OUTCOME OF ULTRASOUND GUIDED FOAM SCLEROTHERAPY IN THE TREATMENT OF VARICOSE VEINS

Varicose veins are one associated aspect of evolution that humans could have happily lived without. It's almost certainly the price we pay for the two-legged erect posture. Though we have achieved cure for various diseases, till now no reliable cure has been found for venous insufficiency.The gold standard for treating chronic venous insufficiency has been surgery. The surgeon dealing with varicose veins has always had to strike a balance between an aesthetically pleasing outcome and a low rate of recurrence and complications. Sclerotherapy, which was first used over 150 years ago, is still the most efficient method for permanently removing pathologically swollen as well as cosmetically unpleasant but otherwise normal veins.Foam sclerotherapy, in which the sclerosant is mixed with air or physiological gases, is more effective than direct injection of sclerosants, because the agent's contact with the endothelium is prolonged by the air in the foam. The use of foam sclerotherapy for big veins has reduced recurrence rates. Large-scale researches have demonstrated the safety of foam sclerotherapy. Foam sclerotherapy has a recurrence rate that is comparable to surgery. The efficacy of foam sclerotherapy has been variable as per different studies across different institutions

A prospective clinical study of endoscopic foam sclerotherapy combined with rubber band ligation in the treatment of grade Ⅱ-Ⅲ internal hemorrhoids (with video) / 中华消化内镜杂志

Objective:To evaluate the safety and long-term effectiveness of endoscopic foam sclerotherapy (FS) combined with endoscopic rubber band ligation (ERBL)in the treatment of grade Ⅱ-Ⅲ internal hemorrhoids.Methods:Consecutive patients diagnosed as having grade Ⅱ-Ⅲ internal hemorrhoids in Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January to December 2020 were prospectively enrolled in the study, and randomly divided into ERBL group and FS combined with ERBL group. The 24 h visual analogue scale (VAS) for pain and 1-week degree of bleeding were evaluated after the treatment. After follow-up of 6 months, the effectiveness of treatment was evaluated.Results:A total of 84 patients with age of 54.4±7.9 years were enrolled, 57.1% (48/84) males, and 73.8% (62/84)grade Ⅱ internal hemorrhoids. Forty-three patients were assigned to the ERBL group and 41 to the FS combined with ERBL group. There was no significant difference between the two groups in baseline data ( P>0.05). In the FS combined with ERBL group, the mean amount of polidocanol foam was 13.8±2.5 mL, the mean number of injection site was 4.7±1.2, and the median scores of VAS was 0 (0, 3), which was significantly lower than that of ERBL group [2 (0, 4), Z=-2.116, P=0.034]. The bleeding rate 1 week after treatment in the ERBL and FS combined with ERBL group were 20.9% (9/43) and 29.3% (12/41), respectively, and mild bleeding was the main symptom. There was no significant difference between the two groups in the bleeding degree ( U=807.0, P=0.378). After 6 months of follow-up, the total effective rates in the ERBL group and the FS combined with ERBL group were 81.4% (35/43) and 90.2% (37/41), respectively ( U=684.5, P=0.044). Conclusion:FS combined with ERBL can effectively relieve post-treatment perianal pain, and improve the long-term effectiveness.

Escleroterapia com espuma de polidocanol em veias safenas magnas e suas tributárias bilateralmente em tempo único / Bilateral foam polidocanol sclerotherapy of great saphenous veins and their tributaries in synchronous procedure

