A COMPREHENSIVE APPROACH TO THE TREATMENT OF ELDERLY PATIENTS WITH ACUTE SUPERFICIAL VEIN THROMBOPHLEBITIS

Abstract

Aim. To evaluate the efficacy and safety of a comprehensive treatment approach for high-risk superficial vein thrombophlebitis (SVT) in elderly and senile patients with contraindications to direct oral anticoagulants (DOACs).

Material and methods. A prospective, open-label, bicenter study was conducted involving 65 patients aged over 60 years. All patients underwent crossectomy to prevent thrombus migration into the deep venous system. Patients were divided into two groups: Group 1 (n=30) received standard conservative therapy; Group 2 (n=35) received comprehensive treatment including phlebocementesis with thrombus evacuation, sclerotherapy using an original technique, and topical application of the multicomponent heparin-containing gel "Detragel". Efficacy was assessed by the dynamics of pain and edema (Visual Analogue Scale, VAS), hemostasis parameters, and quality of life (SF-36 questionnaire) at 12 months.

Result. The application of the comprehensive protocol in Group 2 provided a significantly faster resolution of pain and edema. On postoperative day 7, pain severity was mild (2.3±0.3 points) versus moderate (4.1±0.6 points) in Group 1 (p<0.05). Edema was also less pronounced (1.9±0.6 points vs. 3.8±0.5; p<0.05). The study found no negative impact of sclerosing agents on the hemostasis system. In the long-term period, patients in Group 2 showed a statistically significant improvement in quality of life: vitality increased by 7.1 points (p=0.011), and the mental health component improved by 10.2 points (p=0.0012).

Conclusion. The proposed comprehensive treatment method for acute thrombophlebitis, based on surgical evacuation of thrombotic masses, sclerotherapy, and topical therapy, is effective and safe. It accelerates the regression of clinical