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Pleiotropic therapy for the initial stages of chronic venous insufficiency in post-thrombotic disease

https://doi.org/10.21518/1995-1477-2020-3-4-20-26

Abstract

Introduction. The current surgical techniques for the treatment of post-thrombotic disease are at the design phase, are performed in individual cases, not always result in an unambiguous outcome, and cannot completely solve this complex clinical problem. The use of drugs with a pleiotropic mechanism of action that act on various links in the pathogenesis of chronic venous insufficiency show promise.

Objective of the study. Assess the clinical efficacy of a drug based on deproteinized hemoderivative obtained from calf blood used to treat the initial manifestations of chronic venous insufficiency affected by post-thrombotic disease.

Materials and methods. Results of examination and treatment of 64 patients (30 men, 34 women) with lower extremity post-thrombotic disease and initial manifestations of chronic venous insufficiency (C1-C3). Treatment with a drug based on deproteinized hemoderivative obtained from calf blood at a dosage of 1200 mg per day (intravenous infusion, 30 ml of the drug diluted with 400 ml of Normal Saline) for 10 days. Then, per os at a dose of 1200 mg per day (2 tablets t.i.d.) for 30 days at the outpatient stage. Monotherapy was carried out without the addition of phlebotonics.

Results. The therapy resulted in a significant edema syndrome decrease in the ankle area. This indicator decreased from 27.12 ± 0.41 cm to 24.95 ± 0.38 cm (p <0.05). Patients’ complaints about pins and needles decreased from 5.76 ± 0.81 to 2.31 ± 0.65 points (p < 0.05), the frequency and intensity of seizures decreased from 6.53 ± 1.40 to 3.19 ± 0, 94 points (p < 0.05). The intensity of the edema syndrome significantly decreased from 8.13 ± 1.73 to 4.31 ± 1.19 points (p < 0.05), pain syndrome – from 7.94 ± 1.86 to 3.11 ± 1.44 points (p < 0.05), heaviness in the lower extremities – from 8.54 ± 1.72 to 3.90 ± 1.46 points (p < 0.05), the overall patients’ quality of life improved (the integral indicator decreased from 63.29 ± 1.84 to 44.31 ± 1.18 points, p < 0.05).

Conclusions. The use of pleiotropic drugs is justified in the early stages of chronic venous insufficiency in patients with post-thrombotic disease, as the therapy produces a complex effect on the microcirculatory bloodstream, metabolic processes in tissues and the rheological properties of blood.

About the Authors

M. R. Kuznetsov
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Maxim R. Kuznetsov, Dr. of Sci. (Med.), Professor of RAS, Deputy Director for Clinical Affairs, Institute of Cluster Oncology named after L.L. Levshin

6, Bldg. 1, B. Pirogovskaya St., Moscow, 119991, Russia



V. Yu. Bogachev
Pirogov Russian National Research Medical University
Russian Federation

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

1, Ostrovityanov St., Moscow, 117997, Russia



S. V. Sapelkin
Vishnevsky National Medical Research Center of Surgery
Russian Federation

Sergey V. Sapelkin, Dr. of Sci. (Med.), Leading Research Associate, Department of Vascular Surgery

27, Bolshaya Serpukhovskaya St., Moscow, 117997, Russia



I. P. Marchenko
Bauman City Clinical Hospital No. 29 of the Moscow Department of Health
Russian Federation

Igor P. Marchenko, Cand. of Sci. (Med.), Surgeon, Deputy Chief Physician for Surgery

2, Gospitalnaya Square, Moscow, 111020, Russia



L. A. Neskhodimov
Central Clinical Hospital of the Metropolitan Alexius of Moscow at the Moscow Patriarchy of the Russian Orthodox Church
Russian Federation

Leonid A. Neskhodimov, Endoscopist, Head of Endoscopy Center, Consulting-Diagnostic Department

27, Lenin Ave., Moscow, 119071, Russia



A. A. Khotinskiy
Pirogov Russian National Research Medical University
Russian Federation

Andrey A. Khotinskiy, Postgraduate Student, Department of Intermediate Level Surgery No. 1, Faculty of General Medicine

1, Ostrovityanov St., Moscow, 117997, Russia



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Review

For citations:


Kuznetsov M.R., Bogachev V.Yu., Sapelkin S.V., Marchenko I.P., Neskhodimov L.A., Khotinskiy A.A. Pleiotropic therapy for the initial stages of chronic venous insufficiency in post-thrombotic disease. Ambulatornaya khirurgiya = Ambulatory Surgery (Russia). 2020;(3-4):20-26. (In Russ.) https://doi.org/10.21518/1995-1477-2020-3-4-20-26

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