Approach to tortuous vena saphena magna with insufficiency: Foam scleroterapy

Abstract

Objective This study aimed to investigate the efficacy of foam sclerotherapy in the treatment of tortuous Great Saphenous Vein (GSV) insufficiency. Methods In this prospective non-randomized study 62 patients with tortuous GSV insufficiency were included. All patients were delivered sclerosant agent in the form of foam into the GSV through a cannula above the knee level. Characteristics of patients, diameter of veins, reflux grades, Venous Clinical Severity Score (VCSS) and Clinical, Etiological, Anatomical, Pathological (CEAP) scores, concentration of sclerosant agent, complications and follow-up results were recorded. Results Foam sclerotheraphy was performed with 100% technical success in all patients at operative room. There were no allergic reactions or neurological complications during and after the operations. Ecchymosis was the most common complication with 37.1% frequency. . VCSS scores significantly decreased from 6.43% to 2.53%, during follow-up from initial admission to sixth months, respectively ( P<0.05).In the first month parameters, successful occlusion rate was 88.7%, whereas its rate was 82.3% in sixth month. Recanalization rate significantly increased from 11.3% to 17.7% during follow-up from first to sixth months, respectively ( P<0.05). Conclusions Due to its low complication rate, low cost, acceptable total occlusion rate and reproducibility; Foam sclerotherapy can be considered a reliable treatment for patients with tortuous GSV insufficiency.

Foam sclerotherapy of great saphenous vein: The need for further improvement and ill-defined issues

“…The successful occlusion rate was 88.7% in the 1st postoperative month while decreased further to 82.3% after 6 months of follow-up. 1 In our opinion, the latter reflects the 'real-world' experience and merits further attention and discussion.…”

“…We read with enthusiasm the recent article by Karacalilar and Kutas reporting on the technical and clinical success of treating insufficient tortuous great saphenous veins (GSVs) with foam scleroterapy. 1 The authors document a technical success rate of 100% in 62 patients and significant decrease in Venous Clinical Severity Score (VCSS) scores. The successful occlusion rate was 88.7% in the 1st postoperative month while decreased further to 82.3% after 6 months of follow-up.…”