Surgical treatment of high-risk varicose veins in patients with systemic collagenopathy: Vascular type of Ehlers–Danlos syndrome

Varicose vein disease of the lower extremities in patients with the vascular type of Ehlers–Danlos syndrome (EDS) is associated with a high risk of vascular rupture and postoperative complications. Therefore, an individualized approach to diagnosis, treatment, and postoperative management is essential for patients with varicose veins and vascular-type EDS. An analysis of two clinical cases of patients with confirmed vascular-type EDS was conducted. Diagnosis included clinical examination, genetic testing, duplex vein scanning, CT angiography, and coagulation tests. Minimally invasive treatment methods were applied. A 46-year-old female patient underwent miniphlebectomy without complications, with restored venous outflow. The surgery was successful, with a decrease in the symptoms of chronic venous insufficiency. The second case concerned a 21-year-old patient with a history of recurrent episodes of deep vein thrombosis, as well as nosebleeds and hematomas with minimal trauma. Given the high risk of complications during invasive intervention, as well as the results of genetic analysis confirming the vascular type of EDS, it was decided to refuse surgical treatment. The patient received complex conservative therapy. Surgical treatment for vascular-type EDS should be as minimally invasive as possible. Genetic testing is necessary in cases of early varicose vein development. Individualized anesthesia selection and continuous monitoring are crucial due to the high risk of vascular complications.

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