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To date, modern outpatient minimally invasive interventions for varicose veins, such as endovenous laser or radiofrequency ablation, microphlebectomy, sclerotherapy, non-thermal non-tumescent methods (NTNT), are widely introduced into clinical practice in the Russia. In the approved by the Ministry of Health of the Russian Federation in 2021 clinical guidelines "Varicose veins of the lower extremities" they are recommended as preferred over open surgery. At the same time, there are no federal regulations of preoperative examination of patients before these minimally invasive procedures for varicose veins. That is why the medical community is often forced to prescribe unnecessary diagnostic tests on the "just-in-case" principle, in order to protect itself for cases of complications and subsequent checks. This undoubtedly harms both the patients and the medical service, which has an additional useless and inappropriate burden. The purpose of the round table held on September 28, 2021 under the auspices of the Self-Regulatory Organization “The National College of Phlebology” together with the legal partner “The Faculty of Medical Law LLC” (Moscow), was to review the existing legislation on this issue and then to prepare a resolution regarding the justified preoperative examination of patients before minimally invasive interventions for varicose veins of the lower extremities. The prepared document consists of two parts. The first part presents the legal regulation of the diagnostic tests before interventions in phlebology. The second part contains the opinion of the professional community regarding the appropriateness or inexpediency of different pre-procedural examinations. In addition, based on the conclusions of legal analytics, a form of order of the chief physician has been developed, which regulates the diagnostic tests before the considered phlebological interventions in the clinic.

Introduction Pelvic congestion syndrome (PCS) may be effectively managed with conservative treatment in certain patients. Treatment with venoactive drugs is common, but supportive data are limited. This study evaluated the clinical efficacy of micronized purified flavonoid fraction (MPFF) in women with PCS. Methods In a single-blind, placebo-controlled study, women with duplex ultrasound diagnosis of pelvic varicose veins (PVV) and PCS were randomized to MPFF 1000 mg once daily or placebo for 2 months. Clinical manifestations of PCS were evaluated at baseline and end of treatment (M2) using three assessment tools: disease-specific quality of life (QoL) Pelvic Varicose Vein Questionnaire (PVVQ), Pelvic Venous Clinical Severity Score (PVCSS), and the Visual Analog Scale (VAS) for the main symptoms of the disease. Results A total of 83 women were included, 42 received MPFF and 41 received placebo. In the MPFF group, the mean global PVVQ QoL index decreased significantly from 45.1 ± 14.7 at baseline to 36.6 ± 10.6 at M2 (mean change: 8.2 ± 10.4); no significant change was observed in the control group (mean change: – 0.3 ± 4.0). The between-group difference was statistically significant (P

Recently collated scientific data on the management of C1 clinical class of chronic venous disorders; wide prevalence of the disease and high variability amongst medical practitioners in relation to managing this category of patients and absence of any regulatory documents has prompted the development of clinical guidelines for the treatment of patients with reticular varicose veins and telangiectasias of the lower extremities and various parts of the body. These guidelines have been developed by a self-regulated organization Association “The National College of Phlebology”. The purpose of the de novo guidelines is to systematize the existing evidence and offer minimal standards of care for chronic venous disorders in C1 patients.

The histological differences in the structure of the ovarian vein and saphenous veins of the lower extremities during their varicose transformation have been insufficiently studied in the modern literature. The study aims to determine the morphological parallels of the structure of varicose veins in varicose veins of the pelvis and varicose veins of the lower extremities. Fifty histological biopsy specimens of removed veins were examined in women. Of these, 25 large saphenous veins were obtained from patients with varicose veins of the lower extremities and 25 preparations of a resected ovarian vein from 25 women with varicose veins of the pelvis. The preparation was stained with hematoxylin-eosin and by the Van Gieson method, studied by light microscopy. In the study of the preparations, significant structural changes were noted in all layers of the venous wall, both in varicose veins of the pelvis and in varicose veins of the lower extremities in the form of a combination of atrophic, fibroplastic and hypertrophic processes leading to the loss of its functional properties. Depending on the decompensation of pathological processes, 3 morphological forms of lesions of the venous wall structure were revealed. The hypertrophic form was found in 17 (34%) surgery perform women, fibrous - in 13 (26%), atrophic - in 20 (40%). In the group of patients with varicose veins of the pelvis compared with the group of patients with varicose veins of the lower extremities, the prevalence of initial forms of lesion was revealed. There was a correlation between the severity of venous vascular lesions with the duration of the disease and the patient's age, the number of risk predictors and a high body mass index, which was the determining factor in the occurrence of this phenomenon. The results of this study indicate the similarity of the pathological picture of venous lesions, both in varicose veins of the pelvis and in varicose veins of the lower extremities.

