asurgeryАмбулаторная хирургияAmbulatornaya khirurgiya = Ambulatory Surgery (Russia)2712-87412782-2591ООО «ГРУППА РЕМЕДИУМ»10.21518/1995-1477-2021-18-2-163-168asurgery-266Research ArticleОБМЕН ОПЫТОМ | ПРАКТИКАEXCHANGE OF EXPERIENCE | PRACTICEМикропенная склеротерапия поверхностных венозных мальформаций верхних конечностейMicrofoam sclerotherapy of superficial venous malformations of the upper limbshttps://orcid.org/0000-0002-3940-0787БогачёвВ. Ю.BogachevV. Yu.

Богачёв Вадим Юрьевич, доктор медицинских наук, профессор кафедры факультетской хирургии №2

117997, Москва, ул. Островитянова, д. 1

Vadim Yu. Bogachev, Dr. Sci. (Med.), Professor of the Department of Intermediate Level Surgery No. 2

1, Ostrovityanov St., Moscow, 117997

vadim.bogachev63@gmail.comhttps://orcid.org/0000-0003-4488-9123БолдинБ. В.BoldinB. V.

Болдин Борис Валентинович, доктор медицинских наук, профессор, заведующий кафедрой факультетской хирургии №2

117997, Москва, ул. Островитянова, д. 1

Boris V. Boldin, Dr. Sci. (Med.), Professor, Head of Intermediate Level Surgery No. 2

1, Ostrovityanov St., Moscow, 117997

facultysurgery@gmail.comhttps://orcid.org/0000-0003-3725-1658СаменковА. Ю.SamenkovA. Yu.

Саменков Александр Юрьевич, аспирант кафедры факультетской хирургии №2

117997, Москва, ул. Островитянова, д. 1

Aleksandr Yu. Samenkov, Postgraduate Student, Department of Intermediate Level Surgery No. 2

1, Ostrovityanov St., Moscow, 117997

samen-alex@yandex.ruРоссийский национальный исследовательский медицинский университет имени Н.И. ПироговаРоссияPirogov Russian National Research Medical UniversityRussian Federation202123112021182163168Copyright © Богачёв В.Ю., Болдин Б.В., Саменков А.Ю., 20212021Богачёв В.Ю., Болдин Б.В., Саменков А.Ю.Bogachev V.Y., Boldin B.V., Samenkov A.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.a-surgeon.ru/jour/article/view/266

Венозные мальформации являются наиболее распространенной формой среди ангиодисплазий, которые доставляют пациентам как физиологический, так и эмоциональный дискомфорт. Наиболее частой локализацией артериовенозных мальформаций служат верхние и нижние конечности в соотношении 20,9% и 46,4% соответственно. При этом в 70% случаев поверхностные артериовенозные мальформации находят у женщин. В данной статье представлен клинический пример эффективности микропенной склеротерапии и продемонстрирован отдаленный результат у пациентки с наличием поверхностной венозной мальформации кистей рук с проявлениями в виде болевого синдрома и кровотечений. В качестве склерозирующего агента применялся раствор натрия тетрадецилсульфата в концетрации от 1 до 3% с последующей компрессией с помощью трикотажа 2-го класса (RAL-стандарт) в виде рукава и перчаток. Интервал между процедурами варьировал от 4 до 6 нед. После выполнения нескольких сеансов отмечается уменьшение размера и объема поверхностной венозной мальформации верхней конечности, а также снижение жалоб у пациентки. Наблюдение сроком до 5 лет демонстрирует отсутствие роста мальформации и осложнения в виде повторного кровотечения. Микропенная склеротерапия поверхностных венозных мальформаций, локализованных на верхних конечностях (кисти рук), имеет хорошие результаты в отдаленном периоде и позволяет избежать травматичного хирургического вмешательства. Учитывая данную сопоставимость хирургического и малоинвазивного методов лечения, экономически и финансово целесообразно использовать последний вариант, в частности метод пенной склеротерапии.

Venous malformations are the most common type of angiodysplasia, which cause both physiological and emotional discomfort to patients. Arteriovenous malformations occur most often in the upper and lower limbs at the ratio of 20.9% and 46.4%, respectively. On top of that, 70% of cases of superficial arteriovenous malformations are found in women. In this article, the authors present a clinical example of the effectiveness of microfoam sclerotherapy and show a long-term outcome in a patient with superficial venous malformations of her hands, which are accompanied with such symptoms as as pain and bleeding. As a sclerosing agent, a 1–3% sodium tetradecyl sulphate solution was used, followed by compression using class 2 garments (RAL standard) such as an arm sleeve and gloves. The interval between procedures was 4 to 6 weeks. After several sessions, the superficial venous malformations of the upper limb decreased in the size and volume, and the patient presented less complaints. A 5-year follow-up showed no growth of malformations and re-bleeding complications. Microfoam sclerotherapy of superficial venous malformations in the upper limbs (hands) has good long-term outcomes and allows patients to avoid traumatic surgery. Given this comparability of the surgical and minimally invasive techniques, the use of the latter option, in particular, the foam sclerotherapy technique, makes economic and financial sense.

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The authors declare that there are no conflicts of interest present.