The role of sclerotherapy as an adjunct to Unna's boot for treating venous ulcers: A prospective study

Queral, Luis A.; Criado, Francisco Javier García; Lilly, Michael; Rudolphi, Diane

doi:10.1016/0741-5214(90)90304-s

Cited by 27 publications

(11 citation statements)

References 6 publications

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“…This treatment decreased the regional venous hypertension. 49 In cases of intractable hypertensive venous ulcers caused by iliac obstruction, a Palma crossover venovenous bypass graft should be considered.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of deep venous anomalies in congenital vascular malformations of venous predominance

Eifert¹,

Villavicencio²,

Kao³

et al. 2000

Journal of Vascular Surgery

123

100

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Section: Discussionmentioning

confidence: 99%

Prevalence of deep venous anomalies in congenital vascular malformations of venous predominance

Eifert¹,

Villavicencio²,

Kao³

et al. 2000

Journal of Vascular Surgery

123

100

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“…However, studies of the sclerosing treatment of venous ulcers are scarce and usually report the combined application of surgery and sclerotherapy. 25,26 The use of color duplex scanning would be incorporated into the assessment in all ulcerated limbs. If color venous duplex imaging can accurately demonstrate patients with superficial venous reflux and incompetent perforator veins, it may be possible to improve ulcer outcome by sclerotherapy treatment.Theoretically,sclerosingtreatmentsareoptimaltoclose smallcollaterals.Infact,ourpresentresultsconfirmthatUIPM can achieve this, thus accelerating ulcer closure and preventing recurrences caused by the reappearance of VH.…”

Section: Commentmentioning

confidence: 99%

Ultrasound-Guided Injection of Polidocanol Microfoam in the Management of Venous Leg Ulcers

Redondo¹,

Becerra²,

Garrido³

et al. 2004

Arch Dermatol

114

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Background: Venous leg ulceration is a frequent and severe complication of lower limb venous insufficiency. Compression therapy is associated with a protracted course of healing and multiple recurrences. Minimally invasive surgery (subfascial endoscopic perforating surgery) is only possible in a subset of patients with leg ulcers. Low-cost and noninvasive therapeutic procedures are needed as alternative treatments.Objective: To evaluate the efficacy and safety of sclerosant in microfoam in treating venous leg ulceration.Design: A retrospective study of medical records, pretreatment and posttreatment color photographs, and echo Doppler in patients with venous leg ulceration. All patients were evaluated at 6 months after therapy, 70% were also evaluated at 2 years, 25% at 3 years, and 14% at 4 or more years after treatment. They were assessed for complete (100%) ulcer healing, time to wound closure, and recurrence. Setting: Private vascular surgery clinic in Granada and dermatology department at a hospital in Pamplona, Spain. Patients: Over 115 months, 116 consecutive patients (mean age [range], 57 [25-85] years) treated with ultra-sound-guided injection of polidocanol microfoam (UIPM).Interventions: To reduce venous hypertension, UIPM was used to selectively and progressively sclerose sources of incompetence. The number of sessions per patient varied between 1 and 17 (mean, 3.6).Main Outcome Measures: Complete ulcer healing, defined as full reepithelialization of the wound with absence of drainage. Recurrence was defined as epithelial breakdown in the healed limb.Results: At 6-months' follow-up, treatment with UIPM achieved complete healing in 83% of patients (96/116), with median time to healing of 2.7 months; 7 patients were never cured, and 1 patient was lost to follow-up. There were recurrences in 10 patients. Conclusions:The use of UIPM to selectively and progressively sclerose incompetent veins produced by venous hypertension is highly effective to achieve a stable ulcer healing with minimal invasion, even in elderly patients. Recurrences are easily treatable with this approach. This technique may become a first-line treatment in the management of leg venous ulcers.

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“…The number of patients was low (10), and in 70%, stripping of the long saphenous vein was performed simultaneously. It is also known that sclerotherapy of periulcer varices and perforators can significantly improve local venous hemodynamics and speed ulcer healing 63 . Unfortunately, in most of these studies, superficial venous reflux was treated before or simultaneously with ligation of IPV.…”

Section: Role Of Ipvs In Venous Diseasementioning

confidence: 99%

“…There are several studies on the presence of IPV in patients with recurrent varicosis. Most studies show a high prevalence of IPV in patients with recurrent varicose veins after surgery, 6–74 especially incompetent thigh PVs 37,75,76,77 . Although there seems to be an association between IPV and recurrent varicose veins, it is now essential to establish whether this is a causative link 73 …”

Section: Role Of Ipvs In Venous Diseasementioning

confidence: 99%

Venae Perforantes: A Clinical Review

2003

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Background. Although many articles on perforating veins have been published, much knowledge about these veins is lacking. Objective. In this review relevant facts about the clinical importance of perforating veins in venous disease are described. Methods. A literature search on English, French and German articles has been performed using literature databases like Medline, Embase and Cochrane. Results. Selection criteria are described. Conclusion. A few conclusions are drawn: incompetent perforating veins can be of haemodynamic importance, especially in venous ulceration and (recurrent) varicose veins. The current definition of incompetent perforating veins is reflux more than 0,5 seconds (detected by Duplex ultra‐sonography). Good anatomical and clinical classifications are published and should be integrated in the CEAP classification. Based on the clinical classification treatment options are described for the different types of incompetent perforating veins. Two different treatment modalities for incompetent perforating veins are surgery (SEPS) and sclerotherapy. SEPS seems to be of benefit in patients with venous ulceration and advanced CVI. Sclero‐therapy (especially ultra sound guided sclerotherapy) is promising and worth further evaluation.

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The role of sclerotherapy as an adjunct to Unna's boot for treating venous ulcers: A prospective study

Cited by 27 publications

References 6 publications

Prevalence of deep venous anomalies in congenital vascular malformations of venous predominance

Prevalence of deep venous anomalies in congenital vascular malformations of venous predominance

Ultrasound-Guided Injection of Polidocanol Microfoam in the Management of Venous Leg Ulcers

Venae Perforantes: A Clinical Review

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