This consensus statement of Russian experts is based on a review of the relevant literature on the prevalence, diagnosis, and treatment of non-thrombotic and post-thrombotic venous obstruction, as well as management of patients after venous stenting. In the Part 1 we discussed the clinical manifestations of venous obstruction, the role of duplex ultrasound scan, CT venography, MR venography, direct venography, and intravascular ultrasound scan, as well as typical findings obtained by using these methods. The authors mentioned the functional assessment of venous outflow in healthy subjects and in those with obstruction and changes in them after the intervention. In conclusion, the authors formulated the suggestions for clinical recommendations on the diagnosis of chronic venous obstruction.

It is estimated that more than 200 million people worldwide suffer peripheral artery disease and the rate of amputations remains at a high level. The basis of treatment is timely revascularization wherein the fraction of interventions performed endovascularly has steadily been growing both in Russia and abroad. Nevertheless, the parameters of long-term patency of endovascular reconstructions of the infrainguinal segment are still inferior to open interventions. In order to select an optimal method of revascularization and to predict the duration of patency of the reconstruction modern clinical guidelines suggest using the GLASS and WIfI scales, which may improve the remote results of the intervention. Moreover, modern paclitaxel-coated stents and balloons may help increase primary patency of the reconstruction after endovascular procedures. A not less important method of improving remote results of endovascular treatment of patients with peripheral artery disease is considered to be the use of contemporary regimens of antithrombotic therapy. The VOYAGER PAD trial showed that in patients with peripheral artery disease after endured revascularization of lower limbs rivaroxaban prescribed at a dose of 2.5 mg twice daily in a combination with conventional antithrombocytic therapy made it possible to decrease the risk of such ischaemic complications as acute limb ischaemia, major amputation, myocardial infarction, ischaemic stroke and death of cardiovascular causes.По оценкам, свыше 200 млн человек во всем мире страдают заболеваниями периферических артерий, а частота ампутаций остается на высоком уровне. Основой лечения является своевременная реваскуляризация, где доля вмешательств, выполненных эндоваскулярно, неуклонно растет как в России, так и в других странах. Тем не менее показатели отдаленной проходимости эндоваскулярных реконструкций инфраингвинального сегмента пока уступают открытым вмешательствам. Для выбора оптимального метода реваскуляризации и прогнозирования срока проходимости реконструкции в современных клинических рекомендациях предлагается использовать шкалы оценки GLASS и WIFI, что может улучшить отдаленные результаты вмешательства. Более того, современные стенты и баллоны с паклитакселом также способны помочь увеличить первичную проходимость реконструкции после эндоваскулярных процедур. Не менее важным методом улучшения отдаленных результатов эндоваскулярного лечения пациентов с заболеваниями периферических артерий считается применение современных схем антитромботической терапии. В исследовании VOYAGER PAD было продемонстрировано, что у пациентов с заболеваниями периферических артерий, перенесших реваскуляризацию нижних конечностей, назначение ривароксабана в дозе 2,5 мг 2 р/сут в сочетании со стандартной антитромбоцитарной терапией позволило снизить риск развития таких ишемических осложнений, как острая ишемия конечности, большая ампутация, инфаркт миокарда, ишемический инсульт и смерть от сердечно-сосудистых причин.

