LITERATURE REVIEW
Cardiovascular Surgery
doi: 10.25005/2074-0581-2024-26-1-117-132
UNDERSTANDING OF CHRONIC VENOUS DISEASES AS A MULTIDISCIPLINARY PROBLEM: SHIFTING FROM A DISEASE-SPECIFIC, LINEAR VIEW TO A COMPREHENSIVE SYSTEM PERSPECTIVE

O. SHIRINBEK1,2, G.V. MNATSAKANYAN2, S.N. ODINOKOVA3

1Surgery Department, Centre for Medical and Corporate Training, Moscow, Russian Federation
2“SM-Clinic” Phlebology Centre, Moscow, Russian Federation
3Department of Human Anatomy and Histology, N.V. Sklifosovsky Institute for Clinical Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation

Chronic venous diseases (CVD) are examined in this review from the perspective of the continuity of the venous system of the lower extremities and pelvis. The review emphasizes the most clinically significant manifestations of venous insufficiency in the lower extremities, pelvic veins, and varicose veins of the scrotum and hemorrhoids. Due to the unity of pathogenesis and similarity of symptoms of venous stasis in different locations, the review stresses the need for a multidisciplinary approach in managing this category of patients. Assessing venous symptoms in the presence of comorbidities such as osteoarthritis, diabetes mellitus, and arteriosclerosis obliterans of the lower extremities is one of the most essential clinical tasks facing a phlebologist. At the same time, the modern trend in the treatment of CVD, regardless of the anatomical location, is endovenous and minimally invasive technologies that combine surgical radicalism with minimally invasive interventions. This review is based on analyzing published materials in the three most common electronic databases: PubMed, Web of Science, and EMBASE. The primary search query strategy included the following keywords: chronic venous disease, venous insufficiency, pelvic venous disorders, hemorrhoidal disease, and varicocele.

Keywords: Chronic venous diseases, varicose veins of the lower extremities, pelvic vein diseases, varicocele, hemorrhoids.