Resumo Contexto A insuficiência venosa crônica é uma entidade com alta prevalência. Os casos avançados apresentam morbidade elevada. Objetivos Avaliar os riscos e benefícios da escleroterapia com espuma de polidocanol em pacientes que foram submetidos ao tratamento das veias safenas magnas bilateralmente em tempo único. Métodos Foram revistos retrospectivamente 55 pacientes (110 membros) portadores de incompetência bilateral das veias safenas magnas submetidas a tratamento escleroterápico com espuma bilateralmente, em tempo único, usando uma dose máxima de 20 mL de espuma de polidocanol por paciente. Resultados Das 110 safenas analisadas, obteve-se a oclusão de 81 (73,6%) com uma sessão, de 106 (96,3%) com duas sessões e de 110 (100%) com três sessões. Houve oclusão bilateral das safenas magnas em 27 pacientes (50%) em uma sessão, em 34 (62%) em duas sessões e em 55 (100%) em três sessões. De 11 pacientes portadores de úlceras, houve cicatrização total de sete (63%) e parcial de três (27%) 42 dias após a escleroterapia. Houve lipotimia autolimitada e escotomas visuais em um paciente (1,8%) e manchas em três (5,45%); 19 pacientes (34,5%) foram submetidos a punção para drenagem de coágulo retido. Conclusões A escleroterapia com espuma de polidocanol em veias safenas magnas em tempo único mostrou-se uma técnica segura e eficaz em pacientes selecionados.

Abstract Background Chronic venous insufficiency is a highly prevalent disease. Advanced cases have high morbidity. Objectives To evaluate the risks and benefits of foam sclerotherapy in patients who underwent bilateral treatment of the great saphenous veins in a single procedure, in selected cases of advanced venous insufficiency. Methods We retrospectively reviewed 55 patients (110 limbs) with bilateral incompetence of the great saphenous veins who had undergone foam sclerotherapy treatment bilaterally, using a maximum dose of 20 ml of foam per patient and inelastic compression. Results In 81 (73.6%) of the 110 saphenous veins analyzed, occlusion was obtained in the first session. After a second session this figure rose to 106 (96.3%) and all 110 (100%) veins were occluded after three sessions. Bilateral occlusion of the great saphenous veins was achieved in 27 patients (50%) in one session, in 34 (62%) patients in two sessions, and in 55 (100%) patients in three sessions. At 42 days after sclerotherapy, there was complete ulcer healing in seven (63%) of the 11 patients with ulcers and partial healing in 3 (27%) of these patients. One patient (1.8%) had self-limited lipothymia and visual scotomas, 3 patients (5.45%) had skin spots, and 19 patients (34.5%) developed retained intravascular coagulum. Conclusions Bilateral foam sclerotherapy in a synchronous procedure is an option to be considered for treatment of varicose veins of the lower limbs.

Efficacy of foam sclerotherapy in treatment of grade I and grade II bleeding hemorrhoids at Nalanda Medical College and Hospital, Patna

Background: Sclerotherapy is the treatment of choice for first and second grade haemorrhoidal disease. The aim of this study is to assess the efficacy and safety of polidocanol foam for haemorrhoidal disease.Methods: A total of 50 patients were treated with foam sclerotherapy (polidocanol 3%). Patients who presented with complain of bleeding per anum and diagnosed with first and second grade hemorrhoidal disease were included. Patients without bleeding per anum were not included. The primary objective was the stopping of perianal bleeding after one sclerotherapy session. Sclerotherapy was repeated at 2-week intervals until patients were free of bleeding. The final follow-up was 12 weeks after the last sclerotherapy session.Results: After one foam sclerotherapy session, 82% of patients (41 out of 50) were treated successfully. After second sclerotherapy, 98% of the patients (46 out of 50) were treated successfully. 2% of the patients received third sclerotherapy.Conclusions: In the treatment of first and second grade haemorrhoidal disease, polidocanol 3% foam is very effective and safe. The results of this study show that foam sclerotherapy is a new, innovative, effective and safe non-surgical treatment option for haemorrhoidal disease.