Presented in the article is a prospective study of endovascular embolization of ovarian veins in female patients suffering from primary pelvic varicose veins, with the assessment of the immediate and remote results, as well as a 1-year follow up.The aim of our investigation was a comprehensive clinical and instrumental assessment of efficacy of endovascular embolization in women with pelvic varicose veins.Our single-centre study included a total of 29 female patients presenting with pelvic varicose veins and undergoing embolization of ovarian veins using microcoils, in 5 cases the procedure was supplemented with injecting a foam sclerosant.The technical success of endovascular occlusion of ovarian veins amounted to 100%. Two women immediately after the operation were subjected to a redo intervention: in one case - resection of the ovarian vein and in the second case - repositioning of the microcoils. In the remote period, one patient due to recurrent relapses underwent repeat embolization followed by retroperitoneal resection of the ovarian vein. The findings of the clinical methods of examination demonstrated a decrease in the intensity of manifestations of pelvic varicose veins according to the pelvic venous clinical severity score and visual analogue scale, as well as improvement of the women's quality of life.Endovascular occlusion of ovarian veins is a highly effective, minimally invasive, and safe method of treatment of female patients with incompetent ovarian veins. Endovascular treatment may be regarded as a method of choice in management of the primary form of pelvic varicose veins.В статье представлено проспективное исследование эндоваскулярной эмболизации яичниковых вен у пациенток с первичной варикозной болезнью таза с оценкой ближайших и отдаленных результатов, а также годового наблюдения. Цель – комплексная клиническая и инструментальная оценка эффективности эндоваскулярной эмболизации у пациенток с варикозной болезнью таза. Материалы и методы. В одноцентровое исследование включено 29 пациенток с варикозной болезнью таза, которым была выполнена эмболизация яичниковых вен микроспиралями, в 5 случаях процедура дополнялась введением пенного склерозанта. Результаты. Технический успех эндоваскулярной окклюзии яичниковых вен составил 100%. В двух случаях непосредственно после операции осуществлено повторное вмешательство: в одном – резекция яичниковой вены, во втором – повторное позиционирование микроспиралей. В отдаленном периоде одной из пациенток вследствие повторных рецидивов проведены операции повторной эмболизации, а затем забрюшинной резекции яичниковой вены. При оценке клинических методов исследования отмечали снижение интенсивности проявлений варикозной болезни таза по шкале тяжести и визуально-аналоговой шкале, а также улучшение качества жизни пациенток. Выводы. Эндоваскулярная окклюзия яичниковых вен является высокоэффективным, миниинвазивным и безопасным методом лечения пациенток с несостоятельностью яичниковых вен. Эндоваскулярные методы лечения могут считаться методом выбора в лечении первичной формы варикозной болезни таза.

Contraction (retraction) of the blood clot is a part of the clotting process driven by activated platelets attached to fibrin that can potentially modulate the obstructiveness and integrity of thrombi. The aim of this work was to reveal the pathogenic importance of contraction of clots and thrombi in venous thromboembolism (VTE). We investigated the kinetics of clot contraction in the blood of 55 patients with VTE. In addition, we studied the ultrastructure of ex vivo venous thrombi as well as the morphology and functionality of isolated platelets. Thrombi from VTE patients contained compressed polyhedral erythrocytes, a marker for clot contraction in vivo. The extent and rate of contraction were reduced by twofold in clots from the blood of VTE patients compared with healthy controls. The contraction of clots from the blood of patients with pulmonary embolism was significantly impaired compared with that of those with isolated venous thrombosis, suggesting that less compacted thrombi are prone to embolization. The reduced ability of clots to contract correlated with continuous platelet activation followed by their partial refractoriness. Morphologically, 75% of platelets from VTE patients were spontaneously activated (with filopodia) compared with only 21% from healthy controls. At the same time, platelets from VTE patients showed a 1.4-fold reduction in activation markers expressed in response to chemical activation when compared with healthy individuals. The results obtained suggest that the impaired contraction of thrombi is an underappreciated pathogenic mechanism in VTE that may regulate the obstructiveness and embologenicity of venous thrombi.

The persistent sciatic artery is situated superficially in the gluteal region wherein it can be traumatized in normal daily activities: during a prolonged sitting position or while attempting to sit down. This leads to an early atherosclerotic lesion of the sciatic artery, to the development of aneurysmatic dilatation, and damage to the arterial wall. The present article describes a 72-year-old female patient presenting with a persistent sciatic artery of the left leg and a PSA aneurysm which consequently resulted in critical ischaemia of her left lower limb. This abnormality was detected during an examination and the woman was subjected to the operation of internal iliac-posterior tibial bypass grafting using an autologous vein with ligation of the sciatic artery. The bypass graft has been functioning for 5 months, with no events of critical ischaemia.Сохраненная седалищная артерия располагается поверхностно в ягодичной области, где может быть травмирована при нормальной повседневной деятельности: во время длительного нахождения в положении сидя, либо при попытке присесть. Это приводит к ранним атеросклеротическим поражениям седалищной артерии, развитию аневризматического расширения и повреждению стенки артерии. В этой работе представлено описание пациентки 72 лет с наличием атипичной седалищной артерии левой нижней конечности и развитием ее аневризмы, что впоследствии привело к критической ишемии левой нижней конечности. В ходе обследования данная аномалия была выявлена и проведена операция внутреннеподвздошно-заднебольшеберцового шунтирования аутовеной с лигированием седалищной артерии. Шунт функционирует в течение 5 месяцев. Явления критической ишемии купированы.

