Change in perception of sclerotherapy results after exposure to pre–post intervention photographs

Santiago, Fabricio; Piscoya, Mario; Chi, Yung-Wei

doi:10.1177/0268355517736178

Cited by 6 publications

(3 citation statements)

References 26 publications

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“…In conclusion, in order to properly report evidence-based data and clinical recommendations related to aesthetic phlebology, future investigations should focus on identify proper objective assessment tools for proper homogeneous comparison. This aspect includes photographic material (itself a potential bias in patient satisfaction analysis according to recent literature), 236 quantification of the aesthetic lesion and the impact on patient satisfaction score. The same patient subjectivity and self-perception should be taken into consideration as possible confounding factor.…”

Section: Discussionmentioning

confidence: 99%

Global guidelines trends and controversies in lower limb venous and lymphatic disease

et al. 2019

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Guidelines are fundamental in addressing everyday clinical indications and in reporting the current evidence-based data of related scientific investigations. At the same time, a spatial and temporal issue can limit their value. Indeed, variability in the recommendations can be found both among the same nation different scientific societies and among different nations/continents. On the other side, Garcia already published in 2014 data showing how, after three years in average, one out of five recommendations gets outdated (Martinez Garcia LM, Sanabria AJ, Garcia Alvarez E, et al. The validity of recommendations from clinical guidelines: a survival analysis. CMAJ 2014;186(16):1211–1219). The present document reports a narrative literature revision on the major international recommendations in lower limb venous and lymphatic disease management, focusing on the different countries’ guidelines, trends and controversies from all the continents, while identifying new evidence-based data potentially influencing future guidelines. World renowned experts’ opinions are also provided. The document has been written following the recorded round tables scientific discussions held at the vWINter international meeting (22–26 January 2019; Cortina d’Ampezzo, Italy) and the pre- and post-meeting literature search performed by the leading experts.

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Section: Discussionmentioning

confidence: 99%

Global guidelines trends and controversies in lower limb venous and lymphatic disease

et al. 2019

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“…Hyperpigmentation is expected post sclerotherapy; most cases resolve within months with the majority disappearing within a year. Finally, photographic documentation pre-and post-procedures are essential to ensure patient satisfaction as patients' recall of preoperative appearance is often poor [4].…”

Section: Choosing the Right Patient And The Right Veinsmentioning

confidence: 99%

Sclerotherapy – How to Achieve a Spectacular Outcome

Mann

2020

Phlebologie

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AbstractWhen performed correctly, sclerotherapy results in fibrous occlusion that is not amenable to recanalization. Paramount to success is adequate contact time of a sclerosant to the endothelial cells to cause sufficient damage to the vein while minimizing side effects. To optimize sclerotherapy results, one needs to choose the right patient and the right vein and then use the proper sclerosing agent and injection techniques. This paper will review current literature on sclerotherapy, as well as tips and tricks to optimize outcome and minimize complications.

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“…However, there is very little scientific literature on the mechanism of action of hypertonic 70% dextrose sclerosant in human veins. Published studies use rabbit ear models, or report clinical success rates, surgeon/patient opinions or study protocols [16][17][18][19][20] .…”

Section: Introductionmentioning

confidence: 99%

Comparison of detergent and osmotic sclerotherapy agent action on ex-vivo human vein – a histological and immunocytochemical analysis

Cross¹,

Walker²,

Setyo³

et al. 2022

Preprint

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Background:Sclerotherapy is used widely for the treatment of varicose veins. Little has been written on the mechanism of action of detergent sclerosants on the vein wall, and very little on osmotic sclerosants. We compared the damage profile inflicted by a detergent sclerosant (3% Sodium Tetradecyl Sulphate (3% STS)) to that of an osmotic sclerosant (70% dextrose) using explanted human veins. Methods:Ten varicose vein samples were harvested during routine phlebectomy surgery. Each sample was divided into three segments that were treated for two minutes with (1) normal saline (control), 3% STS, or 70% dextrose. Treated samples were incubated for 24 hours (37℃, 5% CO2), fixed in buffered formalin, paraffin embedded, and sectioned for staining with haematoxylin and eosin (H&E) and immunohistochemical (IHC) markers (caspase-3 (C3), smooth muscle actin (SMA), and CD31).Results:Both sclerosants produced cell death deep to the endothelium and into the tunica media of the vein. However, 3% STS exerted a significantly greater damage profile than 70% dextrose across all layers, destroying 75% more endothelial cells (P<0.0001) and 30-33% more smooth muscle cells across the tunica media (P<0.01). Efficacy of 70% dextrose in damaging peripheral cells of the tunica media was poor. Patterns of IHC reactivity were consistent with damage observed in H&E-stained sections. Minimal C3 reactivity was detected, and necrosis was the observed cell-death rather than apoptosis in all treated samples.Conclusion:Despite 3% STS showing more efficacy than 70% dextrose in extent and penetration of damage inflicted, both treatments were efficacious in inducing transmural cell death in this ex-vivo study. Therefore, 70% dextrose may be more appropriate for the ablation of thinner-walled veins, and 3% STS for thicker walled veins. In addition, the observation of necrotic cell death challenges the previously reported mechanism of apoptosis after sclerotherapy.

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Change in perception of sclerotherapy results after exposure to pre–post intervention photographs

Abstract: Patient exposure to pre- and postsurgical photographs is a simple intervention with the potential of improving patient satisfaction up to six months after treatment with sclerotherapy

Cited by 6 publications

References 26 publications

Global guidelines trends and controversies in lower limb venous and lymphatic disease

Global guidelines trends and controversies in lower limb venous and lymphatic disease

Sclerotherapy – How to Achieve a Spectacular Outcome

Comparison of detergent and osmotic sclerotherapy agent action on ex-vivo human vein – a histological and immunocytochemical analysis

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