Medium-and long-term effects of DSA-guided foam sclerotherapy for lower extremity varicosities / 中国介入影像与治疗学

Objective: To observe the effect of DSA-guided foam sclerotherapy for lower extremity varicose veins and its influence on patients' quality of life. Methods: Totally 573 patients (744 limbs) with lower extremity varicosities were treated with DSA-guided foam sclerotherapy and were followed up for 4 years. The health survey short form 12 (SF-12) and venous clinical severity score (VCSS) were counted before treatment and 1, 2, 3 and 4 years after treatment. The expectation for efficacy and treatment satisfaction were collected through filling questionnaires for the lower extremity symptom improvement 4 years after treatment. Results: All the limbs were successfully treated, the average usage of the foam was (21.62±10.83) ml/limb, and no severe side effects such as deep venous thrombosis or pulmonary embolism happened during or after procedures. Both physical component summary (PCS) score and mental component summary (MCS) score in SF-12 scale increased 1, 2, 3 and 4 years after treatment compared with that before treatment (all P<0.05), while VCSS decreased compared with that before treatment (all P<0.01). Upon the time of 4-year follow-up, the proportions of patients' expectations for improvement of appearance, pain, itching, swelling and heaviness of the affected limbs exceeded expectations + reached expectations were 100% (91/91), 100% (36/36), 93.55% (29/31), 88.46% (23/26) and 91.38% (53/58), respectively. The patients' overall satisfaction on the treatment was 100% (72/72). Conclusion: The medium- and long-term efficacy of DSA-guided foam sclerotherapy for lower extremity varicose veins were good, and the quality of life was improved.

Safety and efficacy of a novel shunt surgery combined with foam sclerotherapy of varices for prehepatic portal hypertension: a pilot study

OBJECTIVES: This pilot study investigated the safety and efficacy of a novel shunt surgery combined with foam sclerotherapy of varices in patients with prehepatic portal hypertension. METHODS: Twenty-seven patients who were diagnosed with prehepatic portal hypertension and underwent shunt surgeries were divided into three groups by surgery type: shunt surgery alone (Group A), shunt surgery and devascularization (Group B), and shunt surgery combined with foam sclerotherapy (Group C). Between-group differences in operation time, intraoperative blood loss, portal pressure decrease, postoperative complications, rebleeding rates, encephalopathy, mortality rates and remission of gastroesophageal varices were compared. RESULTS: Groups A, B and C had similar operation times, intraoperative bleeding, and portal pressure decrease. The remission rates of varices differed significantly (p<0.001): one patient in Group A and 6 patients in Group B had partial response, and all 9 patients in Group C had remission (2 complete, 7 partial). Two Group A patients and one Group B patient developed recurrent gastrointestinal bleeding postoperatively within 12 months. No postoperative recurrence or bleeding was observed in Group C, and no sclerotherapy-related complications were observed. CONCLUSIONS: Shunt surgery combined with foam sclerotherapy obliterates varices more effectively than shunt surgery alone does, decreasing the risk of postoperative rebleeding from residual gastroesophageal varices. This novel surgery is safe and effective with good short-term outcomes.

LFK-SLT30 semiconductor laser combined with polidocanol for the treatment of varicose veins of the lower extremities / 中华普通外科杂志

Objective To explore the clinical efficacy and satety of LFK-SLT30 semiconductor laser combined with polidocanol for the treatment of varicose veins of the lower extremities.Methods The clinical data of 105 patients treated by traditional surgery (surgery group) and 113 patients with endovascular laser treatment (EVLT) combined with polidocanol (combination group) were retrospectively analyzed from Apr 2013 to Apr 2015.Results The operative time [(50 ± 12) min vs.(70 ±10)min] and blood loss [(19 ± 6)ml vs.(41 ± 8)ml] between combination group and surgery group were significantly different (P ＜ 0.05).The rate of complications in surgery group was significantly higher than that in the combination group[15.2％ (16/105)vs.6.3％ (7/113),x2 =4.717,P =0.030].The overall 1',2' and 3 year follow-up rate was 85.3％ (186/218),76.6％ (167/218),and 60.6％ (132/218).The average follow up was (20 ± 13)months.No significant difference existed in the rate of recurrence [0 vs.3.5％(4/113),x2 =3.786,P=0.123] between the two groups.Conclusions EVLT combined with foam sclerotherapy is as effective as surgery,while resulting in less complications,less invasive,safer and more effective for the treatment of varicose veins of the lower extremities.

