LONG-TERM RESULTS OF TREATMENT OF PATIENTS WITH VARICOSE DISEASE AFTER USING ASVAL TECHNIQUE

The goal of this research is to evaluate the effectiveness of using the ASVAL technique in patients with varicose disease of lower limbs. The authors evaluated the results of treatment and the dynamics of life indicators of 84 patients with varicose disease of lower limbs after using the ASVAL technique. The age of operated patients varied from 18 to 57 years, 22 (26,2%) were male and 62 (73,8%) were female. The failure of the saphenofemoral junction was detected in all patients, the diameter ranged from 0.6 to 1.2 cm, averaged 0.79cm. All patients underwent miniflebectomy of varicose tributaries with preservation of the great saphenous vein using the ASVAL technique under local anesthesia. The operation lasted from 22 to 45 minutes. All patients underwent a study of the level of pain using a visual analogue scale on the second day after the intervention. The intensity of pain varied from 1 to 3 points, the average value of this indicator was 2.6 points. Early postoperative complications included extensive hematoma in 1 (1.2%) patient, thrombosis of the preserved trunk of the great saphenous vein in 2 (2.4%), neurological disorders in 2 (2.4%), hyperpigmentation in 3 (3.6%). Thrombotic complications were treated with conservative treatment, hematoma was evacuated by puncture, hyperpigmentation and paresthesia disappeared on their own in 6-12 months after the intervention. Long-term results of treatment and quality of life of patients were studied in 1 year after surgery in 84 patients. Long-term the average diameter of the saphenofemoral junction was decreased from 0.79 to 0.65 cm, reflux along the great saphenous vein disappeared in 64 (62%) patients. Relapse of the disease was detected in 10 (11.9%) cases. 7 patients of these 64 underwent endovasal laser coagulation, 2 - epifascial ligation of communicant veins according to Cockett and miniflebectomy, 1 - radiofrequency obliteration. A study of the dynamics of indicators of the quality of life of patients during the preoperative and postoperative periods was carried out according to the CIVIQ 2 questionnaire. A positive dynamic of all indicators of the quality of life was noted by 20.3-30.9% after operation with using the ASVAL technology. Thus, the ASVAL technique is a safe, low-traumatic method of treating patients with varicose disease. The usage of this operation allows to achieve the disappearance of reflux along the great saphenous vein in 62% of patients, to improve the quality of life of patients