"SCLEROTHERAPY 15+. What gives experience in 15 years or more: advice from those who have gone through everything ”, Moscow, 14.11.2020.

November 14, 2020 at GKB No. 1 named after N.I. Pirogov, an interactive conference with a live master class was held, which was devoted to the technique of sclerobliteration of the veins of the lower extremities and was called: “SCLEROTHERAPY 15+. What gives experience in 15 years or more: advice from those who have gone through everything. " 

The President of the "Association of Phlebologists" of Russia, cardiovascular surgeon, doctor of medical sciences, professor, Igor Aleksandrovich Suchkov (Ryazan) made a welcoming speech.

Welcoming speech of the President of the AFR, Ph.D. Suchkova I.A.

Welcoming speech of the President of the AFR, Ph.D. Suchkova I.A.

 

Phlebologists with the most extensive experience in using sclerotherapy techniques took part in the event as speakers. Artyom Yuryevich Semyonov, phlebologist, vascular surgeon, candidate of medical sciences, head of the Medical Innovative Phlebological Center, (Moscow) was invited as an expert in vein sclerobliteration.

Igor Anatolyevich Zolotukhin, surgeon, phlebologist, professor, doctor of medical sciences, GKB No. 1 named after N.I. Pirogov, (Moscow), presented the message: "Sclerotherapy - Cinderella of invasive phlebology?"

"Sclerotherapy - Cinderella of Invasive Phlebology?" - reports professor Zolotukhin I.A.

"Sclerotherapy - Cinderella of Invasive Phlebology?" - reports professor Zolotukhin I.A.

 

Igor Anatolyevich spoke about the decrease in the attention of the professional community to the method of sclerotero-obliteration. Much more attention of specialists was paid to laser technologies. But is it really that bad? The sclerotherapy technique came to our country in the 90s. The history of modern sclerotherapy begins in the 40s of the last century. That is, long before the appearance and introduction of ultrasound scanning into practice. Without going into details, the method has a sufficient theoretical and practical foundation for use in the daily practice of a specialist. There are various methodological approaches, often overlapping each other, with different interpretations of the authors. Even a certain truth is characterized by fatigue.

The next part of the conference program was the demonstration of patients with clinical analysis of diagnostic data and the construction of treatment tactics from the masters of phlebological science of our country.

Practical part of the conference. Ultrasound of veins. Sclerotherapy.

Practical part of the conference. Ultrasound of veins. Sclerotherapy.

 

Four patients were considered. Each expert expressed his opinion on this matter. The tactical approach reflected both the peculiarities of the practice of a particular specialist and the experience of using various techniques in the treatment of patients with a phlebological profile. Far from in all cases the experts were unanimous in their approach to treatment tactics, but each of the options had its own advantages and an unconditional right to exist.

In continuation of the master class, phlebologists demonstrated the technical skills of sclerobliteration of telangiectasias and reticular veins.

Phlebologist Rustem Ginyatullaevich Chabbarov (Saratov) demonstrates his technique of sclerotherapy

Phlebologist Rustem Ginyatullaevich Chabbarov (Saratov) demonstrates his technique of sclerotherapy

 

Each of the invited experts had significant experience of this manipulation, calculated in years and years of daily practice. We saw different approaches to the sclerotherapy technique and were able to assess the advantages and disadvantages of each of them.

In the second part of the master class, Artyom Yuryevich Semyonov and Dmitry Evgenievich Lishov continued to demonstrate their skills in sclerobliteration of venous vessels.

Demonstration of the "one hand" technique - without interception with constant control of the needle in the vein

Demonstration of the "one hand" technique - without interception with constant control of the needle in the vein

 

Dr. Lishov showed an interesting technique for sclerotherapy of the reticular veins of the lower extremities. Artyom Yuryevich turned to a more interesting issue of aesthetic phlebology, namely, sclerotherapy of veins in the arms. Dr. Semyonov performed a procedure for sclerobliteration of hand veins with a foam form of the drug. Artyom Yurievich demonstrated the technique of injecting the drug with one hand, but most importantly, he commented on the main nuances of the procedure.

Sclerotherapy of veins in the arms performed by Dr. Semenov A.Yu.

Sclerotherapy of veins in the arms performed by Dr. Semenov A.Yu.

 

This master class from Dr. Semyonov, quite possibly, can be used as a guide for introducing this technique into your own clinical practice.

Then Artyom Yurievich presented the message: “My attitude to sclerotherapy. Why am I doing hand sclerotherapy? Sclerotherapy on the upper limbs ”.

“Why am I doing hand sclerotherapy? Sclerotherapy on the upper extremities "- reports A.Yu. Semenov. (Moscow)

“Why am I doing hand sclerotherapy? Sclerotherapy on the upper extremities "- reports A.Yu. Semenov. (Moscow)

 

Artyom Yurievich spoke about the methodology of approach to sclerotherapy of veins in the arms based on practical experience. The lecture included enough information for the practical implementation of the methodology. The doctor also well covered the psychological and legal aspects of sclerotherapy of veins in the arms, which are no less important than the quality of the procedure itself. Any aesthetic intervention requires an impartial and critical attitude towards the patient's personality. The latter's opinions and views tend to change over time, and this must be borne in mind. Despite the ambiguous attitude of the domestic audience to aesthetic sclerotherapy of veins in the arms, it is necessary to take into account the realities and needs of modern society. The beauty industry has become a part of everyday life, people are ready to invest time and other resources in improving their appearance. Hand sclerotherapy, in most cases, is performed solely for aesthetic reasons. But is it possible to deny an adequate patient the desire to look better?

