The treatment of varicose veins by compression sclerotherapy

Abstract

Two hundred and eighty-four patients (348 legs) with varicose veins were treated by compression sclerotherapy and reviewed 1-4 years later. Successful results were obtained at the end of a course of treatment in 89 per cent and after an interval of 3-4 years in 68 per cent. The majority of recurrences presented within 2 years. Factors affecting the results were examined. Women whose varicose veins first appeared in relation to a pregnancy and those whose symptoms were aggravated at the time of menstruation had significantly better results than the group as a whole. Patients with varicose veins who had previously been treated by surgery or sclerotherapy had a success rate not significantly different to that for new patients. Local thrombophlebitis following injection was not uncommon and the success rate in this group was not significantly different from that in the whole group.

The value of different forms of treatment for varicose veins

“…Following a long period during which operative treatment clearly dominated, the international literature covering the past 15 years reveals an increasing enthusiasm for sclerotherapy as described by Fegan (1967) andSigg (1976). In a number of publications, results apparently up to the standard of those following operative treatment have been reported (Reid and Rothnie, 1968;Chant et al, 1972;Stother et al, 1974;Doran and White, 1975), and it is maintained that outpatient sclerotherapy is not only more economical for the community but also more advantageous for the individual patient than operative treatment involving a period of stay in hospital (Piachaud and Weddell, 1972).…”

Management of varicose veins from chronic venous insufficiency

“…Sclerotherapy eventually fell in disfavor, and stripping and ligation of the vein became the most common treatment. A modified technique of sclerotherapy was described by Fegan in 1963 [3], and several studies have since indicated that it benefited patients [16,21,22]. Advantages of a high ligation are that the greater saphenous vein is spared for a possible arterial conduit, local anesthesia can be used, it can be done on outpatients, there is only one incision in the groin and there is no distal nerve damage [2,8].…”

Assessment of the results of surgery for varicose veins

“…This simple-sounding state of affairs in fact constitutes a considerable barrier to the adequate evaluation of surgery for varicose veins, for which of these two disparate evaluations is to be held to be the 'correct' one? Stother et al (1974) assessed as 'successful' patients those who still had varicose veins but were not concerned about them. This makes inter-series comparisons quite impossible, since the 'success' rate depends upon the patients' attitudes to residual varices.…”

“…DURING the past two or three decades, the results of surgery for varicose veins have been analysed in some detail in a series of studies from various centres (McElwee and Maisel, 1947;Mathieson, 1953;Dodd and Cockett, 1956;Agrifolio and Edwards, 1961;Fegan, 1967;Chant et al, 1972;Nabatoff and Stark, 1973;Stother et al, 1974;Doran and White, 1975). Unfortunately, the picture which has emerged from such studies is far from clear, most operations appearing to give 'satisfactory' results in approximately 70-90 per cent of cases and no single procedure being universally accepted as superior to alternative forms of therapy.…”