Kronik Venöz Yetmezlikte Varis Cerrahisi ve Skleroterapi Sonrası Egzersiz Zamanlaması ve Rehabilitasyon Yaklaşımları
Özet
Kronik venöz yetmezlik (KVY), yüzeyel ve derin venöz sistemdeki kapak yetmezliği sonucunda alt ekstremitelerde venöz basınç artışına ve çeşitli klinik bulgulara neden olan yaygın bir hastalıktır. Varis cerrahisi ve skleroterapi, KVY tedavisinde etkin biçimde kullanılan yöntemlerdir. Güncel kılavuzlar ve klinik çalışmalar, bu işlemler sonrasında fiziksel aktivitelere dönüş süresi ve egzersiz önerileri konusunda ayrıntılı bilgiler sunmaktadır. Bu kitap bölümünde, varis cerrahisi ve kozmetik skleroterapi sonrasında spora ne zaman ve hangi düzeyde başlanabileceği, komplikasyon riskleri, egzersizin terapötik rolü ve bireyselleştirilmiş egzersiz planlaması, literatüre dayalı şekilde sunulmuştur.
Referanslar
Eberhardt RT, Raffetto JD. Chronic venous insufficiency. Circulation. 2014;130(4):333-346. doi:10.1161/CIRCULATIONAHA.113.006898
Criqui MH, Denenberg JO, Langer RD, Fronek A. The epidemiology of chronic venous disease. Phlebology. 2007;22(1):1-7. doi:10.1258/026835507780220185
O'Donnell TF Jr, Passman MA, Marston WA, et al. Management of chronic venous disease. J Vasc Surg Venous Lymphat Disord. 2022;10(1):3S-35S. doi:10.1016/j.jvsv.2021.10.008
Padberg FT Jr, Johnston MV, Sisto SA. Structured exercise improves calf muscle pump function in chronic venous insufficiency: a randomized trial. J Vasc Surg. 2004;39(1):79-87. doi:10.1016/j.jvs.2003.09.036
Wittens C, Davies AH, Bækgaard N, et al. Management of chronic venous disease: Clinical practice guidelines of the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg. 2015;49(6):678-737. doi:10.1016/j.ejvs.2015.02.007
De Maeseneer M, Kakkos SK, Gohel M, et al. 2022 Clinical Practice Guidelines on the Management of Chronic Venous Disease of the Lower Limbs. Eur J Vasc Endovasc Surg. 2022;63:184–267.
Kakkos SK, Nicolaides AN. Management of chronic venous disorders of the lower limbs. BMJ. 2020;371:m4149. doi:10.1136/bmj.m4149
American College of Sports Medicine. ACSM’s Guidelines for Exercise Testing and Prescription. 11th ed. Philadelphia (PA): Wolters Kluwer; 2021.
Lurie F, Passman M, Meisner M, et al. Compression therapy after invasive treatment of superficial veins of the lower extremities: Clinical practice guidelines. J Vasc Surg Venous Lymphat Disord. 2019;7(1):17–28. doi:10.1016/j.jvsv.2018.10.013
Rabe E, Pannier F, Breu FX, et al. Sclerotherapy in the treatment of varicose veins: S2k guideline of the Deutsche Gesellschaft für Phlebologie (DGP) in cooperation with German phlebology societies. Hautarzt. 2021 Dec;72(Suppl 2):23–36. doi:10.1007/s00105-020-04705-0
Pannier F, Noppeney T, Alm J, Breu FX, et al. S2k guidelines: diagnosis and treatment of varicose veins. Hautarzt. 2022 May;73(Suppl 1):1–44. doi:10.1007/s00105-022-04977-8
Medscape. Sclerotherapy Treatment & Management. eMedicine. Updated April 2023. https://emedicine.medscape.com/article/1271091-treatment
Gloviczki P, Lawrence PF, Dalsing MC, et al. Clinical practice guidelines for the management of varicose veins of the lower extremities. J Vasc Surg Venous Lymphat Disord. 2023;11(1):3S–73S. doi:10.1016/j.jvsv.2022.11.007
Barnes GD, Fukaya E, Kolluri R. Nonsurgical management of chronic venous insufficiency. American College of Cardiology (ACC) website. Published December 19, 2024. Accessed June 13,2025.https://www.acc.org/latest-in-cardiology/ten-points-to remember/2024/12/19/18/42/nonsurgical-management-of-cvi
Lim CS, Davies AH. Graduated compression stockings. CMAJ. 2014;186(10):E391–E398. doi:10.1503/cmaj.131281
Orr L, Klement KA, McCrossin L, et al. A systematic review and meta-analysis of exercise intervention for the treatment of calf muscle pump impairment in individuals with chronic venous insufficiency. Ostomy Wound Manage. 2017;63(8):30–43. doi:10.25270/owm.2017.08.3043
Predicting and preventing varicose vein recurrence. Endovasc Today. March 2018.
Pina IL, Bourassa MG, Chaitman BR, et al. Behavioral interventions to enhance physical activity adherence in patients with cardiovascular disease: A scientific statement from the AHA. Circulation. 2013;128(4):369–376. doi:10.1161/CIR.0b013e31829b5b44
Lorenc T, Petticrew M, Welch V, et al. What types of interventions generate inequalities? Evidence from systematic reviews. J Epidemiol Community Health. 2013;67(2):190–193. doi:10.1136/jech-2012-201257
Menegatti E, Mandini S, Chi Y-W, Gianesini S. Physical fitness changes induced by thermal aquatic standardized exercise in chronic venous disease patients. J Vasc Surg Venous Lymphat Disord. 2021;9:1226–1234. doi:10.1016/j.jvsv.2020.12.040
Cesarone MR, Belcaro G, Nicolaides AN, et al. Postpartum varicose veins registry: evolution after pregnancy. Int J Angiol. 2017;26(3):123–130. doi:10.1055/s-0037-1599202
Varisport Study Authors. High physical activity volume is associated with increased calibre of lower limb veins: the Varisport study. Eur J Vasc Endovasc Surg. 2023. doi:10.1016/j.ejvs.2023.00624
