Compression after sclerotherapy for telangiectasias and reticular leg veins: A randomized controlled study

Kern, Philippe; Ramelet, Albert‐Adrien; Wütschert, R.; Hayoz, Daniel

doi:10.1016/j.jvs.2007.02.039

Cited by 124 publications

(76 citation statements)

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“…This result seems to contradict those found in the literature, which attribute an anti-inflammatory action to compression therapy 10,21 . The result of this research, however, showed that the size of the thrombus had a positive and significant relationship with the inflammatory intensity, and also that the degree of vein obstruction by the thrombus was not significantly different in the various compression periods.…”

Section: Correlation Between the Inflammatory Intensity And Size Of Tcontrasting

confidence: 88%

Effect of the period of extrinsic mechanical compression following sclerotherapy in veins in rabbit ears

Ivo¹,

Ivo

Salles

et al. 2011

Acta Cir. Bras.

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Purpose:Research whether a post-sclerotherapy venous compression period of up to 120 hours is sufficient to avoid reperfusion in treated veins; whether there is a relationship between the inflammatory intensity in venous walls and adjacent tissue and the size of venous thrombosis; whether the intensity of the post-sclerotherapy inflammation varies with the period of compression; whether there is a relationship between the presence of hemosiderin in the tissues adjacent to the sclerosing blood vessels and venous blood clots. Methods: Twenty eight rabbits, all male, were utilized, distributed into four groups (0, 24, 72 and 120). All the animals were administered with 0.25 ml of 1% polidoconal solution and, as a control, 0.25 ml of 0.9% sodium chloride solution in the marginal dorsal vein of the right and left ears, respectively. Mechanical compression was applied to the perfused stretch of the vein, except for the animals in group 0. The period of compression varied from 0 to 120 hours in the groups. An anatomopathological examination of the section of the right and left marginal dorsal veins of all the animals was conducted. Results: There was no significant difference among the various compression periods, both in terms of the degree of vein thrombosis and in the inflammatory intensity in both ears of the various groups. A positive and significant correlation was observed between the inflammatory intensity and the size of the thrombus and in the occurrence of thrombi and hemosiderin. Conclusions: A compression period of up to 120 hours is not sufficient to prevent reperfusion in sclerosing blood vessels. The intensity of tissue inflammation is related to the size of the thrombus, but not to the compression period. The presence of hemosiderin in the tissues adjacent to the vessels subjected to sclerosis is related to the presence of venous coagulation. Key words: Sclerotherapy. Sclerosing Solutions. Varicose Veins. Animal Experimentation. Academic Dissertations. Rabbits. RESUMOObjetivo: Pesquisar se o tempo de compressão venosa de até 120 horas pós-escleroterapia é suficiente para evitar reperfusão nas veias tratadas; se há relação entre a intensidade inflamatória na parede venosa e tecidos adjacentes e o tamanho do trombo venoso; se a intensidade da inflamação pós-escleroterapia varia com o tempo de compressão; se há relação entre a presença de hemossiderina nos tecidos adjacentes ao vaso esclerosado e coágulo venoso. Métodos: Utilizaram-se 28 coelhos, machos, distribuídos em quatro grupos (0, 24, 72 e 120). Em todos os animais foram administrados 0,25 ml de solução de polidocanol 1% e, como controle, 0,25 ml de solução de cloreto de sódio 0,9% na veia marginal dorsal das orelhas direita e esquerda, respectivamente. Realizou-se compressão mecânica em trecho da veia perfundida, exceto nos animais do grupo 0. O tempo de compressão variou de 0 a 120 horas nos grupos. Realizou-se exame anatomopatológico de trecho das veias marginais dorsais direita e esquerda de todos os animais. Resultados: Não houve dife...

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Section: Correlation Between the Inflammatory Intensity And Size Of Tcontrasting

confidence: 88%

Effect of the period of extrinsic mechanical compression following sclerotherapy in veins in rabbit ears

Ivo¹,

Ivo

Salles

et al. 2011

Acta Cir. Bras.

