<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.3 20210610//EN" "JATS-journalpublishing1-3.dtd">
<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">asurgery</journal-id><journal-title-group><journal-title xml:lang="ru">Амбулаторная хирургия</journal-title><trans-title-group xml:lang="en"><trans-title>Ambulatornaya khirurgiya = Ambulatory Surgery (Russia)</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2712-8741</issn><issn pub-type="epub">2782-2591</issn><publisher><publisher-name>ООО «ГРУППА РЕМЕДИУМ»</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21518/akh2026-015</article-id><article-id custom-type="elpub" pub-id-type="custom">asurgery-634</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОБМЕН ОПЫТОМ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>EXCHANGE OF EXPERIENCE | PRACTICE</subject></subj-group></article-categories><title-group><article-title>Ривароксабан в практике амбулаторного флеболога</article-title><trans-title-group xml:lang="en"><trans-title>Rivaroxaban in the outpatient phlebological practice</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1455-9916</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Борсук</surname><given-names>Д. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Borsuk</surname><given-names>D. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Борсук Денис Александрович, д.м.н., доцент кафедры хирургии Института дополнительного профессионального образования, Южно-Уральский государственный медицинский университет; профессор, КазахстанскоРоссийский медицинский университет</p><p>454141, Челябинск, ул. Воровского, д. 64,</p><p>050004, Алматы, ул. Абылай Хана, д. 51/53</p></bio><bio xml:lang="en"><p>Denis A. Borsuk, Dr. Sci. (Med.), Associate Professor of the Department of Surgery, Institute of Continuing Professional Education, South Ural State Medical University; Professor, Kazakhstan-Russian Medical University</p><p>64, Vorovskiy St., Chelyabinsk, 454092, </p><p>51/53, Abylay Khan St., Almaty, 050004</p></bio><email xlink:type="simple">borsuk-angio@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Южно-Уральский государственный медицинский университет;&#13;
Казахстанско-Российский медицинский университет</institution><country>Россия</country></aff><aff xml:lang="en"><institution>South Ural State Medical University; &#13;
Kazakhstan-Russian Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2026</year></pub-date><pub-date pub-type="epub"><day>07</day><month>06</month><year>2026</year></pub-date><volume>23</volume><issue>1</issue><fpage>145</fpage><lpage>148</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Борсук Д.А., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Борсук Д.А.</copyright-holder><copyright-holder xml:lang="en">Borsuk D.A.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.a-surgeon.ru/jour/article/view/634">https://www.a-surgeon.ru/jour/article/view/634</self-uri><abstract><p>На сегодняшний день отмечается стремительное развитие клинической флебологии. Рассматривая этот подъем на линии времени в разрезе интервала два-три десятилетия, качество диагностики и лечения венозной патологии кратно возросло. Кроме знакового перехода из стационара в амбулаторные условия при вмешательствах у пациентов с варикозной болезнью, огромные достижения наблюдаются при всех нозологиях и их осложнениях, где, так или иначе, вовлечен венозный компонент. Вместе с тем, кроме технико-организационных и гемодинамических успехов, прогресс в фармакологической сфере, в частности антикоагуляции, проходящей красной линией через всю флебологическую помощь, позволил упростить терапевтические стратегии и минимизировать побочные эффекты при назначении препаратов этой группы. Одним из таких лекарственных средств, получившим широкое распространение и в силу своего удобства активно использующимся в клинической практике, стал пероральный антикоагулянт ривароксабан. На текущий момент его действие хорошо изучено, многочисленные исследования подтверждают эффективность и безопасность. В статье рассматриваются вопросы применения ривароксабана, а также уделяется значение качеству и контролю за его производством на примере доступного на российском рынке препарата Риваксаб®.