Oksana Vasilievna Bukina, vascular surgeon, phlebologist, candidate of medical sciences, leading specialist of the Doctor Profi clinic (Tambov), presented the message: “My attitude to sclerotherapy. Why am I doing this and not otherwise? Sclerotherapy in a patient with C1 ”.

“Why am I doing this and not otherwise? Sclerotherapy in a patient with C1 "- reports OV Bukina. (Tambov)

“Why am I doing this and not otherwise? Sclerotherapy in a patient with C1 "- reports OV Bukina. (Tambov)

 

Oksana Vasilievna shared her many years of experience in using the sclerotherapy technique. The phlebologist spoke about the applied aspects of the technique to achieve a good result and improve operator comfort. The choice of high-quality syringes and needles with laser sharpening, the optimal concentration of the sclerosant, increase the chances of success of the procedure and reduce side effects. Dr. Bukina also spoke about her attitude to compression after the sclerotherapy procedure. After many years of practice, Oksana Vasilievna is somewhat skeptical about any compression, with the exception of eccentric, in the context of reticular vein sclerosis and telangiectasias. Many can argue with this opinion, but more and more experienced specialists today refuse to use compression therapy during procedures.

Evgeny Arkadievich Ilyukhin, surgeon-phlebologist, candidate of medical sciences, member of the Association of Phlebologists of Russia, member of EVF (St. Petersburg), presented the message: "Sclerotherapy in clinical guidelines."

"Sclerotherapy in clinical guidelines" - reports EA Ilyukhin. (St. Petersburg)

"Sclerotherapy in clinical guidelines" - reports EA Ilyukhin. (St. Petersburg)

It is difficult to name a technique that has been so widely used in recent decades as sclerobliteration. It is quite natural that the accumulated clinical experience is reflected in a huge number of publications and clinical studies. At the moment, only sclerotherapy is recommended for the removal of all, without exception, venous vessels. This makes the sclerobliteration technique universal for use in clinical practice. But is everything so good? Many phlebologists with considerable experience have gone through various trends in vein removal. Including the trend of stem sclerobliteration, a method actively used in the prelaser era. Today we clearly understand that it is better to subject the main varicose veins to thermoobliteration. Many will agree that large varicose veins are best removed with a miniflebectomy. We also understand perfectly well that for some issues it is sclerotherapy that will be the ideal solution. Reticular veins, telangiectasias, residual varicose veins after other interventions are excellent targets for sclerobliteration. Both European and American, as well as domestic recommendations speak about the effectiveness and versatility of the sclerobliteration technique. You should not read this as an opportunity to absolutize the approach and remove all veins using sclerotherapy. You need to use the best and most effective for your patients. And this approach for sclerotherapy has its own, definite, and very important place.

Dmitry Evgenievich Lishov, surgeon-phlebologist, candidate of medical sciences, "Center of phlebology", (Moscow), presented the message: "My attitude to sclerotherapy. Why am I doing it this way and not otherwise? Sclerotherapy in a patient with C2 ”.

“Why am I doing it this way and not another? Sclerotherapy in a patient with C2 "- reports DE Lishov. (Moscow)

“Why am I doing it this way and not another? Sclerotherapy in a patient with C2 "- reports DE Lishov. (Moscow)

 

Dmitry Evgenievich shared his view on the sclerobliteration technique from the standpoint of a specialist with many years of practical experience. It is difficult to disagree with most of Dr. Lishov's theses. Sclerotherapy, on the one hand, is the simplest and most accessible technique for a practicing phlebologist, on the other hand, the most difficult. The lack of standardization, the presence of many techniques, views and approaches to the same issues makes sclerotherapy today not just a phlebologist's tool, but a form of medical art. Each specialist creates his product based on existing knowledge and skills, imprinting theory in practice at the workplace. Taking into account the number of subtleties and countless nuances of the sclerotherapy method, it is obvious that not everyone is approaching an ideal result. A significant number of doctors performing sclerotherapy do not meet the expectations of their patients.

Sclerotherapy today is a highly individualized way of removing veins, both for patients and individual doctors. In modern practice, sclerotherapy is used in the complex treatment of venous pathology, often complementing endovascular thermo-obliteration and miniflebectomy. This fact not only does not add clarity to the situation, but even more confuses those who are far from the modern principles of phlebology. Nevertheless, the sclerobliteration technique is in the right hands, it is the ultimate tool for solving complex phlebological problems. To understand the true essence of the method, it is probably necessary to master not only sclerotherapy at the expert level, but also all other relevant techniques for removing veins.

Oksana Igorevna Efremova, surgeon-phlebologist, candidate of medical sciences, R.N. N.I. Pirogova, (Moscow), presented the message: "Complications of sclerotherapy: what can happen and what to do about it?"

"Complications of sclerotherapy: what can happen and what to do about it?" - reports O.I. Efremova. (Moscow)

"Complications of sclerotherapy: what can happen and what to do about it?" - reports O.I. Efremova. (Moscow)

 

Oksana Igorevna spoke about the side effects and complications of sclerotherapy. Fortunately, the latter are very rare, but there is no reason to deny them. Side effects such as metting, hyperpigmentation, pain and discomfort have been encountered in the practice of every phlebologist. It is important to understand what to do and how to behave when unplanned effects appear. Dr. Efremova very vividly and interestingly told about a variety of adverse events that any practicing specialist can meet. It is impossible to completely exclude all adverse medical events, but we are able to minimize the likelihood of their occurrence.

Speakers of the conference “SCLEROTHERAPY 15+. What gives experience in 15 years or more: advice from those who have gone through everything "answer questions

Speakers of the conference “SCLEROTHERAPY 15+. What gives experience in 15 years or more: advice from those who have gone through everything "answer questions

 

At the end of this interesting event, all participants answered the questions of phlebologists from different parts of our country.