Observation of curative effect of treatment of varicose veins of lower extremity with polyurethane foam sclerosing agent under fluoroscopic guidance / 中国生化药物杂志

Objective To investigate and analyze the effect of polyurethane foam sclerotherapy on varicose veins of lower extremity under the guidance of fluoroscopy. Methods 90 patients with varicose veins treated in our hospital from February 2015 to May 2017 were selected and randomly divided into the control group and the experimental group, with 45 patients in each group. The patients in the control group were given conventional high ligation and stripping of the great saphenous vein. The patients in the experimental group were treated with fluoroscopic guided polyurethane foam sclerotherapy. The therapeutic effects of the 2 groups were compared and analyzed. Results After operation, 2 patients relapsed in the experimental group, and the recurrence rate was 4.4％. In the control group, 6 patients relapsed. The recurrence rate (13.3％) in the control group was significantly higher than that in the experimental group, with statistical difference. After the corresponding treatment, the intraoperative blood loss in the experimental group was (10.23±1.52) mL, and the bleeding volume in the control group was (32.19±2.34) mL. The bleeding volume in the experimental group was significantly less than that in the control group, with statistical difference. In addition, the average length of stay, length of operation and length of incision in the experimental group were significantly better than those in the control group, with statistical difference. Conclusion The clinical effect of fluoroscopy guided lauromacrogol foam sclerosing agent in the treatment of varicose vein of lower limb is better, the recurrence rate is low, can significantly reduce the amount of bleeding, shorten operation time, has clinical significance.

Postoperative complications of patients with varicose vein of lower limbs treated with foam sclerotherapy and endovenous laser / 中华普通外科杂志

Objective To Compare postoperative complications between patients with varicose veins of the lower limbs treated with foam sclerotherapy or endovenous laser.Method From 2011 to 2015,simple varicosis of great saphenous vein patients (grade C3-6) in 2 542 cases,3 468 limbs were divided into 2 groups.Combined with high ligation of great saphenous vein plus stripping,foam sclerotherapy group (1 355 cases) underwent calf foam sclerotherapy (1％ polidocanol),endovenous laser group (1 187 cases) underwent endovenous laser therapy.All postoperative patients were treated with stretch socks for 3 months.Postoperative pain (calf),deep vein thrombosis,pulmonary embolism,superficial thrombophlebitis,saphenous nerve injury,ecchymoma,migraine,allergic dermatitis,pigmentation in 2 groups were compared.Result During the follow-up,28 cases in foam sclerotherapy group had saphenous nerve injury (2％),1 071 (79.1％) cases had subcutaneous ecchymosis,613 cases (51.6％) in endovenous laser group had saphenous nerve injury,979 cases (82.5％) had subcutaneous ecchymosis,8 cases (1.0％) had skin burns (x2 =824.660,4.786,9.161,P ＜ 0.05).Endovenous laser group (23.8％) was significantly better than that of foam sclerotherapy group (30.8％) in pigmentation (x2 =15.243,P ＜0.05).Conclusion Treatment of varicose veins of the lower leg with foam sclerotherapy has less postoperative complications compared with endovenous laser.

Clinical Efficacy of Foam Sclerotherapy Combined with Melilotus Extract Tablets for Varicose Veins of Lower Extremities / 广州中医药大学学报

