Клінічні та патофізіологічні особливості гемодинамічних змін у пацієнтів із варикозною хворобою нижніх кінцівок

Chronic venous disease (CVD) of the lower extremities, specifically at the stage of chronic venous insufficiency, is a prevalent condition among adults characterized by a progressive clinical course and declining quality of life. This necessitates a detailed assessment of hemodynamic changes within the venous system. Aim. To identify the clinical and pathophysiological features of hemodynamic changes prior to surgery and determine their association with the clinical class of the disease. Materials and methods. The study included 139 patients (aged 18–75 years) with CVD classes C3–C6 (CEAP classification). Patients were divided into three groups with subgroups based on the treatment method. Assessment included clinical examination, duplex scanning (measuring diameters of the saphenofemoral and saphenopopliteal junctions (SFJ and SPJ), great and small saphenous veins (GSV and SSV), tributaries, and perforators). Disease severity was evaluated using the Venous Clinical Severity Score (VCSS), and quality of life using the Chronic Venous Insufficiency Questionnaire (CIVIQ-20). Statistical analysis utilized Student’s t-test and Pearson correlation coefficient (r). Results. A statistically significant direct correlation was found between higher CEAP clinical classes and worsening CIVIQ-20 and VCSS scores (p < 0.05). Duplex ultrasound revealed a strong positive correlation between disease progression and increased diameters of the GSV, SSV, SFJ, and SPJ, as well as a greater number and size of tributaries and perforators with pathological reflux. The number of affected anatomical segments in the superficial venous system also increased with disease severity. Conclusions. Combined analysis of duplex data, CIVIQ-20, and VCSS is critical for optimal surgical decision-making. Future studies should prioritize elucidating the biochemical mechanisms underlying CVD progression and assessing the long-term outcomes associated with various surgical approaches.