To assess the efficacy and safety of ultrasound guided foam sclerotherapy (UGFS) with a long saphenous trunk reflux. Methods: One hundred and seventy cases with primary long saphenous (LSV) trunk reflux underwent foam sclerotherapy. Patients were evaluated using Venous Clinical Severity Score (VCSS) and duplex ultrasound pre procedure, 2 weeks and 6 months following the procedure. Complications were detected and recorded 2 weeks and 6 months following the procedure. Results: Between (September 2010 and December 2011). One hundred and seventy patients with (LSV) trunk reflux underwent foam sclerotherapy 102 females (60%), 68 males (40%). The mean age of patients was 38.8 years, SD (11.35). Two weeks after the first treatment session, the success rate was 93.5%. The failure rate was 6.5%. The complications detected in 23 cases 2 weeks after the first treatment session and included thrombophlebitis in 8 cases, DVT in 3 cases and pain in 12 cases. Six months after the first treatment session, the success rate was 88%. The failure rate was 12%. The complication detected 6 month after the first treatment session was skin staining in 19cases. Conclusion: UGFS is a safe and effective method of treating long saphenous trunk reflux.

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Objective: This study is evaluating the effectiveness of salvage interventions to rescue threatened infra-popliteal (IP) bypasses in critical limb ischemia (CLI) patients. Materials and methods:Data of all CLI patients who underwent distal IP bypasses at a single institution between 2016 and 2021 are analysed retrospectively. Patency rates, amputation-free survival, patient survival, and wound healing rates after a 1-year follow-up period are calculated. Comparative analyses of amputation free survival and patient survival rates between non-threatened, threatened and acutely occluded grafts are also done.Results: A total of 121 IP bypasses were performed in 115 patients (84 male; mean age, 74.4±8; hypertension, 84%; diabetes mellitus, 69%). 24% originated from the common femoral artery, 40% from the superficial femoral artery and 36% from the popliteal artery. The most common outflow arteries are the anterior tibial artery (36%) and the posterior tibial artery (33%). Secondary interventions in the form of endovascular and surgical revisions are necessitated in 53 (44%) grafts.At one-year follow-up, primary, assisted-primary, and secondary patency rates are 50%, 78% and 88%, respectively. Amputation-free survival and patient survival rates are 93% and 86%, respectively. Complete wound healing rate is 83%. Amputation-free survival among acutely occluded grafts is significantly worse when compared with threatened and non-threatened grafts (P-value<0.001). Conclusion:Secondary interventions to rescue threatened distal bypasses are successful at maintaining graft patency with amputation-free survival rate comparable to non-threatened grafts. Salvage angioplasty is a viable alternative to surgical revision to rescue limbs with threatened grafts in CLI patients.

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