Endovenous radiofrequency surgery treating chronic venous insufficiency in Central Africa
We report our expertise related to the multidisciplinary treatment of the chronic venous insufficiency condition in the lower limbs at different stages of the CEAP classification. We present our approach used to treat its complicated form namely: the venous ulcer or "Non-infectious MBASU". Over a retrospective period of 2 years, it has been established that 80% of CEAP cases considered as "non-infectious MBASU" have been successfully treated with endovenous radiofrequency surgery.
MBASU, Treatment of chronic venous insufficiency, CEAP
Abstract Context and objectives
Since 2016 in the DRC, we practice the multidisciplinary treatment of the chronic venous insufficiency patient at different stages of the CEAP classification. Over a 24-month period (2017-19), we treated 135 members with chronic venous insufficiency in the lower limbs and, in particular, its complicated form namely the venous ulcer: "the non-infectious MBASU" . The cases treated are divided into : CEAP 1: 5% - CEAP 2: 15% - CEAP 3: 20% CEAP 4a-b: 15% - CEAP 5: 6% - CEAP 6: 39% Considering the cases CEAP 3 (oedema), CEAP 4a-b (dermatitis), CEAP 5 (healed ulcer) and CEAP 6 (active ulcer), it is thus established that 80% of the “MBASU” cases were treated successfully via RFA. Moreover, in 95% of the treated limbs, the anaesthesia was “local-regional".
This results in the need for a specialized vascular pathology centre in Kinshasa for better management with a focus on the differential diagnosis of ulcers and trophic disorders of arterial and / or venous causes. In fact, contrary to local preconceptions, the most common cause of lower extremity ulcers is a vascular and non-infectious origin alone, which is usually superinfection on compromised soil.
Among all the measures to be taken, it emerges that a better medical and paramedical training in vascular pathology is imperative. We advocate a global approach to cardiovascular diseases (hypertension, stroke, TVP-EP, AOMI, VASCULAR TRAUMA, ...) which naturally calls for a collaboration with other specialists in the cardiovascular discipline. The aim is to reduce the number of MBASU cases by raising awareness and informing the public.
Over a period of three years, despite limited resources based exclusively on own funds, TVC Medical has achieved spectacular results in the treatment of venous insufficiency in Central Africa.
It is now time to amplify the pioneering role of TVC Medical. This presentation is an opportunity to elaborate about suggested recommendations.