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References
  1. Varaki ES, Gargiulo GD, Penkala S, Breen PP. Peripheral vascular disease assessment in the lower limb: A review of current and emerging non-invasive diagnostic methods. Biomed Eng Online. 2018;17(1):61. https://doi.org/10.1186/ s12938-018-0494-4
  2. Yetkın E, İleri M. Dilating venous disease: Pathophysiology and a systematic aspect to different vascular territories. Medical Hypotheses. 2016; 91:73-6. https://doi.org/10.1016/j.mehy.2016.04.016
  3. Yetkın E, Öztürk S. Dilating vascular diseases: Pathophysiology and clinical aspects. International Journal of Vascular Medicine. 2018;2018:1-9. https://doi. org/10.1155/2018/9024278
  4. Yetkın E, Öztürk S, İleri M. Varicose vein and ecchymosis: A case report. International Archives of Medicine. 2017;10(238):1-2. https://doi.org/10.3823/2508
  5. Ozturk S, Yetkın E. Pelvic venous reflux in male: Varicocele? Phlebology. 2018;33(6):430-1. https://doi.org/10.1177/0268355517747643
  6. Eklof B, Perrin M, Delis KT, Rutherford RB, Gloviczki P. American Venous Forum; European Venous Forum; International Union of Phlebology; American College of Phlebology; International Union of Angiology. Updated terminology of chronic venous disorders: The VEIN-TERM Transatlantic Interdisciplinary Consensus Document. J Vasc Surg. 2009;49(2):498-501. https://doi.org/10.1016/j. jvs.2008.09.014
  7. Raffetto JD, Mannello F. Pathophysiology of chronic venous disease. Int Angiol. 2014;33(3):212-21.
  8. Bradbury AW, Evans CL, Allan PL, Lee DA, Ruckley CV, Fowkes FGR. The relationship between lower limb symptoms and superficial and deep venous reflux on duplex ultrasonography: The Edinburgh Vein Study. Journal of Vascular Surgery. 2000;32(5):921-31. https://doi.org/10.1067/mva.2000.110509
  9. Yetkın E. Re: “Association of Venous Disorders with Leg Symptoms: Results from the Bonn Vein Study 1.” Eur J Vasc Endovasc Surg. 2015;50(6):828. https://doi. org/10.1016/j.ejvs. 2015.08.024
  10. Wrona M, Jöckel K, Pannier F, Bock E, Hoffmann B, Rabe E. Association of venous disorders with leg symptoms: Results from the Bonn Vein Study 1. Eur J Vasc Endovasc Surg. 2015;50(3):360-7. https://doi.org/10.1016/j.ejvs.2015.05.013
  11. Robertson LA, Evans CJ, Lee AJ, Allan PL, Ruckley CV, Fowkes FG. Incidence and risk factors for venous reflux in the general population: Edinburgh Vein Study. Eur J Vasc Endovasc Surg. 2014;48(2):208-14. https://doi.org/10.1016/j. ejvs.2014.05.017
  12. Newlin Lew K, Arnold T, Cantelmo C, Jacque F, Posada-Quintero H, Luthra P, Chon KH. Diabetes distal peripheral neuropathy: Subtypes and diagnostic and screening technologies. J Diabetes Sci Technol. 2022;16(2):295-320. https:// doi.org/10.1177/19322968211035375
  13. Eklöf B. New revision of the 25-year-old CEAP classification is timely and warranted. J Vasc Surg Venous Lymphat Disord. 2020;8(3):341. https://doi. org/10.1016/j.jvsv.2020.01.002
  14. Lurie F, Passman MA, Meisner MJ, Dalsing M, Masuda E, Welch H, et al. The 2020 update of the CEAP classification system and reporting standards. Journal of Vascular Surgery: Venous and Lymphatic Disorders. 2020;8(3):342-52. https://doi.org/10.1016/j.jvsv.2019.12.075
  15. Iannone M, Janowska A, Dini V, Tonini G, Oranges T, Romanelli M. Itch in chronic wounds: Pathophysiology, impact, and management. Medicines (Basel). 2019;6(4):112. https://doi.org/10.3390/medicines6040112
  16. Perrin M, Eklof B, van Rij A, Labropoulos N, Vasquez M, Nicolaides A, et al. Venous symptoms: The SYM Vein Consensus statement developed under the auspices of the European Venous Forum. Int Angiol. 2016;35(4):374-98.
  17. Salmhofer W. Ätiologie, Nomenklatur und Pathophysiologie der chronisch venösen Insuffizienz [Etiology, nomenclature and pathophysiology of chronic venous insufficiency]. Wien Med Wochenschr. 2016;166(9-10):264-9. https:// doi.org/10.1007/s10354-016-0466-x
  18. Chen Y, Peng W, Raffetto JD, Khalil RA. Matrix metalloproteinases in remodeling of lower extremity veins and chronic venous disease. Prog Mol Biol Transl Sci. 2017;147:267-99. https://doi.org/10.1016/bs.pmbts.2017.02.003
  19. Slone EA, Pope MR, Fleming SD. Phospholipid scramblase 1 is required for β2-glycoprotein I binding in hypoxia and reoxygenation-induced endothelial inflammation. J Leukoc Biol. 2015;98(5):791-804. https://doi.org/10.1189/ jlb.3A1014-480R
  20. Selçuk Kapısız N, Uzun Kulaoğlu T, Fen T, Kapısız HF. Potential risk factors for varicose veins with superficial venous reflux. Int J Vasc Med. 2014; 531-689. https://doi.org/10.1155/2014/531689
  21. Grant Y, Onida S, Davies A. Genetics in chronic venous disease. Phlebology. 2017;32(1):3-5. https://doi.org/10.1177/0268355515624030