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“…Those with untreated incompetent saphenous veins have the highest rate of recurrence. 295, 328 Kern et al 329 reported results of liquid sclerotherapy of telangiectasia and reticular veins in 96 patients. Those who wore elastic stockings for 3 weeks after treatment had an early success rate of 76%.…”

Section: Sclerotherapymentioning

confidence: 99%

The care of patients with varicose veins and associated chronic venous diseases: Clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum

Gloviczki

Comerota²,

Dalsing

et al. 2011

Journal of Vascular Surgery

1,266

952

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The Society for Vascular Surgery (SVS) and the American Venous Forum (AVF) have developed clinical practice guidelines for the care of patients with varicose veins of the lower limbs and pelvis. The document also includes recommendations on the management of superficial and perforating vein incompetence in patients with associated, more advanced chronic venous diseases (CVDs), including edema, skin changes, or venous ulcers. Recommendations of the Venous Guideline Committee are based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system as strong (GRADE 1) if the benefits clearly outweigh the risks, burden, and costs. The suggestions are weak (GRADE 2) if the benefits are closely balanced with risks and burden. The level of available evidence to support the evaluation or treatment can be of high (A), medium (B), or low or very low (C) quality. The key recommendations of these guidelines are: We recommend that in patients with varicose veins or more severe CVD, a complete history and detailed physical examination are complemented by duplex ultrasound scanning of the deep and superficial veins (GRADE 1A). We recommend that the CEAP classification is used for patients with CVD (GRADE 1A) and that the revised Venous Clinical Severity Score is used to assess treatment outcome (GRADE 1B). We suggest compression therapy for patients with symptomatic varicose veins (GRADE 2C) but recommend against compression therapy as the primary treatment if the patient is a candidate for saphenous vein ablation (GRADE 1B). We recommend compression therapy as the primary treatment to aid healing of venous ulceration (GRADE 1B). To decrease the recurrence of venous ulcers, we recommend ablation of the incompetent superficial veins in addition to compression therapy (GRADE 1A). For treatment of the incompetent great saphenous vein (GSV), we recommend endovenous thermal ablation (radiofrequency or laser) rather than high ligation and inversion stripping of the saphenous vein to the level of the knee (GRADE 1B). We recommend phlebectomy or sclerotherapy to treat varicose tributaries (GRADE 1B) and suggest foam sclerotherapy as an option for the treatment of the incompetent saphenous vein (GRADE 2C). We recommend against selective treatment of perforating vein incompetence in patients with simple varicose veins (CEAP class C(2); GRADE 1B), but we suggest treatment of pathologic perforating veins (outward flow duration ≥500 ms, vein diameter ≥3.5 mm) located underneath healed or active ulcers (CEAP class C(5)-C(6); GRADE 2B). We suggest treatment of pelvic congestion syndrome and pelvic varices with coil embolization, plugs, or transcatheter sclerotherapy, used alone or together (GRADE 2B).

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“…25,26 For example, compression after sclerotherapy has been shown to reduce the formation of thrombi and to prevent pigmentation and matting by minimizing inflammation and angiogenesis. 27 However, one study that randomly assigned 60 pa tients to wear graduated compression stockings for three weeks or to go without compression after ultrasoundguided foam sclerotherapy found no difference in efficacy, adverse effects, satisfaction scores, symptoms and quality of life between the two groups. 26 We found no evidence that one form of compression was better than another, although graduated compression stockings may be better accepted by patients than bandages.…”

Section: Postsurgical or Interventional Treatment Of Varicose Veinsmentioning

confidence: 99%

Graduated compression stockings

Lim

Davies

2014

CMAJ

122

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Compression after sclerotherapy for telangiectasias and reticular leg veins: A randomized controlled study

Abstract: Wearing compression stockings (23 to 32 mm Hg) for 3 weeks enhance the efficacy of sclerotherapy of leg telangiectasias by improving clinical vessel disappearance.

Cited by 124 publications

References 10 publications

Effect of the period of extrinsic mechanical compression following sclerotherapy in veins in rabbit ears

Effect of the period of extrinsic mechanical compression following sclerotherapy in veins in rabbit ears

The care of patients with varicose veins and associated chronic venous diseases: Clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum

Graduated compression stockings

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