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Currently, there is no clear guidance on the management of patients with concomitant chronic diseases of the veins (CVD), such as varicose and postthrombotic disease of the lower limbs, with endoprosthetics of the knee or hip joint. To reduce the risk of thromboembolic complications in patients of this group, the authors developed individual algorithms of reference.

A number of patients with problems of major joints increases every year. These patients need the replacement arthroplasty. The rate of thrombotic complications rises in given category of patients simultaneously with the increase of the number of performed operations. There weren’t well-defined instructions of management of the patients with associated chronic vein diseases at the preparation period for arthroplasty performance in spite of the presence of clinical recommendations for prevention of thromboembolic complications. The authors analyzed the experience of management of such patients and presented these data for doctors from polyclinic and hospitals in order to apply the common treatment strategy.

The main pathogenetic causes of the development of lower limb chronic venous insufficiency (CVI) are associated with hypertension in the inferior vena cava, venous stasis, and ischaemia of the vascular wall. Alterations in microcirculation responsible for the metabolic and trophic processes of the venous wall appear on the background of change in the macrocirculatory bed. A considerable role of the venous endothelial dysfunction was noted. Prescription of phleboprotectors and phlebotonics is of fundamental importance. Efficacy of Antistax makes it possible to recommend its use in combined therapy of various-aetiology and various-grade CVI.

The authors have analyzed the results of an experimental-clinical investigation devoted to studying the efficiency of local treatment of trophic ulcers at the stage of healing using transplantation of dermal allogenic fibroblasts. The method was proved to accelerate epithelization and to shorten the time of preparing to operations for correction of the venous blood flow.

The article presents results of treatment of 53 patients with acute thrombosis of profound veins of various localizations by means of a new home thrombolytic drug, physiologic activator plasminogen--renokinase. High effectiveness of thrombolytic therapy with good rehabilitation or marked clinical improvement was obtained in 79% of the patients. Renokinase is areactogenic and may be used many times.