Significance of Local Microcirculation Parameters in Predicting the Results of Surgical Treatment of Varicose Veins with Trophic Disorders

Objective. To study microcirculation in patients with varicose veins of the lower extremities and trophic disorders; to assess significance of local microcirculation parameters in predicting the results of minimally invasive surgical treatment. Material and methods. The study included 74 patients with C4—C6 varicose veins who underwent endovenous laser obliteration and mini-phlebectomy, as well as 20 healthy volunteers for analysis of reference values. Severity of disease was assessed using the VCSS scale, quality of life — the CIVIQ-20 questionnaire. Microcirculation was assessed before and after surgery considering prognostic criteria of microcirculation. We estimated microcirculation using laser Doppler flowmetry. Results. In healthy individuals, microcirculation parameters had monotonous nature, high blood flow velocity and relative monotony of flaxmotion with small amplitudes. According to LDF data, all patients with CVD and trophic disorders had spastic-congestive type of microcirculation at all levels (arterioles, precapillaries and venules). In the main group, surgery was followed by decrease of initially elevated microcirculation parameters (M-total, M-nutritional, myogenic oscillations, standard deviation and coefficient of variation) and increase of parameters (M-general, M-nutritive, myogenic oscillations, COEX, Kv) compared to preoperative values. Conclusions. The study demonstrated better microcirculation indicators characterizing relief of disease and QoL improvement after surgical treatment of varicose veins of the lower extremities with trophic disorders.