Objective To compare the short-term clinical effect of the foam sclerotherapy combined with Melilotus Extract Tablets vs foam sclerotherapy alone in treating varicose veins of the lower extremities.Methods A retrospective cohort study was carried out in 120 cases receiving foam sclerotherapy in the Invasive Technology Department of Panyu District Central Hospital.Seventy-two patients in trial group wore graduated compression stockings and received oral use of Melilotus Extract Tablets after the operation,while 48 cases in the control group only wore graduated compression stockings after the operation.The follow-up for the two groups lasted for 3 months.We recorded the relief of symptoms (pain,soreness and distention) and physical signs (edema,hyperpigmentation,ulcer) after the operation.The grading levels of clinical-etiology-anatomic-pathophysiologic classification system (CEAP) for lower limb venous disease,venous clinical severity scores (VCSS) and disease quality-of-life questionnaire CIVIQ scores were observed before and after the operation.Results (1) Three months after the operation,the illness state of the two groups was improved to certain degree,and the differences of CEAP grading levels were insignificant(P ＞ 0.05).(2) VCSS and CIVIQ scores of the two groups were improved after the operation (P ＜ 0.01 compared with those before the operation),and the trial group had better effect on improving CIVIQ scores than the control group (P ＜ 0.01).(3) The successful rate of the trial group was 88.89％,and that of the control group was 81.25％,the difference being insignificant (P ＞ 0.05).(4) Time for obvious relief of lower limb symptom in the trial group was shorter than that in the control group (P ＜ 0.05),but the time for hyperpigmentation and ulcer disappearing as well as the medical expenses in the trial group did not differ from those in the control group (P ＞ 0.05).Conclusion Foam sclerotherapy combined with Melilotus Extract Tablets is effective,safe and economical for the treatment of varicose veins of the lower extremities,and its efficacy is superior to foam sclerotherapy alone.

Clinical study of foam sclerotherapy for varicose veins of lower extremity with deep venous valve incompetence / 实用放射学杂志

Objective To investigate the clinical effectiveness of foam sclerotherapy for lower extremity varicose vein with deep venous valve incompetence.Methods A retrospective study was carried out in 124 patients (185 limbs) receiving foam sclerotherapy in our department.Sixty-one limbs diagnosed as deep venous valve incompetence were categorized as the observation group,while 124 limbs without that were the control group.The main outcome were success rate,remission rate of various symptoms and signs,the scores of CEAP and CIVIQ.Results The follow up rate was 69.3％,and the follow-up period ranged from one to nine months.There was no statistical difference in the success rate between the observation group (93.4％) and control group (94.4％)(P＞0.05).However,the symptom of heaviness and oedema and the CIVIQ scores in observation group be inferior to the control group,and the difference of them were statistically significant (P＜0.05).Conclusion Deep venous valve incompetence could not decrease the success rate of foam sclerotherapy,but may influence the remission of some symptoms.It should be supplemented with medical elastic stockings or ringing of femoral veins.

Study on foam sclerotherapy for varicose veins of lower extremities / 临床外科杂志

Objective To explore the relationship between recurrence rate and side effects of the treatment of varicose veins in lower extremity with lauromacrogol foam sclerosing agent.Methods The data of 62 patients(98 limbs)with varicose veins was collected,including 27 males (41 limbs)and 35 females (57 limbs).They were treated with 1％ lauromacrogol foam sclerosing agent combined with great saphenous vein high ligation and endovenous laser treatment.Statistical indicators included side effects such as pain,induration,hyperpigmentation,swelling,numbness and the recurrence rate.Results Two patients were lost,57 patients were injected once,further foam sclerotherapy was carried out again for 3 patients.Obvious abnormal varicose veins as well as the soreness and fatigue of lower extremity disappeared in all patients.Thirty-seven patients had pain and 43 patients developed superficial venous thrombotic sclerosis,among which 50 patients faded away after 1 to 3 months by taking diosmin.Thirty-one cases of pigmentation occurred and 20 disappeared after 1 to 3 months by applying the vitamin E whitening essence.Six patients with lower extremity ulcers recovered after 1 to 3 months.Through statistics analysis of the patients in 1-month follow-up,we found that the differences in recurrence rate after 6 months were statistically significant between group with pain induration reaction and group without (P ＜ 0.05).Among the patients without using the vitamin E whitening essence,there was a significant correlation between the duration of pigmentation and recurrence rate after 6 months.Conclusion In the process of foam sclerotherapy,the more pain induration reaction they had and the longer the duration of pigmentation sustained,the lower the recurrence rate would be accordingly.