Using assessment scales in clinical and research practice is one of fundamental reference methods of evaluation in human pathological states. Pelvic vein varicosity is an independent nosological entity within the framework of chronic vein diseases. Currently, the clinical methods of assessment in the aspect of a patient-oriented approach in this type of disease are largely understudied and still not duly defined.The study was aimed at analyzing clinical outcomes of surgical treatment in the form of resection of the ovarian vein in female patients with pelvic varicose veins, based on the developed specialized scale of clinical assessment of disease severity.We carried out an open prospective study of efficacy of resection of the ovarian vein in 37 women with pelvic varicose veins. The main criterion for assessment was a clinical method of determining manifestations of the disease by means of the Pelvic Venous Clinical Severity Score.According to the Pelvic Venous Clinical Severity Score, improvement of the condition was observed in 36 (97.3%) operated female patients and 1 (2.7%) woman turned out to have negative dynamics. The median of the composite score of the severity scale decreased form 11.78±5.06 points to 5.22±3.19 (p0.05). The total positive gradient of the score amounted to 6.57±3 .65 points. A significant decrease in manifestations of severity was observed for 9 of the 10 clinical descriptors of the disease.The use of the suggested scale in practical assessment of the results made it possible to prove high efficacy of resection of the ovarian vein in women with pelvic varicose veins in the form of decreased intensity of the disease's symptomatology. The VCSS is an easy-to-fill-in tool, taking up little time, ensuring no influence of the physician's personality on the answers, presenting quantitative expression of therapeutic results.Использование оценочных шкал в клинической и исследовательской практике является одним из основополагающих референтных методов оценки при патологическом состоянии человека. Варикозная болезнь таза является самостоятельной нозологической единицей в рамках хронических заболеваний вен. В настоящее время клинические методы оценки в аспекте пациент-ориентированного подхода при данном заболевании не до конца изучены и определены. Цель исследования. Клинический анализ результатов хирургического лечения в виде резекции яичниковой вены у пациенток с варикозной болезнью таза на основании разработанной специализированной шкалы клинической оценки тяжести заболевания. Материалы и методы. Проведено открытое проспективное исследование эффективности операции резекции яичниковой вены у 37 женщин с варикозной болезнью таза. Основным критерием оценки являлся клинический метод определения тяжести проявлений болезни в виде балльной клинической шкалы оценки тяжести заболевания пациентки с варикозной болезнью таза – Pelvic Venous Clinical Severity Score. Результаты. Согласно клинической шкале тяжести заболевания, улучшение состояния отмечено у 36 (97,3%) оперированных пациенток, у 1 (2,7%) больной зарегистрирована отрицательная динамика. Медиана суммарного показателя шкалы тяжести регрессировала с 11,78±5,06 баллов до 5,22±3,19 (p0,05). Суммарный положительный градиент шкалы составил 6,57±3,65 баллов. Достоверное снижение проявлений тяжести отмечали по 9 признакам заболевания из 10. Заключение. Применение предложенной шкалы в практической оценке результатов позволило доказать высокую результативность операции резекции яичниковой вены у пациенток с варикозной болезнью таза в виде снижения интенсивности симптоматики заболевания. Заполнение данной шкалы не представляет трудности, занимает минимальное количество времени, исключает влияние личности врача на ответ, представляет количественное выражение результатов лечения.

