomy. 67 patients with dysplasia were included into the main group; patients without dysplasia were included into the control group. Examination of patients and ultrasound scanning of lower extremity veins were made in 3, 6, 12, 36 months. The Cox regression analysis was used to assess the influence of dysplasia on the risk of developing thrombophlebitis of varicose veins. Results. The progress of clinical manifestations of varicose disease after crossec- tomy was found for 57 (85.1 %) female patients with dysplasia and for 14 (21.5%) female patients without dysplasia (p=0.002), which needed making phlebectomy The recurrence of thrombophlebitis of varicose veins was found for 22 (32.8%) female patients with dysplasia and for 5 (7.7%) female patients without dysplasia (p=0.002). The indication of Cox-model Exp(S), which characterizes the predicted change of risks for dysplasia, was 4,216 (95% С11.595-11.147). Conclusion. The clinical course of varicose disease for patients with undifferentiated connective tissue dysplasia is characterized by the progression of clinical manifestations of chronic venous insufficiency of extremity. Undifferentiated connective tissue dysplasia increases the risk of developing the recurrence of thrombophlebitis of varicose veins after crossectomy by more than 4.2 times.

1. Pokrovskiy AV, Gradus AV, Bredikhin RA. Diagnosis and treatment of varicose disease. Moscow: RMAPO, 2013; 125 p.
2. Stojko YuM, Kirienko Al, llyukhin EA, et al. Diagnosis and treatment of superficial trombophlebitis. Guidelines of the Russian association of phlebologists. Phlebology 2019; 13 (2): 78-97.
3. Kirienko Al, Matyushenko АА, Andriyashkin VV. Acute thrombophlebitis. 2nd ed. Moscow: Medical News Agency LLC, 2019; 108 p.
4. Jeanneret С, Brunner S. Superficial venous thrombosis. A review. Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und Verwandte Gebiete 2012; 63 (8): 609-15.
5. Shevchenko YuL, Stojko YuM. Clinical Phlebology. Moscow: DPC Press, 2016; 256 p.
6. Goldhaber S. Venous thromboembolism: epidemiology and magnitude of the problem. Best Pract Res Clin Haematol 2012; 25(3): 235-42.
7. Kudlaty E, Oriowo B, Yang M, et al. Isolated great saphe-nous vein thrombus is associated with high rates of complications regardless of management. Ann Vase Surg 2017; 45 (4): 154-9.
8. Bachmeyer О Risk for venous thromboembolism in patients with superficial venous thrombosis. Ann Intern Med 2010; 153(1): 62-3.
9. Heit JA, Spencer FA, White RH. The epidemiology of venous thromboembolism. J Thromb Thrombolysis 2016; 41 (1): 3-14.
10. Milio G, Siragusa S, Mina C, et al. Superficial venous thrombosis: prevalence of common genetic risk factors and their role on spreading to deep veins. Thromb Res 2008; 123 (2): 194-9.
11. Cosmi B. Management of superficial vein thrombosis. J Thromb Haemost 2015; 13 (7): 1175-83.
12. Frappe P, Buchmuller-Cordier A, Bertoletti L, et al. STEPH Study Group. Annual diagnosis rate of superficial vein thrombosis of the lower limbs: the STEPH community-based study. J Thromb Haemost 2014; 12 (6): 831-8.
13. Kalny J, Tomaskova L, Pazin J. Superficial thrombophlebitis of the lower limbs from the surgeons point of view. Rozhl Chir 2014; 93 (5): 260-2, 264-70.
14. Karathanos C, Spanos K, Saleptsis V, et al. Recurrence of superficial vein thrombosis in patients with varicose veins. Phlebology 2016; 31 (7): 489-95.
15. Studennikova VV, Severgina LO, Dziundzia AN, Koro-vin IA. Lower extremity varicose veins in childhood and at a young age: Mechanism of development and specific features. Arkhiv Patologii 2017; 79 (4): 56-60.
16. Sacharian EA. Morphological and phenotypic markers of connective tissue dysplasia in patients with varicose vein disease of the lower extremities. Medical Journal 2013; (1): 12-6.
17. Tsarev ОА, Anisimov AYu, Prokin FG, et al. The role of connective tissue dysplasia in aetiopathogenesis of varicose disease and acute varicothrombophlebitis. Saratov Journal of Medical Scientific Research 2019; 15 (2): 302-7.
18. Clinical recommendations of the Russian Scientific Medical Society of Therapists on the diagnosis, treatment and rehabilitation of patients with connective tissue dysplasia (first revision). Medical Gazette of the North Caucasus 2018; 13 (1, 2): 137-209.
19. Sushkov SA, Kuhenkov PA, Nebylytsyn YS, Sushkova OS. Phenotypic symptom complex connective tissue dysplasia in deep vein failure in patients with varicose disease. News of Surgery 2006; (2): 32-7.
20. Klemenov AV Hereditary connective tissue disorders: nomenclature and diagnostic algorithm. The Clinician 2015; 9 (1): 42-9.

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