  22. Yongbo X, Wei H, Lei W, Jianhua Zh, Tao Wang, Jinyuan T, et al. Changes in levels of apoptosis in the walls of different segments of great saphenous varicose veins. Phlebology. 2016;31(9):632-9. https://doi.org/10.1177/0268355515605670
  23. Davies AH. Editor’s choice – Management of chronic venous disease. Eur J Vasc Endovasc Surg. 2015;49(6):678-737. https://doi.org/10.1016/j. ejvs.2015.02.007
  24. Youn YJ, Lee J. Chronic venous insufficiency and varicose veins of the lower extremities. Korean J Intern Med. 2019;34(2):269-83. https://doi.org/10.3904/ kjim.2018.230
  25. De Maeseneer MG, Kakkos SK, Aherne T, Baekgaard N, Black S, Blomgren L, et al. Editor’s choice – European Society for Vascular Surgery (ESVS) 2022 Clinical Practice Guidelines on the Management of Chronic Venous Disease of the Lower Limbs. Eur J Vasc Endovasc Surg. 2022;63(2):184-267. https://doi. org/10.1016/j.ejvs.2021.12.024
  26. Farah MH, Nayfeh T, Urtecho M, Hasan B, Amin M, Sen I, et al. A systematic review supporting the Society for Vascular Surgery, the American Venous Forum, and the American Vein and Lymphatic Society guidelines on the management of varicose veins. J Vasc Surg Venous Lymphat Disord. 2022;10(5):1155-71. https://doi.org/10.1016/j.jvsv.2021.08.011
  27. Öztürk S, Çuğlan B, Turhan H, Yetkın E. Comment on “Vein size and disease severity in chronic venous disease” by Radhakrishnan et al. International Journal of Angiology. 2019;28(04):272-3. https://doi.org/10.1055/s-0039-1695781
  28. Nicolaides A, Kakkos S, Baekgaard N, Comerota A, de Maeseneer M, Eklof B, et al. Management of chronic venous disorders of the lower limbs. Guidelines according to scientific evidence. Part I. Int Angiol. 2018;37(3):181-254. https:// doi.org/10.23736/S0392-9590.18.03999-8
  29. Shirinbek O, Mnatsakanyan GV, Odinokova SN. Tsianoakrilatnaya kleevaya obliteratsiya varikoznykh ven v real'noy klinicheskoy praktike: dvukhletnie rezul'taty lecheniya [Cyanoacrylate adhesive closure in the real-world practice: 2-year results of varicose vein treatment]. Ambulatornaya khirurgiya. 2022;19(1):132-9. https://doi.org/10.21518/1995-1477-2022-19-1-132-139
  30. Shirinbek O, Mnatsakanyan GV, Odinokova SN. Nezhelatel'nye yavleniya i oslozhneniya posle tsianoakrilatnoy kleevoy obliteratsii varikoznykh ven [Adverse events and complications following cyanoacrylate adhesive closure of varicose veins]. Angiologiya i sosudistaya khirurgiya. 2023;29(1):59-66. https://doi. org/10.33029/1027-6661-2023-29-1-59-66
  31. Meissner MH, Khilnani NM, Labropoulos N, Gasparis AP, Gibson K, Greiner M, et al. The Symptoms-Varices-Pathophysiology classification of pelvic venous disorders: A report of the American Vein & Lymphatic Society International Working Group on Pelvic Venous Disorders. J Vasc Surg Venous Lymphat Disord. 2021;9(3):568-84. https://doi.org/10.1016/j.jvsv.2020.12.084
  32. Whiteley MS, Dos Santos SJ, Harrison CC, Holdstock JM, Lopez AJ. Transvaginal duplex ultrasonography appears to be the gold standard investigation for the haemodynamic evaluation of pelvic venous reflux in the ovarian and internal iliac veins in women. Phlebology. 2015;30(10):706-13. https://doi. org/10.1177/0268355514554638
  33. Stern JR, Patel VI, Cafasso DE, Gentile NB, Meltzer AJ. Left-sided varicocele as a rare presentation of May-Thurner syndrome. Ann Vasc Surg. 2017;42(305):13- 6. https://doi.org/10.1016/j.avsg.2016.12.001
  34. Ahlberg NE, Bartley O, Chidekel N. Right and left gonadal veins. An anatomical and statistical study. Acta Radiol Diagn (Stockh). 1966;4(6):593-601. https:// doi.org/10.1177/028418516600400601
  35. Holdstock JM, Dos Santos SJ, Harrison CC, Price BA, Whiteley MS. Haemorrhoids are associated with internal iliac vein reflux in up to one-third of women presenting with varicose veins associated with pelvic vein reflux. Phlebology. 2015;30(2):133-9. https://doi.org/10.1177/0268355514531952
  36. Raum G, Schroeder A. The perplexity of posterior pelvic pain: A clinical vignette. Am J Phys Med Rehabil. 2022;101(11):169-72. https://doi:10.1097/ PHM.0000000000002069
  37. Sulakvelidze L, Tran M, Kennedy R, Lakhanpal S, Pappas PJ. Presentation patterns in women with pelvic venous disorders differ based on age of presentation. Phlebology. 2021;36(2):135-44. https://doi.org/10.1177/0268355520954688
  38. Gavrilov SG. Vulvar varicosities: Diagnosis, treatment, and prevention. Int J Womens Health. 2017;9:463-75. https://doi.org/10.2147/IJWH.S126165
  39. Gavrilov SG, Efremova OI, Grishenkova AS, Krasavin GV. Lechenie venoznoy tazovoy boli: vozmozhnosti khirurgicheskikh i endovaskulyarnykh metodov (lektsiya № 2) [Venous Pelvic Pain Management: Surgical and Endovascular Approaches (Lecture № 2)]. Flebologiya. 2019;13(4):326-34. https://doi. org/10.17116/flebo201913041326