Presented herein is an original method of preparing a bypass graft (a non-reversed autovein for femoropopliteal and femorotibial bypass grafting) and assessment of quality of valvulotomy using a thermal imager. The study included a total of 31 patients. All patients subdivided into 2 groups were subjected to bypass grafting operations with the use of a non-reversed autovein. In group 1 (n=16) prior to applying a bypass graft we assessed its patency with the use of an original method by means of a thermal imaging camera. In group 2 (n=15) assessment of graft patency after destruction of valves was not performed. In group 1 there were no bypass graft thromboses in the postoperative period, whereas three (20%) patients in group 2 developed bypass graft thrombosis within the first 24 postoperative hours, requiring repeat operation. Bypass graft thrombosis was caused in all cases by insufficiently destroyed valves of the venous transplant. There were no lethal outcomes within 1 year postoperatively. Control ultrasonographic examination after 1 year revealed bypass graft thrombosis in two (13.3%) patients in group 2, leading to the development of critical ischaemia and gangrene in one (6.6%) of these patients and later on requiring limb amputation at the level of the femur. A conclusion drawn is that thermal imaging makes it possible to intraoperatively assess quality of valvulotomy in using a non-reversed autovein as a bypass graft and to improve the results of surgical treatment.Представлен оригинальный способ подготовки шунта (нереверсированной аутовены для операции бедренно-подколенного и бедренно-берцового шунтирования) и оценки качества вальвулотомии с использованием тепловизора. В исследование включен 31 больной. Всем больным, разделенным на 2 группы, проводились шунтирующие операции с использованием нереверсированной аутовены. В 1 группе (n=16) перед наложением шунта оценивалась его проходимость с использованием оригинального способа с помощью тепловизора. Во 2 группе (n=15) оценка проходимости шунта после разрушения клапанов не проводилась. В послеоперационном периоде в 1 группе тромбозов шунта отмечено не было, тогда как во 2 группе тромбоз шунта в первые сутки после операции возник у 3 (20%) больных, что потребовало выполнения повторной операции. Причиной тромбоза шунта во всех случаях были недоразрушенные клапаны венозного трансплантата. В сроки до 1 года после операции летальных исходов не было. При проведении контрольного ультразвукового исследования через 1 год у 2 (13,3%) больных во 2 группе выявлен тромбоз шунта, что привело к развитию критической ишемии и гангрены у 1 (6,6%) из этих пациентов и в дальнейшем потребовало выполнения ампутации конечности на уровне бедра. Сделан вывод, что тепловизионное исследование позволяет интраоперационно оценить качество вальвулотомии при использовании в качестве шунта нереверсированной аутовены и улучшить результаты хирургического лечения.

The problem of haemostasis in cardiovascular surgery is of current concern. Recent trends are towards increased use of topical haemostatic agents. Tachocomb has been used for more than 30 years in abdominal surgery and oncology. The purpose of the present publication is to analyse the literature data and formulate the indications for the use of Tachocomb in cardiovascular surgery. Multicenter randomized and local studies have demonstrated efficacy of Tachocomb in treatment of surgical haemorrhage in operations on the heart, thoracic aorta, carotid arteries and lower-limb arteries, resulting in significantly decreased time to achieve haemostasis, decreased volume of blood loss and haemotrasfusion, as well as reduced frequency of complications. Also shown was economic efficacy, including a shortened length of patients' hospital stay. This is followed by describing a wide spectrum of examples of alternative use of Tachocomb, including its use for seamless closure of defects of cardiac chamber walls, aero- and lymphostasis, prevention of formation of commissures. Convincing experimental and clinical results make it possible to formulate a series of indications for the use of Tachocomb in cardiovascular surgery.В настоящее время остро стоит проблема гемостаза в сердечно-сосудистой хирургии. В этой связи в последние годы широко применяются местные гемостатические средства. Препарат Тахокомб используется более тридцати лет в абдоминальной хирургии и онкологии. Целью настоящей публикации является анализ литературных данных и формирование показаний к использованию Тахокомба в сердечно-сосудистой хирургии. Многоцентровые рандомизированные и локальные исследования продемонстрировали эффективность Тахокомба в лечении хирургических кровотечений при операциях на сердце, грудной аорте, сонных артериях и артериях нижних конечностей. Достоверно значимо уменьшается время достижения гемостаза, объем кровопотери, гемотрансфузии и снижается количество осложнений. Также показана экономическая эффективность, в том числе в виде уменьшения времени пребывания пациента в стационаре. Также описан широкий спектр примеров альтернативного использования препарата Тахокомб, в том числе с целью бесшовного закрытия дефектов стенок камер сердца, аэро- и лимфостаза, предотвращения образования спаек. Убедительные экспериментальные и клинические данные позволяют сформулировать целый ряд показаний к применению препарата Тахокомб в сердечно-сосудистой хирургии.

