Ultrasound assessment of alterations in venous haemodynamics in patients with post-thrombotic disease permanently taking phlebotonics

Zudin A.M.^1,2, Zasorina M.A.¹, Vikhert T.A.^1,3, Gonsales A.K.¹, Tarkovskii A.A.¹

1) Department of Vascular Surgery No 2, N.A. Semashko Central Clinical Hospital No 2, Open Joint-Stock Company "Russian Railways",
2) Chair of Hospital Surgery, Medical Department, Russian University of Friendship of Peoples, Moscow, Russia,
3) Department of Instrumental Diagnosis, Russian National Research Medical University named after N.I. Pirogov, Moscow, Russia

Objective. The study was aimed at using ultrasound duplex scanning for determining the sequence and terms of formation of venous haemodynamics impairments in the affected lower extremity in patients after endured acute thrombosis of deep veins and assessing the effect of phlebotonic drugs on the course of these processes.

Materials and methods. We examined and treated a total of 66 patients presenting with newly onset acute thrombosis of deep veins of lower limbs without concomitant varicose disease. Group I patients (n=22) received the standard course of angiotropic and metabolic infusion therapy, direct and indirect anticoagulants, as well as used elastic compression. Group II patients (n=22) in addition to the similar course of treatment received a phlebotonic drug (Venarus) according to the standard regimen: 1,000 mg daily for two months every half year. Group III patients (n=22) additionally to the same standard treatment regimen were also given VenarusR at a dose of 1,000 mg daily but taken uninterruptedly and constantly during the whole period of follow up. All patients were subjected to ultrasound duplex scanning of deep veins of lower limbs initially at admission, then 3 weeks, 3, 6, 12 and 18 months after making the diagnosis of acute thrombosis.

Results. Group II and III patients additionally taking the phlebotonic were found to have acceleration of processes of recanalization averagely by 15-20% as compared with Group I patients. Group III patients taking the phlebotonic agent permanently demonstrated deceleration of the processes of formation of horizontal and vertical veno-venous refluxes on the background of more adequate recanalization by the end of the follow-up period.

Conclusions. Permanent taking of phlebotonics increases the rate and scope of recanalization of the thrombosed deep veins of lower limbs, as well as dramatically decreases the development of the horizontal and vertical reflux, decreasing clinical manifestations of chronic venous insufficiency.

KEY WORDS: post-thrombotic disease, chronic venous insufficiency, venous haemodynamics, phlebotonics, recanalization, veno-venous reflux, ultrasound duplex scanning.

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