  40. Basile A, Failla G, Gozzo C. Pelvic congestion syndrome. Semin Ultrasound CT MR. 2021;42(1):3-12. https://doi.org/10.1053/j.sult.2020.07.001
  41. O’Brien M, Gillespie DL. Diagnosis and treatment of the pelvic congestion syndrome. Journal of Vascular Surgery: Venous and Lymphatic Disorders. 2015;3(1):96-106. https://doi.org/10.1016/j.jvsv.2014.05.007
  42. Akhmetzianov RV, Bredikhin RA. Clinical efficacy of conservative treatment with micronized purified flavonoid fraction in female patients with pelvic congestion syndrome. Pain Ther. 2021;10(2):1567-78. https://doi.org/10.1007/ s40122-021-00312-6
  43. Dorobisz TA, Garcarek JS, Kurcz J, Korta K, Dorobisz AT, Podgórski P, et al. Diagnosis and treatment of pelvic congestion syndrome: Single-centre experiences. Adv Clin Exp Med. 2017;26(2):269-76. https://doi.org/10.17219/acem/68158
  44. Pyra K, Woźniak S, Drelich-Zbroja A, Wolski A, Jargiełło T. Evaluation of effectiveness of embolization in pelvic congestion syndrome with the new vascular occlusion device (ArtVentive EOSTM): Preliminary results. Cardiovascular and Interventional Radiology. 2016;39(8):1122-7. https://doi.org/10.1007/s00270- 016-1380-8
  45. Sandler RS, Peery AF. Rethinking what we know about hemorrhoids. Clinical Gastroenterology and Hepatology. 2019;17(1):8-15. https://doi.org/10.1016/j. cgh.2018.03.020
  46. Bogomazov AM, Golovko EB, Zagryadskiy EA. Chastota faktorov riska vozniknoveniya gemorroya i opredelenie vzaimosvyazi mezhdu gemorroem i khronicheskimi zabolevaniyami ven. Rezul'taty Rossiyskoy chasti mezhdunarodnoy programmy CHORUS [Incidence of hemorrhoid occurrence risk factors and definition of the relationship between hemorrhoids and chronic vein diseases. Results of the Russian part of the international program CHORUS]. Ambulatornaya khirurgiya. 2017;3-4:94-104.
  47. Cengiz TB, Görgün E. Hemorrhoids: A range of treatments. Cleveland Clinic Journal of Medicine. 2019;86(9):612-20. https://doi.org/10.3949/ccjm.86a.18079
  48. Guttenplan M. The evaluation and office management of hemorrhoids for the gastroenterologist. Curr Gastroenterol Rep. 2017;19(7):30. https://doi. org/10.1007/s 11894-017-0574-9
  49. Jin JZ, Bhat S, Park B, Hardy MO, Unasa H, Mauiliu-Wallis M, Hill AG. A systematic review and network meta-analysis comparing treatments for anal fissure. Surgery. 2022;172(1):41-52. https://doi.org/10.1016/j.surg.2021.11.030
  50. Zagriadskiĭ EA, Bogomazov AM, Golovko EB. Conservative treatment of hemorrhoids: Results of an observational multicenter study. Adv Ther. 2018;35(11):1979-92. https://doi.org/10.1007/s12325-018-0794-x
  51. Soares MB, Pitombo MB, Paulo FL, de Castro Júnior PC, Schlinz JR, Amorim Júnior A, Hamada KGL. Partial stapled hemorrhoidopexy: Clinical aspects and impact on anorectal physiology. Hemorroidopexia por grampeamento parcial: aspectos clínicos e impacto sob a fisiologia anorretal. Rev Col Bras Cir. 2017;44(3):278-83. https://doi.org/10.1590/0100-69912017003010
  52. Aslan R, Erbin A, Çelik S, Ucpinar B, Sahinalp S, Yıldızhan M, et al. Evaluation of hemorrhoidal disease and lower extremity venous insufficiency in primary adult varicocele: A prospective controlled study. Phlebology. 2019;34(9):621-6. https://doi.org/10.1177/0268355519834426
  53. Holdstock JM, Santos SJD, Harrison C, Price BA, Whiteley MS. Haemorrhoids are associated with internal iliac vein reflux in up to one-third of women presenting with varicose veins associated with pelvic vein reflux. Phlebology. 2015;30(2):133-9. https://doi.org/10.1177/0268355514531952
  54. Yetkın E. Hemorrhoid, internal iliac vein reflux and peripheral varicose vein: Affecting each other or affected vessels? Phlebology. 2015;30(2):145. https:// doi.org/10.1177/0268355514565196
  55. Chen D, Luo Q, Fan W, Chen C, Liu G. The association between varicocele and other vascular diseases: A systematic review and meta-analysis. Phlebology. 2022;37(4):233-40. https://doi:10.1177/02683555211069247
  56. Godeberge P, Sheikh P, Zagriadskiĭ E, Lohsiriwat V, Montaño AJ, Košorok P, De Schepper H. Hemorrhoidal disease and chronic venous insufficiency: Concomitance or coincidence; results of the CHORUS study (Chronic venous and HemORrhoidal diseases evalUation and Scientific research). J Gastroenterol Hepatol. 2020;35(4):577-85. https://doi.org/10.1111/jgh.14857
  57. Zagryadskiy EA, Bogomazov AM, Golovko EB. Klassifikatsiya khronicheskogo gemorroya, kriterii ob"ektivnosti [Classification of hemorroidal disease, criteria of objectivity]. Koloproktologiya. 2019;18(1):46-56. https://doi. org/10.33878/2073-7556-2019-18-1-46-56