Aim. To study the effect of the blood components on clot contraction dynamics in vitro.Methods. The original method based on the optical detection of changes in the blood clot volume over time was used. Whole blood, as well as reconstructed samples using washed platelets, erythrocytes, purified fibrinogen, platelet-poor and platelet-rich plasma were studied.Results. Blood clot contraction has a non-linear kinetics, reflecting the complexity of the underlying mechanisms. Platelets increase the blood clot contraction, while the red blood cells have an inhibitory effect. Blocking the fibrin and platelets interaction using the RGDS peptide, an integrin αIIbβ3 antagonist, reduces the extent and rate of clot contraction. The exogenous Ca2+ is not required for contraction, but its addition stabilizes clots by inhibiting the erythrocytes. Thrombin has a dose-dependent effect and increases the rate and extent of contraction. In blood samples of patients taking warfarin, blood clot contraction was delayed.Conclusion. The blood clot contraction is a process which depends on many factors, including the blood cell composition, amount of fibrinogen, the endogenous thrombin activity and platelets interaction with fibrin; understanding the mechanisms of the blood clot contraction could form the basis for the development of novel approaches to the hemostatic disorders treatment.

Post-thrombotic iliac vein lesion is one of the causes of secondary pelvic varicose veins (PVV) in women. Endovascular treatment of this cohort of patients requires further studies.The study was undertaken to investigate the aspects of endovascular treatment of female patients diagnosed as having PVV secondary to post-thrombotic alterations of the iliac veins.Presented herein are the results of diagnosis and treatment of nine women suffering from PVV in obstructive lesion of the iliac veins. All patients underwent phlebography with stenting of the iliac veins, followed by clinical and instrumental assessment of efficacy of treatment.The technical success rate of stenting amounted to 100%. In the early postoperative period thrombotic complications developed in two women and in the remote period in one. The operation was followed by a decrease in the intensity of PVV manifestations, as well as chronic venous insufficiency of the lower limbs, which was confirmed by clinical and instrumental methods of objectification and visualization. The composite index of quality of life was noted to decrease from 47±5.3 to 27.8±3.3 points (p0.05). The median of the composite value of the Pelvic Venous Clinical Severity Score decreased by 8.6±1.8 points (p0.05). The average value of the composite index of the Venous Clinical Severity Score (VCSS) diminished by 6.8±1.4 points (p0.05) and that of the Villalta score by 8.3±1.6 points (p0.05).Pelvic varicose veins appear to develop in two of three women after endured thrombosis. The experience with stenting of the iliac veins demonstrated good efficacy and safety. Efficiency of the intervention was determined by improved quality of life of the patients and positive dynamics of the clinical course of the disease.Посттромботическое поражение подвздошных вен является одной из причин возникновения вторичной варикозной болезни таза (ВБТ) у женщин. Эндоваскулярное лечение этих пациенток требует дальнейших исследований. Цель - изучение аспектов эндоваскулярного лечения пациенток с вторичной ВБТ, обусловленной посттромботическими изменениями подвздошных вен. Материалы и методы. Приведены результаты диагностики и лечения девяти пациенток с ВБТ при обструктивном поражении подвздошных вен. Всем пациенткам выполнена флебография со стентированием подвздошных вен с последующей клинической и инструментальной оценкой эффективности лечения. Результаты. Технический успех стентирования составил 100%. В раннем послеоперационном периоде тромботические осложнения развились у двух пациенток, в отдаленном - у одной. После операции отмечали снижение интенсивности проявлений ВБТ, а также хронической венозной недостаточности нижних конечностей, доказанное клиническими и инструментальными методами объективизации и визуализации. Зарегистрировано уменьшение глобального индекса качества жизни ? с 47±5,3 до 27,8±3,3 балла (p0,05). Снижение медианы суммарного показателя клинической шкалы оценки тяжести ВБТ составило 8,6±1,8 балла (p0,05). Среднее значение суммарного показателя клинической шкалы оценки тяжести хронической венозной недостаточности нижних конечностей (Venous Clinical Severity Score - VCSS) снизилось на 6,8±1,4 балла (p0,05), по шкале Виллалта (Villaltа) - на 8,3±1,6 балла (p0,05). Заключение. Варикозная болезнь таза развивается у двух женщин из трех после перенесенного тромбоза. Опыт стентирования подвздошных вен показал хорошую результативность и безопасность. Эффективность вмешательства обусловлена улучшением качества жизни пациенток и положительной динамикой клинического течения заболевания.

Varicose vein disease (VD) of the lower extremities is the most common pathology of the peripheral vessels: 26-38% of women and 10-20% of men of working age suffer from it. The annual increase of new cases of VD among the inhabitants of industrialized countries reaches 2.6% among women and 1.9% among men. Its course is accompanied by a number of complications and a high level of disability of patients, which, in turn, is associated with significant economic costs. These circumstances make the development of an effective system for diagnosing VD an important medical and social problem.