</p></abstract><trans-abstract xml:lang="en"><p>Nowadays, ambulatory phlebology is rapidly developing. Considering this progress over a period of two to three decades, the quality of diagnosis and treatment of venous disorders has increased exponentially. In addition to the significant shift from inpatient to outpatient settings for interventions on patients with varicose veins, significant advances are being observed across all conditions and their complications where the venous component is involved. Furthermore, in addition to technical, organizational, and hemodynamic advances, more simple therapeutic strategies and minimization of side effects are seen in anticoagulation which is a key component of phlebological care. Rivaroxaban is widely adopted and, due to its convenience, actively used in clinical practice. It has now been well investigated, with numerous studies confirming its efficacy and safety. The article considers the use of rivaroxaban and highlights the importance of quality and production control in example of the Rivaxab®, which is available on the Russian market.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>флебология</kwd><kwd>антикоагулянты</kwd><kwd>пероральные антикоагулянты</kwd><kwd>ривароксабан</kwd><kwd>Риваксаб</kwd></kwd-group><kwd-group xml:lang="en"><kwd>phlebology</kwd><kwd>anticoagulants</kwd><kwd>oral anticoagulants</kwd><kwd>rivaroxaban</kwd><kwd>Rivaxab</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Статья подготовлена при поддержке компании Viatris</funding-statement><funding-statement xml:lang="en">The article was prepared with support from Viatris</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Tauraginskii RA, Lurie F, Agalarov R, Simakov S, Borsuk D. Blood flow from competent tributaries is likely contributor to distally increasing reflux volume in incompetent great saphenous vein. J Vasc Surg Venous Lymphat Disord. 2022;10(1):69–74. https://doi.org/10.1016/j.jvsv.2021.04.010.</mixed-citation><mixed-citation xml:lang="en">Tauraginskii RA, Lurie F, Agalarov R, Simakov S, Borsuk D. Blood flow from competent tributaries is likely contributor to distally increasing reflux volume in incompetent great saphenous vein. J Vasc Surg Venous Lymphat Disord. 2022;10(1):69–74. https://doi.org/10.1016/j.jvsv.2021.04.010.</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Лобастов КВ, Бондарчук ДВ, Борсук ДА, Бредихин РА, Букина ОВ, Панков АС и др. Диагностика и лечение хронической венозной обструкции: согласованное мнение российских экспертов (часть 1). Хирург. 2020;(5-6):5–37. https://doi.org/10.33920/med-15-2003-01.</mixed-citation><mixed-citation xml:lang="en">Lobastov KV, Bondarchuk DV, Borsuk DA, Bredikhin RA, Bukina OV, Pankov AS et al. Diagnosis and treatment of chronic venous obstruction: consensus statement of the Russian experts (Part 1). Khirurg. 2020;(5-6):5–37. (In Russ.) https://doi.org/10.33920/med-15-2003-01.</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Лобастов КВ, Бондарчук ДВ, Борсук ДА, Бредихин РА, Букина ОВ, Панков АС и др. Диагностика и лечение хронической венозной обструкции: согласованное мнение российских экспертов (часть 2). Хирург. 2020;(7-8):22–55. https://doi.org/10.33920/med-15-2004-02.</mixed-citation><mixed-citation xml:lang="en">Lobastov KV, Bondarchuk DV, Borsuk DA, Bredikhin RA, Bukina OV, Pankov AS et al. Diagnosis and treatment of chronic venous obstruction: consensus statement of the Russian experts (Part 2). Khirurg. 2020;(7-8):22–55. (In Russ.) https://doi.org/10.33920/med-15-2004-02.</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Lane RJ, Cuzzilla ML, Harris RA, Phillips MN. Popliteal vein compression syndrome: obesity, venous disease and the popliteal connection. Phlebology. 2009;24(5):201–207. https://doi.org/10.1258/phleb.2008.008039.</mixed-citation><mixed-citation xml:lang="en">Lane RJ, Cuzzilla ML, Harris RA, Phillips MN. Popliteal vein compression syndrome: obesity, venous disease and the popliteal connection. Phlebology. 2009;24(5):201–207. https://doi.org/10.1258/phleb.2008.008039.</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Dimopoulos C, Papastefanou I, Theodoridis P, Iatrou N, Bisdas T. Incidence and management of symptomatic pelvic venous disorders in patients with lower extremity varicose veins. Phlebology. 2026;41(2):154–162. https://doi.org/10.1177/02683555251351184.