  58. Ministerstvo zdravookhraneniya Rossiyskoy Federatsii. Obshcherossiyskaya obshchestvennaya organizatsiya «Assotsiatsiya koloproktologov Rossii». Klinicheskie rekomendatsii «Gemorroy» [Ministry of Health of the Russian Federation. Russian public organization "Association of Coloproctologists of Russia". Clinical recommendations "Hemorrhoids"]. Moscow, RF: 2020. 36 p. Available from: https://cr.minzdrav.gov.ru/schema/178_1
  59. Sun Z, Migaly J. Review of hemorrhoid disease: Presentation and management. Clinics in Colon and Rectal Surgery. 2016;29(1):22-9. https://doi. org/10.1055/s-0035-1568144
  60. Lohsiriwat V. Hemorrhoidal disease. Elsevier EBooks. 2019:51-63. https://doi. org/10.1016/b978-0-12-815346-8.00005-9
  61. Vanlangenhove P. Contribution to the pathophysiology and treatment of varicoceles. J Belg Soc Radiol. 2018;102(1):22. https://doi.org/10.5334/jbrbtr.1453
  62. Lomboy J, Coward RM. The varicocele: Clinical presentation, evaluation, and surgical management. Seminars in Interventional Radiology. 2016;33(03):163- 9. https://doi.org/10.1055/s-0036-1586143
  63. Agarwal A, Esteves SC. Varicocele and male infertility: Current concepts and future perspectives. Asian Journal of Andrology. 2016;18(2):161. https://doi. org/10.4103/1008-682x.172819
  64. Chen SS. Response to editorial comments to varicocele is associated with varicose veins: A population-based case-control study. Int J Urol. 2015;22(10):976- 7. https://doi.org/10.1111/iju.12875
  65. Cargnelutti F, Di Nisio A, Pallotti F, Spaziani M, Tarsitano MG, Paoli D, et al. Risk factors on testicular function in adolescents. J Endocrinol Invest. 2022;45(9):1625-39. https://doi.org/10.1007/s40618-022-01769-8
  66. Fariba F, Moradi M, Arabi A, Ghaderi B. Prevalence of coronary artery ectasia with atherosclerosis and associated risk factors in the West of Iran: A cross-sectional study. J Res Health Sci. 2016;16(1):22-5.
  67. Yetkin E, Ozturk S. Dilating venous diseases: Varicocele and varicose vein. Ann Vasc Surg. 2017;38:348. https://doi.org/10.1016/j.avsg.2016.09.004
  68. da Silva NHV, Meller RL, Ogundipe EA, Rochon PJ. Varicoceles: Overview of treatment from a radiologic and surgical perspective. Semin Intervent Radiol. 2022;39(5):490-7. https://doi.org/10.1055/s-0042-1757939
  69. Pacey AA. Varicoceles and other controversies. Hum Fertil (Camb). 2021;24(2):77. https://doi.org/10.1080/14647273.2021.1916145
  70. Afshar K, Domes T. Varicocele. Can Urol Assoc J. 2018;12(4 Suppl 1):34-6. https://doi.org/10.5489/cuaj.5231
  71. Sadowsky LM, Socik A, Burnes A, Rhodes AR. Genital angiokeratomas in adult men and women: Prevalence and predisposing factors. J Cutan Med Surg. 2019;23(5):513-8. https://doi.org/10.1177/1203475419861072
  72. Ozturk S, Akbaba KT, Kilic S, Cicek T, Peskircioglu L, Tandogan I, et al. Venous leg symptoms in patients with varicocele: A multicenter assessment study (VEIN-TURKEY study). Phlebology. 2019;34(2):128-36. https://doi. org/10.1177/0268355518777110
  73. Amelar RD, Dubin L. Therapeutic implications of left, right, and bilateral varicocelectomy. Urology. 1987;30(1):53-9. https://doi.org/10.1016/0090- 4295(87)90573-5
  74. Paick SH, Choi WS. Varicocele and testicular pain: A review. The World Journal of Men’s Health. 2019;37(1):4. https://doi.org/10.5534/wjmh.170010
  75. Zavattaro M, Ceruti C, Motta G, Allasia S, Marinelli L, Di Bisceglie C, et al. Treating varicocele in 2018: Current knowledge and treatment options. Journal of Endocrinological Investigation. 2018;41(12):1365-75. https://doi. org/10.1007/s 40618-018-0952-7
  76. Broe MP, Ryan JPC, Ryan EJ, Murphy DJ, Mulvin DW. Spermatic vein embolization as a treatment for symptomatic varicocele. Can Urol Assoc J. 2021;15(11):569-73. https://doi.org/10.5489/cuaj.7077
  77. Chung KLY, Hung JWS, Yam FSD, Chao NSY, Li DCY, Leung MWY. Prospective randomized controlled trial comparing laparoscopic Palomo surgery vs scrotal antegrade sclerotherapy in adolescent varicocele. J Urol. 2023;209(3):600-10. https://doi.org/10.1097/JU.0000000000003087
  78. Fabiani A, Pavia MP, Stramucci S, Antezza A, De Stefano V, Castellani D. Do sclero-embolization procedures have advantages over surgical ligature in treating varicocele in children, adolescents and adults? Results from a systematic review and meta-analysis. Andrologia. 2022;54(8):14-51. https://doi. org/10.1111/and.14510
  79. Bouskela E, Lugli M, Nicolaides A. New perspectives on micronised purified flavonoid fraction in chronic venous disease: From microvalves to clinical effectiveness. Adv Ther. 2022;39(10):4413-22. https://doi.org/10.1007/s 12325- 022-02218-x
  80. Amaturo A, Meucci M, Mari FS. Treatment of haemorrhoidal disease with micronized purified flavonoid fraction and sucralfate ointment. Acta Biomed. 2020;91(1):139-41. https://doi.org/10.23750/abm.v91i1.9361

