Review of Published Information on Foam Sclerotherapy

Stücker, Markus; Kobus, Stephan; Altmeyer, Peter; Reich‐Schupke, Stefanie

doi:10.1111/j.1524-4725.2009.01406.x

Cited by 33 publications

(38 citation statements)

References 52 publications

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“…Additionally, USG sclerotherapy is much less expensive and could potentially represent significant savings to the health system. Previous studies of UGS have demonstrated thrombosis rates after 3 months varying from 69% to 96%, while follow-up studies at 1 to 2 years demonstrated rates of 53% to 80% in great saphenous veins and varicose veins 33 , but little work has been done to illustrate the effect of UGS on ulcer healing when performed on patients without other treatable venous pathologies.…”

Section: Discussionmentioning

confidence: 99%

Factors that influence perforator thrombosis and predict healing with perforator sclerotherapy for venous ulceration without axial reflux

Kiguchi

Hager

Winger

et al. 2014

Journal of Vascular Surgery

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OBJECTIVES Refluxing perforators contribute to venous ulceration. We sought to describe patient characteristics and procedural factors that (1) impact rates of incompetent perforator vein (IPV) thrombosis with ultrasound-guided sclerotherapy (UGS) and (2) impact the healing of venous ulcers (CEAP 6) without axial reflux. METHODS Retrospective review of UGS of IPV injections from 1/2010–11/2012 identified 73 treated venous ulcers in 62 patients. Patients had no other superficial/axial reflux and were treated with standard wound care and compression. Ultrasound was used to screen for refluxing perforators near ulcer(s), and these were injected with sodium tetradecyl sulfate or polidocanol foam and assessed for thrombosis at 2 weeks. Demographic data, comorbidities, treatment details and outcomes were analyzed. Univariate and multivariable modeling was performed to determine covariates predicting IPV thrombosis and ulcer healing. RESULTS 62 patients with active ulcers for an average of 28 months with compression therapy prior to perforator treatment had an average age of 57.1 years, were 55% male, 36% had a history of DVT and 30% had deep venous reflux. 32 patients (52%) healed ulcers, while 30 patients (48%) had non-healed ulcer(s) in mean follow-up of 30.2 months. Ulcers were treated with 189 injections, with average thrombosis rate of 54%. Of 73 ulcers, 43 ulcers healed (59%), and 30 ulcers did not heal (41%). Patients that healed ulcers had an IPV thrombosis rate of 69 % vs. 38% in patients who did not heal (P<.001). Multivariate models demonstrated male gender and warfarin use negatively predicted thrombosis of IPVs (P=.03, P=.01). Multivariate model for ulcer healing found complete IPV thrombosis was a positive predictor (P=.02), while large initial ulcer area was a negative predictor (P=.08). Increased age was associated with fewer ulcer recurrences (P=.05). Hypertension and increased follow-up time predicted increased ulcer recurrences (P=.04, P=.02). Calf vein thrombosis occurred after 3% (6/189) of injections. CONCLUSIONS Thrombosis of IPVs with UGS increases venous ulcer healing in a difficult patient population. Complete closure of all IPVs in an ulcerated limb was the only predictor of ulcer healing. Men and patients on warfarin have decreased rates of IPV thrombosis with UGS.

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Section: Discussionmentioning

confidence: 99%

Factors that influence perforator thrombosis and predict healing with perforator sclerotherapy for venous ulceration without axial reflux

Kiguchi

Hager

Winger

et al. 2014

Journal of Vascular Surgery

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“…Surgery has partially lost its central role in the management of the Infantile Hemangiomas in favour of local, systemic therapies or lasers in dangerous areas. [8][9][10][11][12][13] However 14 The surgical way often requires some complementary treatments, to maximize the final results in a multidisciplinary approach. 15 The correct diagnosis and classification of the type of malformation we are facing, do indicate the therapeutic option among a wide range of possibility.…”

Section: Discussionmentioning

confidence: 99%

The Use of Interstitial Echo-Guided Diode Laser 980-nm for Deep Vascular Anomalies in Pediatric Patients: A Preliminary Study

Santecchia

Valassina

Ciprandi

et al. 2013

Surgical Techniques Development

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A wide range of therapeutic options is available to treat vascular anomalies, arising from the systemic therapies to surgery or using lasers. The purpose of this preliminary study is to assess the effectiveness of treatment of vascular anomalies anywhere in the body, along with the use of interstitial echo-guided 980 nm diode laser. The analysis occurs through accurate angio magnetic resonance imaging (MRI) pre-and post-treatment measurements. We enrolled all the patients (16) affected on vascular malformations everywhere in the body, treated from January to August 2012. We obtained excellent results in 6 patients (37.5%) with mean mass reduction of 85%, good in 9 patients (56%) with mean mass reduction of 65% and unsatisfactory in 1 patient (6%). In pediatric patients, low-flow vascular malformations resistant to progressive sclerotherapy or in critical anatomical sites, benefit of echo guided interstitial 980-nm diode laser.

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“…Although their study indicates that lower concentrations of sclerosing foam increase recurrence rates, it also shows that lower concentrations reduce the incidence of AEs. This is a significant consideration that contrasts with early FS treatments, which tended to use much higher concentrations and volumes that resulted in a high incidence of AEs such as thrombophlebitis, deep venous thrombosis, hyperpigmentation, and painful persistent sclerosis reactions 8 …”

mentioning

confidence: 99%

“…In addition, studies have examined the influence of various gases and concentrations of sclerosants on foam stability 11 . Some studies have reported the affect that the treating physician's experience has on outcomes, but country treatment restrictions and a broad array of research objectives preclude meta‐analysis of results 8 …”

mentioning

confidence: 99%

Commentary: Outcomes of Ultrasound-Guided Foam Sclerotherapy for Varicose Veins of the Lower Extremities: Single Center Experience

Raymond‐Martimbeau

2011

Dermatologic Surgery

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Review of Published Information on Foam Sclerotherapy

Abstract: Foam sclerotherapy has significantly better efficacy than liquid. It is essential to select the correct concentration and the correct foam volume. In the hands of an experienced physician, foam sclerotherapy is a safe and effective option for treating varicose veins.

Cited by 33 publications

References 52 publications

Factors that influence perforator thrombosis and predict healing with perforator sclerotherapy for venous ulceration without axial reflux

Factors that influence perforator thrombosis and predict healing with perforator sclerotherapy for venous ulceration without axial reflux

The Use of Interstitial Echo-Guided Diode Laser 980-nm for Deep Vascular Anomalies in Pediatric Patients: A Preliminary Study

Commentary: Outcomes of Ultrasound-Guided Foam Sclerotherapy for Varicose Veins of the Lower Extremities: Single Center Experience

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