</mixed-citation><mixed-citation xml:lang="en">Dimopoulos C, Papastefanou I, Theodoridis P, Iatrou N, Bisdas T. Incidence and management of symptomatic pelvic venous disorders in patients with lower extremity varicose veins. Phlebology. 2026;41(2):154–162. https://doi.org/10.1177/02683555251351184.</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Tan M, Lurie F, Bauza Moreno H, Van den Bussche D, Parsi K, Davies AH; UIP. Management of venous leg ulcers. Phlebology. 2024;39(7):488–491. https://doi.org/10.1177/02683555241243167.</mixed-citation><mixed-citation xml:lang="en">Tan M, Lurie F, Bauza Moreno H, Van den Bussche D, Parsi K, Davies AH; UIP. Management of venous leg ulcers. Phlebology. 2024;39(7):488–491. https://doi.org/10.1177/02683555241243167.</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Mosti G, Benigni JP, Bohbot S, Devoogdt N, Forner-Cordero I, da Matta E et al. Compression terms: Defining terminology of compression therapy — An international compression club consensus document. Phlebology. 2025;40(7):490–495. https://doi.org/10.1177/02683555241313422.</mixed-citation><mixed-citation xml:lang="en">Mosti G, Benigni JP, Bohbot S, Devoogdt N, Forner-Cordero I, da Matta E et al. Compression terms: Defining terminology of compression therapy — An international compression club consensus document. Phlebology. 2025;40(7):490–495. https://doi.org/10.1177/02683555241313422.</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Богачев ВЮ, Росуховский ДА, Борсук ДА, Шонов ОА, Манджикян ОП, Лобастов КВ и др. Российские клинические рекомендации по диагностике и лечению С1-клинического класса хронических заболеваний вен (ретикулярный варикоз и телеангиэктазии). Амбулаторная хирургия. 2020;(3-4):140–206. https://doi.org/10.21518/18/1995-1477-2020-3-4-140-206.</mixed-citation><mixed-citation xml:lang="en">Bogachev VYu, Rosukhovski DA, Borsuk DA, Shonov OA, Manjikian HP, Lobastov KV et al. Russian clinical practice guidelines for the management of C1 clinical class of chronic venous disorders (reticular veins and telangiectasias). Ambulatornaya Khirurgiya. 2020;(3-4): 140–206. (In Russ.) https://doi.org/10.21518/18/1995-1477-2020-3-4-140-206.</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Lee BB, Baumgartner I, Berlien P, Bianchini G, Burrows P, Gloviczki P et al.; International Union of Phlebology. Diagnosis and Treatment of Venous Malformations. Consensus Document of the International Union of Phlebology (IUP): updated 2013. Int Angiol. 2015;34(2):97–149. Available at: https://pubmed.ncbi.nlm.nih.gov/24566499.</mixed-citation><mixed-citation xml:lang="en">Lee BB, Baumgartner I, Berlien P, Bianchini G, Burrows P, Gloviczki P et al.; International Union of Phlebology. Diagnosis and Treatment of Venous Malformations. Consensus Document of the International Union of Phlebology (IUP): updated 2013. Int Angiol. 2015;34(2):97–149. Available at: https://pubmed.ncbi.nlm.nih.gov/24566499.</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Executive Committee of the International Society of Lymphology. The Diagnosis and Treatment of Peripheral Lymphedema: 2023 Consensus Document of The International Society of Lymphology. Lymphology. 2023;56(4):133–151. Available at: https://doi.org/10.2458/lymph.6372.</mixed-citation><mixed-citation xml:lang="en">Executive Committee of the International Society of Lymphology. The Diagnosis and Treatment of Peripheral Lymphedema: 2023 Consensus Document of The International Society of Lymphology. Lymphology. 2023;56(4):133–151. Available at: https://doi.org/10.2458/lymph.6372.</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Faerber G, Cornely M, Daubert C, Erbacher G, Fink J, Hirsch T et al. S2k guideline lipedema. J Dtsch Dermatol Ges. 2024;22(9):1303–1315. https://doi.org/10.1111/ddg.15513.</mixed-citation><mixed-citation xml:lang="en">Faerber G, Cornely M, Daubert C, Erbacher G, Fink J, Hirsch T et al. S2k guideline lipedema. J Dtsch Dermatol Ges. 2024;22(9):1303–1315. https://doi.org/10.1111/ddg.15513.</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Борсук ДА, Фокин АА. Пути улучшения результатов миниинвазивного лечения варикозного расширения вен нижних конечностей. М.: ДПК; 2023. 300 с. Режим доступа: https://elibrary.ru/sdacxx.</mixed-citation><mixed-citation xml:lang="en">Борсук ДА, Фокин АА. Пути улучшения результатов миниинвазивного лечения варикозного расширения вен нижних конечностей. М.: ДПК; 2023. 