A hybrid technique of laser intracavity obstruction and foam sclerosant in treating varicose vein of the lower extremity / 中华普通外科杂志

ABSTRACT

Objective To evaluate the clinic effect of a hybrid technique of laser and foam sclerosant in treating varicose vein of the lower extremity.Methods From April 2009 to April 2013,hybird operation of endovenous laser combined with foam sclerosant was carrird out in 126 patients with lower extremity varicosities.A total 175 diseased legs were treated.Catheter guidewire techniques was performed first in placing optical fiber below saphenous vein flap,which was followed by laser ablation for the great saphenous vein,then foam sclerotherapy were used for greater saphenous vein trunk 4 cm below tibial tubercle and the superficial varicose veins with diameter less than 6 mm.All patients were followed up for 3-24 months.The operation time,average hospitalization days,patients quality of life score,curative effect and complications were analyzed.CT angiography in the evaluation of occlusion of varicose vein of lower limbs trunk and recurrence were performed at the time of discharge and three months later respectively.Results Hybrid operation of endovenous laser treatment and foam sclerosant was successfully performed in all cases.The procedure time for a single leg was (32 ± 7) minutes; the quality of life score and the hospitalization after procedure was (4.2 ± 1.8) days and (40 ± 7) score respectively.CT angiography at discharge and 3 months later revealed that 97 (55.42％) and 111 (63.42％) limbs varicose veins disappeared respectively,78 (44.57％),64 (36.57％) lower limb varicose veins was reduced respectively,143 (81.71％),158 (90.28％) great saphenous vein trunk were in emphraxis respectively and 32 (18.28％),17 (9.71％) great saphenous vein lumen were narrowed.No vascular recanalization was found.The complications included saphenous nerve injury in 5 cases,soft tissue infection in 5 cases,calf skin burn in 11 cases,local funicular patches nodules in 32 cases,edema in 16 cases,subcutaneous hematoma in 10 cases.No complications such as pulmonary embolism,and deep venous thrombosis happened.Conclusions For the treatment of lower extremity varicosities,hybrid operation of laser and foam sclerosant ablation have high limb cure rate,less operation time and complications.