The role of venoactive drugs in the perioperative period of endovenous treatment for varicose veins

Introduction. Varicose veins of the lower extremities are the most common form of chronic venous insufficiency and remain a significant medical and social problem. Endovenous methods for eliminating pathological venous reflux (EVLA, RFA, MOCA, etc.) are currently considered the standard of surgical treatment. However, in the early postoperative period some patients continue to experience undesirable venous-specific symptoms, which are associated with thermal or mechanochemical endothelial injury and activation of inflammatory mechanisms. Despite the widespread use of venoactive drugs, their role in perioperative management during endovenous interventions and their impact on endothelial dysfunction remain a matter of discussion, which determines the relevance of the present analytical review. Aim of the study. Analysing current data on the use of phleboactive drugs in the perioperative period of endovenous treatment of varicose veins, with a focus on their effect on markers of endothelial dysfunction, inflammation, and the severity of clinical symptoms. Materials and methods. Available international and Russian literature analysed using the scientific databases PubMed, Google Scholar, and Scopus. Results. The analysis has demonstrated that the use of venoactive drugs in the perioperative period contributes to a faster regression of venous-specific symptoms, a reduction in the incidence of early adverse events, and an improvement in quality-of-life indicators. A positive effect on markers of endothelial dysfunction and microcirculation was also observed, which may be considered a pathogenetically justified effect. Conclusion. Current concepts regarding the mechanisms and clinical effectiveness of venotonic therapy in the context of endovenous interventions have been systematised. The summarised data provides a comprehensive understanding of the importance of perioperative pharmacological support.