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Таблица 14. Уровни рекомендаций для склеротерапии 1 страница
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| Рекомендация Склеротерапия рекомендуется для устранения варикозно измененных притоков магистральных подкожных вен, резидуальных вен и рецидивных варикозно-расширенных вен после ранее выполненного вмешательства, устранения венозных дисплазий Склеротерапия рекомендуется для устранения стволового рефлюкса по БПВ Склеротерапия рекомендуется для устранения несостоятельных перфорантных вен Склеротерапия рекомендуется для устранения варикозно-расширенных вен, имеющих источником рефлюкс из вен малого таза Склеротерапия рекомендуется для устранения ретикулярных вен и ТАЭ Для склеротерапии рекомендуется использовать препараты из группы детергентов (полидоканол, тетрадецилсульфат натрия) в виде раствора или пены После склеротерапии рекомендуется использовать медицинский компрессионный трикотаж или компрессионный бандаж При проведении склеротерапии с использованием жидкой формы склерозанта рекомендуется использовать концентрацию, соответствующую диаметру сосуда, согласно инструкции производителя Рекомендуется использовать жидкую форму склерозанта при склеротерапии подкожных вен, ретикулярных вен и ТАЭ Пенную форму склерозанта рекомендуется использовать для склеротерапии подкожных и ретикулярных вен Пенную форму склерозанта рекомендуется готовить по методике L. Tessari При введении пенной формы склерозанта в варикозно-расширенные вены рекомендуется использовать иглы диаметром более 25G Рекомендуется использовать ультразвуковое наведение при пункции вены и в процессе введения склерозанта В течение одного сеанса рекомендуется вводить не более 10 мл пенной формы склерозанта Не рекомендуется рутинное обследование пациентов для выявления открытого овального окна (ЭХО-кардиография) перед выполнением пенной склеротерапии |
| Уровень |
| 2аВ 2аА 2аВ 2аС 1А 1А 2аВ 1В 2аВ 2аВ 1А 1С 2аА 2аС 1С |
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выявления питающей вены и ее последующей скле- ротерапии или удаления. Для устранения красных вторичных ТАЭ рекомендуется использовать транс- кутанный лазер или склеротерапию низкоконцен- трированными растворами склерозантов [66, 131].
8. Пациентам, страдающим мигренью, а также при наличии анамнестических указаний на возник- новение неврологических реакций при ранее выпол- ненной склеротерапии рекомендуется проводить процедуру лишь в том случае, если индивидуальная польза значительно превышает риск, отдавать пред- почтение жидкой форме склерозанта, избегать вве- дения больших объемов препарата [96, 100—112].
9. С целью профилактики воздушной эмболии артерий головного мозга не рекомендуется вводить более 10 мл пенной формы склерозанта за одну про- цедуру [70].
10. Пациентам с высоким индивидуальным ри- ском ВТЭО (наличие эпизодов ВТЭО в анамнезе, верифицированная наследственная тромбофилия) рекомендуется проводить фармакопрофилактику в соответствии с актуальными рекомендациями, ис- пользовать эластичную компрессию, избегать введе- ния больших объемов склерозанта, проводить мак- симально раннюю активизацию после выполнения инъекции [131].
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