DSA-guided foam sclerotherapy of lauromacrogol in treatment of lower extremity varicose veins / 实用放射学杂志

Objective To evaluate the clinical effect of DSA-guided foam sclerotherapy for lower extremity varicose veins.Methods A total of 41 legs in 26 patients with lower extremity varicose veins were treated with foam sclerosing agent of lauromacrogol un-der DSA guidance.4 cases with venous return disorder (3 in iliac vein and 1 in inferior vena cava)were treated with balloon dilatation first,and then lauromacrogol foam sclerotherapy after 24 hours.For injection method,2 patients were injected sclerosing agent through a catheter inserted in the trunk of great saphenous vein of sick limb with retrograde catheterization,and the others were in-j ected sclerosing agent directly in the varicose veins.Results The sclerotherapy was successfully accomplished in all affected limbs of 26 patients.The average dose of lauromacrogol for each patient was 5.88 mL.No serious complications occurred during and after operation.In 1 to 12-month follow-up,varicose veins disappeared in 24 patients (92.3%),the soreness,fatigue and pigmentations disappeared in all patients,the ulcer healed in all limbs.Conclusion DSA-guided foam sclerotherapy is a micro-invasive,safe and ef-fective treatment for lower extremity varicose veins.

Foam sclerotherapy of lauromacrogol for the treatment of lower extremity varicose veins：comparison study of two different injection ways Z / 介入放射学杂志

Objective To compare the clinical efficacy of two different injection ways in treating lower extremity varicose veins with foam sclerotherapy of lauromacrogol. Methods During the period from Dec. 2010 to Dec. 2012 a total of 80 patients with clinically-proved lower extremity varicosis were admitted to authors’ hospital. The patients were randomly and equally divided into two groups:anterograde group (n=40) and retrograde group (n=40). For patients of anterograde group, under fluoroscopy guidance the needle was directly punctured into the distal end of the varicose vein with subsequent injection of 1%lauromacrogol foam sclerosing agent, while for patients of retrograde group the opposite femoral vein was punctured by using Seldinger technique, then a catheter was inserted into the proximal part of the great saphenous vein of the diseased side, and 1%lauromacrogol foam sclerosing agent was injected into the varicose vein. The operation time, recovery time, the dosage of the sclerosing agent used, the incidence of complications and the use of additional treatment were recorded, and the results were statistically analyzed. All the patients were followed up for 3 - 6 months. Results No significant difference in the overall effective rate existed between the two groups at 3-6 months after the treatment (P>0.05). The preoperative and postoperative CEAP scores of the anterograde group were 3.70 ± 0.63 and 0.88 ± 1.18 respectively, while the preoperative and postoperative CEAP scores of the retrograde group were 3.73 ± 0.59 and 0.88 ± 1.27 respectively. The difference in CEAP score between preoperative values and postoperative ones was statistically significant in both anterograde group and retrograde group (P < 0.05). Besides, the differences in the operation time, recovery time, the dosage of the sclerosing agent used, the incidence of complications and the use of additional treatment between the two groups were also statistically significant. Conclusion In treating lower extremity varicose veins with foam sclerotherapy of lauromacrogol, the overall effectiveness of anterograde injection and retrograde injection is quite the same. As each injection way has its own advantages and disadvantages, the therapeutic scheme should be individualized for each patient.

Costos del tratamiento de las telangiectasias y várices tronculares con escleroterapia con espuma en el Hospital Freyre de Andrade de La Habana / Cost of the treatment of t elangiectases and varicose veins with foam sclerotherapy in Freyre de Andrade hospital in Havana

Objetivo: determinar cuánto cuesta por paciente el tratamiento de várices por la técnica de escleroterapia con espuma en la consulta externa de Angiología y Cirugía Vascular del Hospital C.Q. Freyre de Andrade. Método: evaluación económica del tipo descripción de costo. Se estudió el costo directo institucional del tratamiento ambulatorio para várices en extremidades inferiores con escleroterapia con espuma y donde el principio activo fue Polidocanol al 0,5 por ciento a una dosis de 2ml. Se emplearon las partidas recursos humanos, material gastable y medicamento. Se determinó el costo promedio por paciente, total y según tipo de consulta. Resultados: el costo total por paciente atendido fue de 68,60 pesos cubanos. El costo medio por paciente de la consulta de clasificación fue de 0,18 centavos de pesos cubanos (DS 95 por ciento= 0,12). El costo medio de la consulta de tratamiento fue de 50,60 pesos cubanos (DS 95 por ciento=7,65). No hubo diferencias significativas entre los diferentes tipos de varices a tratar. Conclusiones: el costo directo institucional del tratamiento de telangiectasias y varices tronculares con escleroterapia con espuma fue similar. A corto plazo, el tratamiento de las várices con escleroterapia con espuma genera menores costos que la opción quirúrgica

