Present and future in the management of venous vascular diseases

Czech version

Authors: Peter Gavorník ^1,2,3; Andrej Dukát ^1,3; Ľudovít Gašpar ^1,3; Eva Gavorníková ⁴
Authors‘ workplace: II. interná klinika LF UK a UN Bratislava, Slovenská republika, prednosta doc. MUDr. Ľudovít Gašpar, CSc. ¹; Prvé angiologické pracovisko (PAP), vedúci lekár doc. MUDr. Peter Gavorník, PhD., mim. prof. ²; Sekcia angiológov Slovenskej lekárskej komory, predseda doc. MUDr. Peter Gavorník, PhD., mim. prof. ³; Ambulancia všeobecného lekára pre dospelých, Poliklinika Ružinov, Bratislava, Slovenská republika ⁴
Published in: Vnitř Lék 2015; 61(2): 151-156
Category: Guidelines

Overview

The prevalence and the incidence of chronic and acute venous vascular disease has been shown to be globally very high, in both industrialized and developing countries. Chronic venous diseases of lower extremities are being an integral part of the third millennium´s deadly angiopandemy, at the present time. The rate of the most severe cases with advanced stage of venous failure is approximately twice as high in the population (2.1 %) as has been assumed so far. Among venoactive drugs (VAD), micronized purified flavonoid fraction (MPFF) of diosmin hesperidin remains the agent with the highest degree of recommendation and it also indicated to pharmacotherapeutical support of leg ulcer healing, along with sulodexide and pentoxifylline. Compressive sclerotherapy, liquid or foam, is a safe and effective invasive method to treat telangiectasias, reticular varicose veins and subcutaneous varicose veins. Direct oral anticoagulants (DOAC) represent one of the therapeutic and preventive options of deep venous thrombosis (DVT) and of venous thromboembolism (VTE) with a limitation in patients with malignant conditions and in pregnancy. The most effective is triple simultaneous pharmaco-kinezio-mechano-phlebothromboemboloprophylaxis. Superficial vein thromboses longer than 5 cm are indicated to anticoagulant therapy too.

Key words:
angiology/vascular medicine – future – management – phlebology/venous medicine – present – vein – venous vascular disease

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