Эффективность эндовазальной лазерной облитерации при лечении трофических язв венозного происхождения

Abstract

Introduction. Venous leg ulcers are one of the most severe complications of chronic venous insufficiency (CVI). Their treatment poses significant challenges due to frequent recurrences, prolonged healing times, and resistance to therapy. Modern minimally invasive methods, particularly endovenous laser obliteration (EVLO), allow for the elimination of the primary pathogenic factor — venous reflux. However, further investigation into the effectiveness of EVLO in the treatment of already developed trophic ulcers remains relevant.

Purpose. To evaluate the clinical effectiveness of endovenous laser obliteration in the comprehensive treatment of venous leg ulcers.

Materials and methods. The study included 60 patients with venous leg ulcers, divided into two groups of 30 patients each. The first group (main) received treatment with EVLO in combination with compression therapy and local wound care. The second group (control) received only conservative treatment (compression therapy, drug therapy, local wound care). The following parameters were assessed: ulcer healing time, pain dynamics, and recurrence rate over 12 months.

Results. In the main group, the average ulcer healing time was 6.2 ± 1.3 weeks, while in the control group it was 10.4 ± 1.9 weeks (p < 0.01). During the one-year follow-up, ulcer recurrence was observed in 6.7% of patients in the main group and in 26.7% of patients in the control group. Additionally, the main group showed a significant reduction in pain and an improvement in general well-being and quality of life.

Conclusion. Endovenous laser obliteration is a highly effective method for treating venous leg ulcers. The use of EVLO accelerates healing, reduces recurrence rates, and improves patients' quality of life. This method deserves wider implementation in clinical practice as part of a comprehensive treatment approach for CVI.