Current indications for phlebotropic therapy and its duration
https://doi.org/10.21518/1995-1477-2021-18-1-13-23
Abstract
Phlebotropic therapy is an important component of the pathogenetic treatment of chronic venous insufficiency (CVI) of the lower extremities. Venoactive drugs, which have proven their effectiveness and safety in a variety of studies, are widely represented in international and Russian clinical guidelines and standards. However, there is no consensus on the regulation of phlebotropic therapy and, above all, its duration in different clinical classes of CVI. In addition, there are no clear indications on the methods of treatment efficacy monitoring, which can be used in real clinical practice. The presented systematized review of the literature data on micronized purified flavonoid fraction not only reveals the possibilities of phlebotropic therapy of different clinical classes and forms of CVI, but also suggests effective regulations for the use of this drug in specific situations. The data concerning the efficacy of phlebotropic therapy in real clinical practice at the initial stages of CVI (C0s-C1s), in the treatment of C2s (varicose superficial veins with venospecific symptoms), C3 (chronic venous edema), C4 (trophic skin disorders), as well as in stages C5-C6 and C6r (venous trophic ulcers) are presented in details. In addition, the results of studies on the use of micronized purified flavonoid fraction in phlebosclerosing treatment are presented. The duration of phlebotropic therapy is in direct relation to the severity of the disease and the response to the ongoing treatment. The important role is played not only by personalization of treatment according to specific symptoms and syndromes, but also, if possible, by objective control of their dynamics.
About the Authors
V. Yu. Bogachev
Pirogov Russian National Research Medical University;
First Phlebological Center
Russian Federation
Russian Federation
Vadim Yu. Bogachev, Dr. Sci. (Med.), Professor, Department of Intermediate Level Surgery No. 2
1, Ostrovityanov St., Moscow, 117997;
31, Dmitry ulyanov St., Moscow, 117447
B. V. Boldin
Pirogov Russian National Research Medical University
Russian Federation
Russian Federation
Boris V. Boldin, Dr. Sci. (Med.), Professor, head of Intermediate Level Surgery No. 2
1, Ostrovityanov St., Moscow, 117997
P. Yu. Turkin
Pirogov Russian National Research Medical University
Russian Federation
Russian Federation
Pavel Yu. Turkin, Cand. Sci. (Med.), Associate Professor, Department of Intermediate Level Surgery No. 2
1, Ostrovityanov St., Moscow, 117997
O. V. Dzhenina
First Phlebological Center
Russian Federation
Russian Federation
Olga V. Dzhenina, Cand. Sci. (Med.), Surgeon, Vascular Surgeon
31, Dmitry ulyanov St., Moscow, 117447
A. Yu. Samenkov
Pirogov Russian National Research Medical University
Russian Federation
Russian Federation
Aleksandr Yu. Samenkov, Postgraduate Student, Department of Intermediate Level Surgery No. 2
1, Ostrovityanov St., Moscow, 117997
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Review
For citations:
Bogachev V.Yu., Boldin B.V., Turkin P.Yu., Dzhenina O.V., Samenkov A.Yu. Current indications for phlebotropic therapy and its duration. Ambulatornaya khirurgiya = Ambulatory Surgery (Russia). 2021;18(1):13-23. (In Russ.) https://doi.org/10.21518/1995-1477-2021-18-1-13-23
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