Microfoam Ultrasound-Guided Sclerotherapy of Varicose Veins in 100 Legs

Barrett, John M.; Allen, Bruce G.; Ockelford, Anne; Goldman, Mitchel P.

doi:10.1111/j.1524-4725.2004.30008.x

Cited by 67 publications

(58 citation statements)

References 7 publications

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“…These results are comparable to those achieved with surgical or other interventional endovascular procedures. 7,[10][11][12][13][14][15][16][17][18][19] Our study consisted of a representative number of patients with uncomplicated VVs (59%) and severe venous insufficiency (41%) referred to a vascular outpatient clinic. We have demonstrated that the rate of complete and partial obliteration does not differ between these patients.…”

Section: Discussionmentioning

confidence: 99%

“…7,[10][11][12][13][14][15][16][17] In the only published US study, Bergan et al demonstrated the efficacy of EFS for the management of CVI in 332 patients (261 uncomplicated VVs, 56 severe CVI, six venous angiomata, and nine KT syndrome), with satisfactory obliteration in all treated veins (average of 2.89 treatments/limb) and a 99% ulcer healing rate at the 6-week follow-up. 7 O'Hare et al achieved 93% obliteration in 165 patients (185 truncal veins) at 2 weeks and 74% complete and 10% partial obliteration at 6 months post-treatment with EFS.…”

Section: Adverse Eventsmentioning

confidence: 99%

“…Most studies report an incidence of transient neurologic events after EFS of less than 1% without long-term sequelae. 7,[12][13][14][15][16]22 Currently, the presence of PFO is not considered a contraindication to EFS, although a restricted amount of foam is recommended in patients with symptomatic PFO. 23 Screening for PFO in patients undergoing EFS is considered unnecessary.…”

Section: Adverse Eventsmentioning

confidence: 99%

“…12 Other studies report similar results. [13][14][15][16][17] Two recent systematic reviews and meta-analyses including randomized controlled trials, prospective cohort studies and retrospective case series have evaluated the efficacy of EFS compared with other endovenous ablation and surgical stripping. 18,19 The first review evaluated 10 studies using EFS, most involving less than 100 patients all performed outside the US, and found that it was as effective as surgical stripping for the treatment of VVs, but less effective than EVLT.…”

Section: Adverse Eventsmentioning

confidence: 99%

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Effectiveness of foam sclerotherapy for the treatment of varicose veins

Nael

Rathbun

2009

Vasc Med

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Varicose veins (VVs) are associated with lifestyle-limiting symptoms and complications. Patients who fail compression therapy are candidates for more invasive treatments. This study evaluates the efficacy and safety of endovenous foam sclerotherapy (EFS) for the treatment of VVs in a US academic center. We reviewed medical records of a consecutive cohort of patients who underwent EFS over a 2-year period. The primary outcome measure was obliteration of VVs. The secondary outcome measures were symptomatic improvement, ulcer healing, recurrence, and adverse events. A total of 166 patients (217 legs) underwent EFS for pain (81%), pruritis (41%), swelling (17%), ulcerations (17%), thrombophlebitis (14%), and varix rupture (3%). Complete (65%) or near-complete (34%) obliteration was achieved in 215 (99%) legs after one injection. Additional injections achieved complete obliteration in 39 of 53 legs. Ninety-three percent (27/29) of active ulcers healed or were decreasing in size. Five ulcers and 11 VVs recurred. Common adverse events included pain and hyperpigmentation. Thrombosis, hematoma, skin necrosis, and neurologic events were rare. In conclusion, EFS appears to be a safe and effective outpatient therapy for the treatment of symptomatic and complicated VVs.

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Section: Discussionmentioning

confidence: 99%

Section: Adverse Eventsmentioning

confidence: 99%

Section: Adverse Eventsmentioning

confidence: 99%

Section: Adverse Eventsmentioning

confidence: 99%

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Effectiveness of foam sclerotherapy for the treatment of varicose veins

Nael

Rathbun

2009

Vasc Med

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“…Immediate or early closure in medium-to-large veins was achieved in over 85% cases usually requiring more than one sitting; [31][32][33] 80-90% of these remained occluded 3 years after foam sclerotherapy. 34 High patient satisfaction and significant improvement in symptoms and QoL was noted at a mean follow-up of 2 years after foam sclerotherapy.…”

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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Efficacy and Safety of Microfoam Sclerotherapy in a Patient With Klippel-Trenaunay Syndrome and a Patent Foramen Ovale

Redondo¹,

Bastarrika²,

Sierra³

et al. 2009

Arch Dermatol

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Background: Sclerotherapy with polidocanol microfoam injection under duplex guidance is a new treatment for venous malformations associated with Klippel-Trenaunay syndrome. Multidetector-row computed tomography (MDCT) venography is extremely helpful in the assessment of disease extension and the planning of therapy. Observation: In this particular case, MDCT venography demonstrated the origin, course, and relationship to adjacent anatomical structures of aberrant vessels that configure the superficial venous system with an anatomically normal and patent deep venous system. At the end of the treatment, which consisted of 8 sessions of microfoam sclerotherapy within 12 months, a considerable reduction in the number and size of the percutaneously treated aberrant veins was observed. The obvious clinical improvement was objectively demonstrated with MDCT venography, which showed clear reduction in the number and size of treated veins. Further clinical investigation performed because of isolated migraine episodes related to the sclerotherapy session revealed that the patient had a patent foramen ovale. A transcranial Doppler examination during the procedure showed middle cerebral artery bubbles, which indicated right-to-left shunt. No cerebral damage was observed in a subsequent diffusionweighted magnetic resonance examination. Conclusions: Microfoam sclerotherapy is an effective treatment option in patients with Klippel-Trenaunay syndrome. MDCT venography allows diagnosis of the disease, planning of therapy, and assessment of response to treatment. Although foam-induced microembolism is a common phenomenon during sclerotherapy, in this report we demonstrate that polidocanol microfoam prepared with a low-nitrogen gas mixture is safe in a patient with a patent foramen ovale.

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Microfoam Ultrasound-Guided Sclerotherapy of Varicose Veins in 100 Legs

Abstract: Ultrasound-guided foam sclerotherapy is effective in treating varicose veins with high patient satisfaction with results and improvement in quality of life.

Cited by 67 publications

References 7 publications

Effectiveness of foam sclerotherapy for the treatment of varicose veins

Effectiveness of foam sclerotherapy for the treatment of varicose veins

The Treatment of Varicose Veins

Efficacy and Safety of Microfoam Sclerotherapy in a Patient With Klippel-Trenaunay Syndrome and a Patent Foramen Ovale

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