Neurological complications of sclerotherapy for varicose veins

Sarvananthan, Tharsi; Shepherd, Amanda; Willenberg, Torsten; Davies, Alun H.

doi:10.1016/j.jvs.2011.05.093

Cited by 77 publications

(64 citation statements)

References 45 publications

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“…41 The authors argue that despite a relatively high estimate of PFO in the adult population (up to 25%), the rate of neurological complications following FS appear to be low. 42 Tissue necrosis, telangiectasia matting, and skin discoloration have also been observed after FS. MOCA has been demonstrated to be less painful than RFA in a cohort study.…”

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confidence: 99%

Endovenous Management of Varicose Veins

et al. 2018

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Abstract:Varicose veins are a very common condition and have been the subject of a recent proliferation of treatment modalities. The advent of the endovenous treatment era has led to a confusing array of different techniques which can be daunting when making the transition from traditional surgery. All modalities offer excellent results in the right situation and each has their own treatment profile. Thermal ablation techniques have matured and have a reassuring and reliable outcome, but the arrival of non-thermal techniques has delivered further options for both patient and surgeon. This article provides an overview of the different treatment devices and modalities available to the modern superficial vein surgeon and details the currently available evidence and summation analysis to help surgeons to make an appropriate treatment choice for their patients. Keywords:Endovenous ablation, varicose veins, venous disease, radiofrequency, sclerotherapy, cyanoacrylate Page 1 of 24 http://mc.manuscriptcentral.com/ang Angiology 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 IntroductionVaricose veins are a common condition affecting up to one-third of the population, with detrimental effects on the quality of life (QoL). 1-2Until the past decade, the traditional technique of saphenofemoral or saphenopopliteal ligation with or without vein stripping has been the gold standard treatment of truncal saphenous incompetence. This usually necessitates either general or regional anaesthesia. 3 Although surgery provides good outcomes, it is associated with ecchymosis, hematoma, tenderness, 4 infection, nerve injury, delayed return to normal activity 3-5 and routinely necessitates narcotic analgesia. 3In response to the need for less invasive treatment, endovenous treatments, namely radio-frequency ablation (RFA) and endovenous laser ablation (EVLA) have been developed. These have led to a reduction in morbidity compared with open surgery, 4-6 by reducing postoperative pain, providing faster recovery time, improving QoL and lowering complication rates. 7-8More recently, new non-thermal, non-tumescent (NTNTs) treatments have been developed to overcome the shortcomings associated with thermal ablation. Both thermal and non-thermal treatments are discussed in this review. Thermal-Tumescent Ablative ManagementSince 1999, endovenous thermal ablation, in the form of RFA and EVLA have been developed. More recently, endovenous microwave ablation (EMA) and steam vein sclerosis (SVS) have also been introduced. Their mechanism of action involves using heat to cause thermal damage to the venous wall. Radio-frequency ablation (RFA)The practice of RFA utilizes radio-frequency waves to produce thermal energy (85-120°C) resulting in endothelial damage and sealing of the incompetent vein ( Figure 1). In 1999, the U.S. Food and Drug Administration (FDA) approved RFA for...

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confidence: 99%

Endovenous Management of Varicose Veins

et al. 2018

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“…According to Morrison et al, chest tightness is more frequent when large foam volumes > 15 ml are injected, and when air, instead of CO 2 or CO 2 / O 2 , is used to prepare foam [22]. However, there is no scientifi c proof that the maximum of 10ml of foam per session recommended in the European guidelines for sclerotherapy (with higher volumes applicable according to an individual risk-benefi t assessment [2]) is associated with a lower risk of serious neurological or cardiac complications [23]. Interestingly, all mentioned cases reporting on cardiac complications used volumes of 10ml or less, with the present case being the exception.…”

Section: Discussionmentioning

confidence: 99%

Myocardial infarction after ultrasoundguided foam sclerotherapy for varicose veins - a case report and review of the literature of a rare but serious adverse event

Engelberger

Ney

Clair

et al. 2016

Vasa

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“…The pathological mechanisms resulting in cerebrovascular events and transient ischemic attacks are likely to be different to those leading to migraine and visual disturbances. 29 In general, occurrence of neurological disorders is frequently associated with right to left shunting conditions (patent foramen ovale). 29,30 However, no direct relationship has ever been documented with foam volume and concentration.…”

Section: Discussionmentioning

confidence: 99%

“…29 In general, occurrence of neurological disorders is frequently associated with right to left shunting conditions (patent foramen ovale). 29,30 However, no direct relationship has ever been documented with foam volume and concentration. 17,23,[31][32][33][34] Also, although less frequently, occurrence of neurological disorders has been described with liquid sclerotherapy.…”

Section: Discussionmentioning

confidence: 99%

Relevant factors affecting the outcome of ultrasound guided foam sclerotherapy of the great saphenous vein

Falaschi

Giannelli

Lova

2013

Veins and Lymphatics

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Ultrasound guided foam sclerotherapy (UGFS) constitutes a valid ablative treatment for superficial vein diseases for the great saphenous vein (GSV), but no standardized protocol for its execution has yet been defined. Different variable factors involved in this procedure influence the final outcome and clinical results. The aim of our study was to analyze the respective influence on efficacy and side effects of three variable factors (foam volume, foam concentration, and contact time between the foam and the endothelium) for UGFS procedures for GSV insufficiency in order to select the best protocol for treatment. A retrospective analysis was made of UGFS procedures (190 patients, 201 legs) performed for GSV insufficiency in our institute from

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Neurological complications of sclerotherapy for varicose veins

Cited by 77 publications

References 45 publications

Endovenous Management of Varicose Veins

Endovenous Management of Varicose Veins

Myocardial infarction after ultrasoundguided foam sclerotherapy for varicose veins - a case report and review of the literature of a rare but serious adverse event

Relevant factors affecting the outcome of ultrasound guided foam sclerotherapy of the great saphenous vein

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