Objective: to determine the cost of the treatment of varicose veins per patient with the foam sclerotherapy in the angiology and vascular surgery outpatient service of Freyre de Andrade clinical and surgical hospital. Method: a cost description-type economic assessment. The institutional direct cost of the leg varicose veins treatment with foam sclerotherapy at the outpatient service, using the active principle called 0.5 percent polidocanol at a dose of 2 ml, was studied. The variables were human resources, disposable materials and drugs. The average cost per patient, the total cost and type of service-depending cost were all estimated. Results: the total cost per patient was 68.60 Cuban pesos. The mean cost per patient at the classification service was 0.18 Cuban cents (SD 95 por ciento=0.12). The mean cost of the treatment service was 50.60 Cuban pesos (95 por ciento SD=7.65). There were no significant differences among the different types of varices under treatment. Conclusions: the institutional direct cost of the treatment of telangiectases and varicose veins by using foam sclerotherapy was comparable. In the short term, the treatment of varices with this method brings lower costs than those of the surgical alternative

Utilización de la escleroterapia con espuma en úlceras varicosas de miembros inferiores / Use of foam sclerotherapy in the treatment of varicose ulcers of lower extremities

La úlcera varicosa es una de las complicaciones más temidas y frecuentes de la insuficiencia venosa crónica, por la sintomatología y discapacidad que provoca en el paciente y los elevados costos que ocasiona. Se presenta un caso de un paciente con antecedentes de de várices en miembros inferiores, y una úlcera varicosa de varios años de evolución en el miembro inferior izquierdo rebelde a diferentes tratamientos, a la cual se le realiza la técnica escleroterapia con espuma y se logra su cicatrización con una evolución favorable

The varicose ulcer is one of the more frequent and fearsome complications of chronic venous insufficiency due to its symptomatology and disability provoked in a patient with a history of lower extremities varices and the high related costs. This is the case a patient with a background of lower extremities varices and a varicose ulcer of some years of evolution in the left lower limb unmanageable for different treatments being necessary to perform the foam sclerotherapy technique achieving its healing with a favorable course

Escleroterapia con espuma, tratamiento para las várices de miembros inferiores en pacientes de la tercera edad / Foam sclerotherapy in treatment of lower extremities varices in elderlies

La escleroterapia con espuma es un método de tratamiento para las várices de miembros inferiores. Se presenta el caso de una mujer de 73 años tratada con este método. La paciente tenía antecedentes de várices en miembros inferiores debido a insuficiencia de la vena safena interna izquierda. Este método, efectivo, satisfactorio y económico, erradicó la várice y una de las principales causas de muerte

Foam sclerotherapy is treatment method for lower extremities varices. This is the case of a woman aged 73 treated with this method. Patient had varices backgrounds in lower extremities due to an insufficiency of left internal saphena vein. This effectiveness, satisfactory and economic method eradicates the varix and one of the leading death causes

Techniques and curative effects of fluoroscopy-guided foam sclerotherapy for lower extremity varicosities / 中华放射学杂志