Authors' information:

Shirinbek Olimi
Doctor of Medical Sciences, Head of the Surgical Department, Centre for Medical and Corporate Training; Deputy Chief Doctor for Surgery and Head of the “SM-Clinic” Phlebology Centre
ORCID ID: 0000-0003-2116-2247
E-mail: olims@mail.ru

Mnatsakanyan Gevorg Vachikovich
Candidate of Medical Sciences, Physician, “SM-Clinic” Phlebology Centre
ORCID ID: 0000-0001-8402-4381
E-mail: cordestro@yandex.com

Odinokova Saniya Nailevna
Candidate of Medical Sciences, Assistant of the Department of Human Anatomy and Histology, N.V. Sklifosovsky Institute for Clinical Medicine, I.M. Sechenov First Moscow State Medical University
ORCID ID: 0000-0002-5403-8456
E-mail: saniya_odinokova@mail.ru

Information about support in the form of grants, equipment, medications

The authors did not receive financial support from manufacturers of medicines and medical equipment

Conflicts of interest: No conflict

Address for correspondence:

Shirinbek Olimi
Doctor of Medical Sciences, Head of the Surgical Department, Centre for Medical and Corporate Training; Deputy Chief Doctor for Surgery and Head of the “SM-Clinic” Phlebology Centre

125130, Russian Federation, Moscow, Staropetrovsky proezd, 7a, bld. 22

Tel.: +7 (926) 4307382

E-mail: olims@mail.ru

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