Comparative efficacy of combination drug regimens after endovenous laser coagulation and sclerotherapy in lower extremity varicose vein disease

Introduction. Endovenouslaser coagulation/obliteration (EVLC/EVLO) and microfoam sclerotherapy (MS) are highly effective treatments for chronic venous diseases, particularly varicose veins. Yet the question remains – what should be done to improve patient care after minimally invasive interventions in the postoperative period.

Aim. To evaluate the efficacy of various combination drug regimens with micronized purified flavonoid fraction (MPFF) and sulodexide after EVLC and sclerotherapy inlower extremity varicose vein disease.

Materials and methods. A comparative study involving 150 patients with CEAP C2–C3 varicose veins was conducted. The patients were divided into three groups of 50. Venous duplex ultrasound demonstrated the great saphenous vein (GSV) valve incompetence in 117 cases (71%) and the small saphenous vein (SSV) valve incompetence in 33 cases (29%). All patients underwent treatment with EVLC on the GSV/ SSV combined with foam sclerotherapy (FS). Three different drug regimens were used in the preand postoperative periods. Follow-up examinations of patients took place on days 1 and 10 after surgery, as well as at 3 and 6 months.

Results. On day 7, the pain intensity began to regress faster in groups 2 and 3 (VAS pain score, p < 0.05). On day 90, statistically significant improvement in the quality oflife was observed in group 3 (VEINES-QOL scores, p < 0.01). On day 180, CIVIQ-20 quality-of-life scores were also higher in group 3. Treatment satisfaction and medication adherence were highest among patients in groups 2 and 3 throughout the entire course.

Conclusion. The topical gel and extended 60-day MPFF-based regimen showed the best results: relief of early symptoms (pain, induration) within the first 7 days after surgery, improved quality oflife, no recurrence of varicose transformed tributaries, adequate management of chronic venous insufficiency symptoms by month 3 and 6, and patient compliance.

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