Kronik venöz yetmezlik ve güncel tedavi seçenekleri

Yıl 2017, Cilt: 9 Sayı: 4, 191 - 197, 01.09.2017

Mehmet Kabalcı Turgut Kültür

https://doi.org/10.21601/ortadogutipdergisi.312129

Öz

Kronik venöz yetmezlik (KVY) hem
kozmetik sebepler hem de komplikasyonları nedeniyle yaşam kalitesini düşüren epidemiyolojik ve sosyoekonomik sonuçlarıyla
önemli bir sağlık sorunudur.  Konservatif
tedavi ile semptomları azaltmak/kontrol altında tutmak ve komplikasyonları
önlemek hedeflenirken, girişimsel tedavinin hedefi minimum komplikasyonla,
venöz hipertansiyon kaynağının yok edilmesi, tüm varikozitlerin eksize
edilmesi, tatminkar bir kozmetik sonuç sağlamaktır.  KVY tedavisi için klasik tedavi yöntemlerinin
yanı sıra perkütan uygulamalar da yaygınlaşmaya devam etmektedir. Endovenöz
lazer ablasyon tedavisi, radyofrekans ablasyon tedavisi, buhar balsyon
tedavisi, siyanoakrilat ile ablasyon tedavisi ve sklerozan madde ile ablasyon
bu güncel yöntemlerin en bilinenlerindendir. Daha az invaziv olan bu yöntemler
daha erken taburculuk ve daha konforlu 
bir tedavi süreci sunmaktadır. Ancak teknik açıdan yeni zorluklar ve
yüksek maliyetler bu güncel seçeneklerin rutin bir uygulama olmasını
engellemektedir. Öte yandan nüks ve başarılı sonuç anlamında kısa ve orta dönem
sonuçları literatürde açık cerrahiye benzer olarak bildirilmeye başlamış olsa
da henüz uzun dönem sonuçları için net veriler yoktur. Sonuçta, KVY için altın
standart hala klasik açık cerrahi teknik olsa da yakın gelecekte değişik
perkütan yöntemlerin ağırlık kazanacağı muhtemeldir.

Anahtar Kelimeler

Kronik venöz yetmezlik, skleroterapi, endovenöz lazer tedavisi, radyofrekans ablasyon, siyanoakrilat

Chronic venous insufficiency and current treatment options

Öz

Chronic venous insufficiency (CVI) is an
important health problem due to both epidemiological and socioeconomic outcomes
that decrease the quality of life due to both cosmetic reasons and
complications. When aiming to reduce / control symptoms and prevent
complications with conservative treatment, the goal of interventional treatment
is to achieve a satisfactory cosmetic result with minimal complications,
elimination of venous hypertension, excision of all varicosities. In addition
to classical treatment methods percutaneous applications comes to be
widespread. Endovenous laser ablation therapy, radiofrequency ablation therapy,
steam ablation therapy, cyanoacrylate ablation therapy and sclerosing agent
ablation are the best known of these current methods. These less invasive
methods offer earlier discharge and more comfortable treatment. However, new
technical challenges  and high costs are
the major problem of these new generation methods. On the other hand, short and
mid-term results in terms of recurrence and successful outcome have been
reported in the literature as similar to open surgery, but there is no clear
data for long-term results yet.

In conclusion, although the gold standard for
CVI is still a classic open surgical technique it is likely that different
percutaneous methods will be more popular in the near future.

Anahtar Kelimeler

Chronic venous insufficiency, sclerotherapy, endovenous laser therapy, radiofrequency ablation, cyanoacrylate

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