TYPES AND CLASSIFICATION SYSTEMS OF VENOUS REFLUX IN CHRONIC VENOUS DISEASE: NARRATIVE SYNTHESIS OF LITERATURE

Abstract

Objectives. Chronic venous disease is currently one of the most common causes of hospitalizations in surgical departments, due to its high incidence and a wide range of clinical manifestations. The multitude of hemodynamic variants of venous reflux, which determines the clinical image and trophic changes in patients with chronic venous disease, also explains the existence of different surgical techniques, which aim to correct hemodynamic disorders depending on the type of pathological reflux, and not always is based on the complete destruction of saphenous trunk. A special place is occupied by interventions with preservation of the saphenous trunk, which have demonstrated their advantages in a certain category of patients. Thus, we conducted a narrative review of studies aimed to describe the types and classification systems of venous reflux in chronic venous disease and their role in selection of surgical treatment.

Material and methods. A structured search was performed in the Google Scholar, PubMed, HINARI and ResearchGate electronic databases, taking into account the relevant articles, which refer to the description of hemodynamic disorders in chronic venous disease, published in the last 13 years. The search terms (in English) used were: „varicose veins”, „chronic venous insufficiency”, „hemodynamic disorders in chronic venous insufficiency”, „types of hemodynamic disorders”, „chronic venous disease - quality of life”, „techniques of treatment for varicose veins”, „preservation of saphenous veins”, „CHIVA”, „ASVAL”.

Conclusions. Basing on the type of hemodynamic disorders and the patient's clinical profile, it becomes possible to select a suitable surgical strategy, specific to each individual case - with or without preservation of the saphenous trunk, which will ensure long-term therapeutic efficacy in patients with chronic venous disease.