Comparative Study of Duplex-Guided Foam Sclerotherapy and Duplex-Guided Liquid Sclerotherapy for the Treatment of Superficial Venous Insufficiency

Yamaki, Takashi; Nozaki, Motohiro

doi:10.1097/00042728-200405000-00011

Cited by 48 publications

(64 citation statements)

References 12 publications

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“…Dos membros tratados (21 membros), 84% apresentaram oclusão total ou recanalização parcial sem refluxo, situações que caracterizam sucesso da intervenção terapêutica 12 . Apenas 16% dos casos (quatro membros) apresentaram recanalização parcial com refluxo ou recanalização completa.…”

Section: Resultsunclassified

“…O sucesso do tratamento é caracterizado pela ocorrên-cia de oclusão total ou recanalização parcial sem refluxo, enquanto o insucesso é caracterizado pela recanalização parcial com refluxo ou recanalização completa 12 .…”

Section: Discussionunclassified

“…A eficiência do tratamento foi monitorada com base nos escores para dor, edema e claudicação, obtidos com a classificação CEAP 11 , antes e depois do procedimento, e nas ultra-sonografias com Doppler colorido, 12 meses após o tratamento, com definição de quatro categorias de resultados: 1) oclusão total; 2) recanalização parcial sem refluxo; 3) recanalização parcial com refluxo; e 4) recanalização completa 12 .…”

Section: Monitoração Do Tratamentounclassified

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Ecoescleroterapia com microespuma em varizes tronculares primárias

Figueiredo

Araújo²,

Penha-Silva

2006

J. vasc. bras.

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177 ResumoObjetivo: Avaliar o tratamento de varizes tronculares primárias por ecoescleroterapia com microespuma.Métodos: A amostra foi constituída de 25 membros de seis pacientes do sexo masculino e 19 do sexo feminino, com incompetência das veias safenas magna (21 membros) ou parva (quatro membros). Eles foram avaliados de acordo com a classificação clínica, etiológica, anatômica e fisiopatológica (CEAP) e classificados nos graus C 3 (10 membros), C 4 (seis membros), C 5 (cinco membros) e C 6 (quatro membros). A microespuma (5 ml), preparada pela mistura de 1 ml de polidocanol a 3% e 5 ml de ar, era injetada na veia do paciente, em posição de Trendelenburg, com monitoração por ultra-sonografia com Doppler colorido. Os membros eram enfaixados com atadura inelástica por 3 dias; depois disso, os pacientes usavam meias elásticas, 30-40 mmHg, 3/4 ou 7/8, durante 3 meses. A eficiência do tratamento foi avaliada pelo escore clínico da classificação CEAP para dor, edema e claudicação e pelas alterações ultra-sonográficas 12 meses depois. Os escores clínicos antes e depois do tratamento foram comparados pelo teste de Wilcoxon.Resultados: Houve diminuição significante nos escores clínicos (P < 0,05) e sucesso terapêutico, com oclusão total e recanalização parcial sem refluxo, em 84% dos casos. Do total, 16% dos casos apresentaram recanalização parcial, com refluxo, ou recanalização completa.Conclusão: A ecoescleroterapia, método simples, de baixo custo, que dispensa internação e anestesia, mostrou ser promissora no tratamento de varizes tronculares primárias.Palavras-chave: Escleroterapia, varizes, polidocanol, ultrasonografia por Doppler colorido. AbstractObjective: To evaluate the treatment of primary trunk varicose veins by microfoam ultrasound-guided sclerotherapy.Methods: The sample was composed of 25 members of six male and 19 female patients, with incompetence of great saphenous vein (21) and short saphenous vein (4). Patients were assessed according to the clinical, etiologic, anatomical and pathophysiological (CEAP) classification and divided into degrees C 3 (10), C 4 (6), C 5 (5) and C 6 (4). With the patients in the Trendelenburg position, microfoam (5 ml), prepared by mixture of 1 ml polidocanol at 3% and 5 ml of air, was injected in their vein and monitored by color-flow Doppler ultrasonography. The members were then swaddled with inelastic bandage for 3 days; afterward, the patients used 30-40 mmHg, 3/4 or 7/8, elastic socks, during 3 months. Treatment efficiency was evaluated based on the CEAP classification for pain, edema and claudication, and on color-flow Doppler ultrasonographic changes 12 months later. Clinical scores, before and after treatment, were compared using the Wilcoxon test.Results: There was a significant decrease in the clinical scores (p < 0.05). Therapeutic success was achieved, with total occlusion and partial recanalization without reflux in 84% of the cases. The remaining 16% of the cases presented partial recanalization with reflux or complete recanalization.Conclusion: Ultrasound-...

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Section: Monitoração Do Tratamentounclassified

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Ecoescleroterapia com microespuma em varizes tronculares primárias

Figueiredo

Araújo²,

Penha-Silva

2006

J. vasc. bras.

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“…The superiority of foam over liquid sclerosant has been clearly demonstrated. 29,30 Recent studies report a high immediate success rate, low cost and acceptable complication rate with foam sclerotherapy. [29][30][31] The use of foamed sclerosants for varicose veins was reported as early as 1939.…”

Section: Sclerotherapy (Liquid and Foam)mentioning

confidence: 99%

The Treatment of Varicose Veins

Subramonia

Lees

2007

annals

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Varicose veins are a common problem and cause disfigurement, disability and impairment in the quality of life (QoL). Over 40,000 operations are performed each year for varicose veins within the NHS in England and Wales. Conservative methods like compression bandaging for ulceration can also be expensive. Varicose veins are, therefore, of significant clinical and economic importance to the health service and also have a major socio-economic impact on society. The advent of endovenous ablation techniques has expanded the surgical options for patients requiring treatment. Materials and MethodsRelevant studies were identified via the MEDLINE, PREMEDLINE, EMBASE, PubMed, Cochrane Library and Science Citation Index using Boolean search terms from their commencement to 2005. Further studies were obtained from references, reviews, specialty journals, trial registries and the internet and by hand-searching. Abstracts were searched for studies reporting safety, efficacy, technique and outcomes with emphasis on comparative studies and large case series. The authors concentrated on evidence published in the last 10 years to achieve a balance between comprehensiveness and precision. Non-English articles were excluded unless a translation could be obtained. Conference abstracts and unpublished reports were excluded. ResultsDefinitive treatment of varicose veins aimed at abolishing sources of venous reflux and removing long refluxing segments and varicose reservoirs can be achieved by conventional surgery or by endovenous ablation techniques. Transilluminated powered phlebectomy and subfascial endoscopic perforator surgery are less commonly employed.The main outcome in the selected studies is the abolition of saphenous vein reflux. However, there is wide variation in the reporting of outcomes between studies. Elimination of varicosities, recanalisation after endovenous ablation, recurrence of reflux, re-appearance of varicose veins, symptomatic improvement and re-treatment rates are not reported in all studies. Varicosities evident at follow-up are not clearly differentiated into residual, recurrent or newly incompetent veins. Some studies are affected by significant follow-up loss.

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“…A couple of randomized studies have shown the superiority of this technique versus liquid sclerotherapy in eliminating the sites of reflux along the great saphenous system. 4,5 The addition of crossectomy to foam sclerotherapy may decrease the incidence of thrombophlebitis, which can be very disturbing and occurs often in patients with ongoing proximal reflux. 6 It also prevents leakage of foam in the deep venous system through a large diameter communication and thus promotes prolonged contact of the endothelium with the foam.…”

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confidence: 99%