Objective To describe the techniques of fluoroscopy-guided foam sclerotherapy for lower extremity varicosities, and evaluate the feasibility, safety and curative effects of it. Methods From October 2008 to December 2009, a total of 21 legs in 16 patients with lower extremity varicosities received radiological-guided foam sclerotherapy. They were enrolled in this study. Sodium morrhuate was foamed with by the filling-defects technique under fluoroscopy guidance. Postoperative compression was maintained for 2 weeks. Clinical effect was assessed as full success, partial success and no success. Complications were classified as minor or serious. Results The technical procedure was successful in all foam sclerotherapies for 21 legs. And, a single sclerotherapy session was adequate for all legs. The median follow-up period was 6. 0 months after treatment, ranged from 3.0 to 17.0 months. In this period, Clinical effect was assessed as full success for 17 legs (81.0%) and partial success for 4 legs ( 19.0% ). All patients presented selflimiting minor complications, including cordlike subcutaneous indurations along the treated veins (21 cases), skin hyperpigmentation in 11 legs (8 cases), local pain in 7 legs (6 cases) and superficial thrombophlebitits in one leg ( 1 case). No serious complications or systemic events occurred. Conclusion Fluoroscopy-guided foam sclerotherapy was a feasible, safe and effective treatment for lower extremity varicosities.

The Effects of Foam Sclerotherapy for the Treatment of Lower Limb Varicose Veins

PURPOSE: To evaluate the effectiveness of foam sclerotherapy, we compared the clinical data and results of foam sclerotherapy with conventional sclerotherapy. METHOD: Ninety-three cases of varicose veins were retrospectively reviewed; these were treated by sclerotherapy from January 2000 to September 2005 (women: 82 cases, men: 12 cases, mean age: 43.7 years old). The enrolled cases were divided into the conventional sclerotherapy (CS) group (n=53) and the foam sclerotherapy (FS) group (n=40) according to the applied technique. We assessed the results with the disappearance scoring scale (DSS) and the satisfaction scoring scale (SSS). RESULT: In DSS, complete disappearance was reported as 28.3% by physicians and 30.2% by the patients in CS group and as 47.5% and 52.5% in the FS group, respectively. On the SSS, a satisfaction score scale above 3 (4: Good, 5: Very good) was reported for 79.1% in the CS group and 90.0% in the FS group, retrospectively. The average amounts of sclerosants used were significantly lower in the FS group (1.2+/-0.4 vials) than in the CS group (2.1+/-0.5 vials)(P=0.001). Post injection complications were retrospectively observed in 16.1% of all the patients, in 20.7% of the CS group and in 10.0% of the FS group. CONCLUSION: Sclerotherapy is a very effective and sufficient treatment for telangiectases or reticular varicose veins. Especially, foam sclerotherapy is more effective than conventional liquid sclerotherapy for the clinical results and the patient satisfaction, and it shows a with lower incidence of complications.

The Effects of Foam Sclerotherapy for the Treatment of Lower Limb Varicose Veins

PURPOSE: To evaluate the effectiveness of foam sclerotherapy, we compared the clinical data and results of foam sclerotherapy with conventional sclerotherapy. METHOD: Ninety-three cases of varicose veins were retrospectively reviewed; these were treated by sclerotherapy from January 2000 to September 2005 (women: 82 cases, men: 12 cases, mean age: 43.7 years old). The enrolled cases were divided into the conventional sclerotherapy (CS) group (n=53) and the foam sclerotherapy (FS) group (n=40) according to the applied technique. We assessed the results with the disappearance scoring scale (DSS) and the satisfaction scoring scale (SSS). RESULT: In DSS, complete disappearance was reported as 28.3% by physicians and 30.2% by the patients in CS group and as 47.5% and 52.5% in the FS group, respectively. On the SSS, a satisfaction score scale above 3 (4: Good, 5: Very good) was reported for 79.1% in the CS group and 90.0% in the FS group, retrospectively. The average amounts of sclerosants used were significantly lower in the FS group (1.2+/-0.4 vials) than in the CS group (2.1+/-0.5 vials)(P=0.001). Post injection complications were retrospectively observed in 16.1% of all the patients, in 20.7% of the CS group and in 10.0% of the FS group. CONCLUSION: Sclerotherapy is a very effective and sufficient treatment for telangiectases or reticular varicose veins. Especially, foam sclerotherapy is more effective than conventional liquid sclerotherapy for the clinical results and the patient satisfaction, and it shows a with lower incidence of complications.