Compression Sclerotherapy: Theory, Method and Practice

Fegan, George

doi:10.1007/978-1-4471-3473-2_7

Cited by 2 publications

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“…4 Others contend that this was a low point following publication of an article by Faxon in 1933 where he questioned the validity of excellent success rates from earlier publications based on poor results from the Massachusetts General Hospital with a recurrence rate of 63%, in line with other contemporary studies. 34,35 However, there was a growing sense that surgery was too invasive with recurrence rates that were too high to be accepted, and the pendulum was swinging back to the less invasive injection procedures. The optimal treatment was never to be established given that none ‘cure’ varicose veins.…”

Section: Progress In the Early 1900smentioning

confidence: 99%

“…Three groups formed that were to determine future practice: Tournay (Figure 4) 36,37 at multiple clinics in Paris, Sigg (Figure 5) at the Varicose Veins and Phlebitis Polyclinic, Women’s Hospital, Basle, 38,39 and Fegan (Figure 6) at the Rotunda and Sir Patrick Dun’s Hospitals in Dublin. 34 All three schools developed an enormous experience, and they were to restore faith in most countries that sclerotherapy had become safe and effective. The impetus was sustained by Hobbs working at St Mary’s Hospital, London, in the 1960s who presented the first randomised trial of sclerotherapy against surgery.…”

Section: Progress In the Early 1900smentioning

confidence: 99%

“…38,39 Fegan also injected from distal to proximal in the belief that the source of reflux was incompetent perforator veins. 34 The focus was to produce fibrosis rather than thrombosis. Fegan’s detractors claimed that he had not produced statistical evidence of results, but he responded that this was because he was dyslexic.…”

Section: Progress In the Early 1900smentioning

confidence: 99%

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A history of injection treatments – II sclerotherapy

Myers

2018

Phlebology

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Introduction Sclerotherapy in all its current forms is based on experience going back to the 1850s. Methods To trace the evolution of sclerotherapy over the past 250 years, using the internet for past documentation and the literature. Conclusion Sclerotherapy principles were established long ago, although current modifications have been made possible by the introduction of detergent sclerosants and ultrasound guidance.

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Section: Progress In the Early 1900smentioning

confidence: 99%

Section: Progress In the Early 1900smentioning

confidence: 99%

Section: Progress In the Early 1900smentioning

confidence: 99%

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A history of injection treatments – II sclerotherapy

Myers

2018

Phlebology

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“…During the 1950s, 1960s, and 1970s, several of the modern, innovative European sclerotherapy practitioners, notably G. Fegan [2,3], K. Sigg [4,5], and R. Tournay [6] had each developed different "schools" of sclerotherapy; and they all offered something of value. A resurgence of sclerotherapy was also taking place in United States in the 1970s.…”

Section: Introductionmentioning

confidence: 99%

Combination sclerotherapy for exceptionally large varicose veins: One method of preserving the greater saphenous vein for future grafts

Malkoff¹

2001

Int J Angiol

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The aim of this study was to demonstrate that sclerotherapy of exceptionally large varicose veins, i.e., >2.0 cm in diameter, is achievable, and should be the method of choice if one wishes to preserve the greater saphenous vein as a source for future bypass grafts. There is an increasing propensity toward microphlebectomy when treating varicose veins in America today. And, there is a corresponding reluctance to perform sclerotherapy, especially when dealing with the larger varices. The following are possible reasons for these decisions: 1. Unsatisfactory sclerotherapy results obtained by the clinician; 2. A belief that sclerotherapy is not useful for large veins; 3. A belief that only ligation and stripping or microphlebectomy can eliminate these huge veins; 4. Unsatisfactory scarring from stripping procedures; and/or 5. Difficulty in obtaining third-party reimbursement for sclerotherapy. Once deep vein pathology has been ruled out, sclerotherapy can be a successful treatment for any large vein. The second caveat is that significant saphenofemoral junction (SFJ) reflux (>1 second) must be eliminated prior to sclerotherapy; the author feels this should be accomplished surgically, not with sclerotherapy. With large varices, if the SFJ is competent then there is most likely a responsible perforator that must either be ligated and/or injected with sclerosant. Less frequently the short saphenous may be involved, and in these cases there are several alternatives, i.e., sclerotherapy or ligation and stripping of the short saphenous vein. Finally, but of great importance, ligation and stripping the greater saphenous vein in order to eliminate the varices that are merely branches of it, creates an unacceptable loss of potential bypass grafts for future CAD patients. This, alone, is reason enough to promote sclerotherapy for very large varicose veins. The author presents two enormous varices that were successfully treated with combination sclerotherapy, with a detailed description of the method utilized.

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Compression Sclerotherapy: Theory, Method and Practice

Cited by 2 publications

References 0 publications

A history of injection treatments – II sclerotherapy

A history of injection treatments – II sclerotherapy

Combination sclerotherapy for exceptionally large varicose veins: One method of preserving the greater saphenous vein for future grafts

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