300 с. Режим доступа: https://elibrary.ru/sdacxx.</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Nicolaides AN, Fareed J, Spyropoulos AC, Kakkar RHL, Antignani PL, Avgerinos E et al. Prevention and management of venous thromboembolism. International Consensus Statement. Guidelines according to scientific evidence. Int Angiol. 2024;43(1):1–222. https://doi.org/10.23736/S0392-9590.23.05177-5.</mixed-citation><mixed-citation xml:lang="en">Nicolaides AN, Fareed J, Spyropoulos AC, Kakkar RHL, Antignani PL, Avgerinos E et al. Prevention and management of venous thromboembolism. International Consensus Statement. Guidelines according to scientific evidence. Int Angiol. 2024;43(1):1–222. https://doi.org/10.23736/S0392-9590.23.05177-5.</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Lobastov KV, Shaldina MV, Matveeva AV, Kovalchuk AV, Borsuk DA, Schastlivtsev IV et al. The correlation between Caprini score and the risk of venous thromboembolism after varicose vein surgery. Int Angiol. 2023;42(6):477–487. https://doi.org/10.23736/S0392-9590.23.05050-2.</mixed-citation><mixed-citation xml:lang="en">Lobastov KV, Shaldina MV, Matveeva AV, Kovalchuk AV, Borsuk DA, Schastlivtsev IV et al. The correlation between Caprini score and the risk of venous thromboembolism after varicose vein surgery. Int Angiol. 2023;42(6):477–487. https://doi.org/10.23736/S0392-9590.23.05050-2.</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Lobastov K, Urbanek T, Stepanov E, Lal BK, Marangoni J, Krauss ES et al. The Thresholds of Caprini Score Associated with Increased Risk of Venous Thromboembolism Across Different Specialties: A Systematic Review. Ann Surg. 2023;277(6):929–937. https://doi.org/10.1097/SLA.0000000000005843.</mixed-citation><mixed-citation xml:lang="en">Lobastov K, Urbanek T, Stepanov E, Lal BK, Marangoni J, Krauss ES et al. The Thresholds of Caprini Score Associated with Increased Risk of Venous Thromboembolism Across Different Specialties: A Systematic Review. Ann Surg. 2023;277(6):929–937. https://doi.org/10.1097/SLA.0000000000005843.</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Апханова ТВ, Ахметзянов РВ, Ахтямов ИФ, Баринов ВЕ, Бахметьев АС, Белов МВ и др. Тромбоз глубоких вен: клинические рекомендации. 2025. Режим доступа: https://diseases.medelement.com/disease/84-2025/19013.</mixed-citation><mixed-citation xml:lang="en">Апханова ТВ, Ахметзянов РВ, Ахтямов ИФ, Баринов ВЕ, Бахметьев АС, Белов МВ и др. Тромбоз глубоких вен: клинические рекомендации. 2025. Режим доступа: https://diseases.medelement.com/disease/84-2025/19013.</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Borsuk DA, Sadek M, Kabnick LS. Current status of endothermal heat induced thrombosis. Int Angiol. 2021;40(4):277–282. https://doi.org/10.23736/S0392-9590.21.04667-8.</mixed-citation><mixed-citation xml:lang="en">Borsuk DA, Sadek M, Kabnick LS. Current status of endothermal heat induced thrombosis. Int Angiol. 2021;40(4):277–282. https://doi.org/10.23736/S0392-9590.21.04667-8.</mixed-citation></citation-alternatives></ref><ref id="cit18"><label>18</label><citation-alternatives><mixed-citation xml:lang="ru">Фокин АА, Борсук ДА, Казачков ЕЛ. Эффективность применения ривароксабана для лечения термоиндуцированных тромбозов после эндовенозной лазерной коагуляции. Ангиология и сосудистая хирургия. 2016;22(4):97–101. Режим доступа: https://angiolsurgery.org/magazine/2016/4/14.htm.</mixed-citation><mixed-citation xml:lang="en">Fokin AA, Borsuk DA, Kazachkov EL. Efficacy of rivaroxaban for the treatment of endothermal heat-induced thrombosis after endovenous laser ablation. Angiology and Vascular Surgery. 2016;22(4):97–101. (In Russ.) Available at: https://angiolsurgery.org/magazine/2016/4/14.htm.</mixed-citation></citation-alternatives></ref><ref id="cit19"><label>19</label><citation-alternatives><mixed-citation xml:lang="ru">Борсук ДА, Фокин АА. Пути улучшения результатов миниинвазивного лечения варикозного расширения вен нижних конечностей. М.: ДПК Пресс; 2023. 300 с. Режим доступа: // https://elibrary./sdacxx.</mixed-citation><mixed-citation xml:lang="en">Борсук ДА, Фокин АА. Пути улучшения результатов миниинвазивного лечения варикозного расширения вен нижних конечностей. М.: ДПК Пресс; 2023. 300 с. Режим доступа: // https://elibrary./sdacxx.</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
