Treatment of varicose veins by compression sclerotherapy

Reid, Ronald; Rothnie, N. G.

doi:10.1002/bjs.1800551204

Cited by 58 publications

(30 citation statements)

References 6 publications

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“…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].…”

Section: Introductionmentioning

confidence: 98%

Management of varicose veins from chronic venous insufficiency

Chang

Stein

2011

Int J Angiol

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Chronic venous insufficiency is a progressive disease, which may require surgical intervention to prevent complications. This study was done to determine the usefulness of a high ligation with sclerotherapy to prevent the return of symptoms. Duplex scanning was used to locate incompetent veins. There was no evidence of incompetent perforating or deep veins in the 322 patients who had 483 high ligations of the greater saphenous vein. Multiple phlebectomies and limited vein stripping were done for large (>20 mm) varicose veins. The clinical, etiologic, anatomic and pathophysiologic (CEAP) score evaluated the severity of venous dysfunctions. Symptoms of leg aches, ankle edema, night cramps or ulceration were evaluated after 1-3 months, and then at 6-12 month intervals. Sclerotherapy of the saphenous vein, using a sodium tetradecyl sulfate solution from 0.1-3.0%, was done if there was no significant improvement of a non-healing ulcer or the recurrence of symptoms. Compression hose, 30-40 mm Hg, was prescribed unless contraindicated by arterial occlusive disease, acute deep vein thrombosis or severe congestive heart disease. After the high ligation, symptoms improved in 212 limbs, were unchanged in 187 limbs and became worse in 84 limbs. After sclerotherapy in 264 limbs, 237 limbs improved, 21 remained unchanged and six became worse. Patients who have varicose veins from superficial venous incompetence can achieve a good long-term outcome with the high ligation procedure. However, it is important to control venous reflux and the related symptoms with sclerotherapy as needed.

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Section: Introductionmentioning

confidence: 98%

Management of varicose veins from chronic venous insufficiency

Chang

Stein

2011

Int J Angiol

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“…Admission to hospital is unnecessary and this is a particular advantage to patients with domestic and professional commitments. The advantages to the hospital and surgeon have been pointed out by others (Reid and Rothnie, 1968) . Although the waiting list for vein surgery is abolished it may be necessary to maintain one for sclerotherapy.…”

Section: Discussionmentioning

confidence: 96%

The Injection Treatment of Varicose Veins: a Follow-Up Study of 264 Patients

Pattisson

Tretbar

1971

Vascular Surgery

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The successful treatment of varicose veins is difficult, time consuming and tedious. A variety of surgical operations, including combinations of saphenofemoral ligation, stripping, multiple ligations, and ligation of perforating veins have been carried out with varying degrees of success. Injections of sclerosant solutions have been used to produce thrombotic occlusion which is usually ineffective and sometimes dangerous. Recently a new method of treatment by injection and compression (Fegan, 1953-4) has aroused considerable interest and controversy. Sclerosant solution is injected into an emptied segment of vein in order to damage the intima and initiate inflammation. Compression is then applied to appose the walls of the vein and reduce the size of any thrombus to a minimum. The lumen becomes occluded by fibrosis and the vein converted to a fibrous cord. This paper reports the results of this method of treatment in a series of 264 patients who were treated at the West All patients were treated in a special clinic to which they were referred from the surgical outpatient clinics and injections were performed by a number of surgical registrars and consultants. Patients with primary saphenofemoral incompetence or major varices in the thigh, which could not be compressed adequately with a bandage, were not accepted for sclerosant therapy. Women were advised to stop taking oral contraceptives for two cycles before treatment was started and until treatment was complete. Patients with varicose ulcers were treated, before injections were given, by dressings and bandaging until the ulcer was clean enough to withstand six weeks of bandaging.Sites of perforating veins were identified by palpation with the patient flat and the limb raised. The course of the varices and the sites of the perforators were then marked with the patient standing, and the markings recorded in the notes on a rubber stamp outline. Injections were begun distally with the patient lying down. A 17 gauge needle was introduced into the vein and blood drawn From: The West Middlesex Hospital, Isleworth.

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“…Sclerotherapy is associated with a high recurrence rate, and the possibility of an anaphylactic reaction is always present, as well as inadvertent arterial injection. 8,9 Recently, closure of the saphenous vein using radiofrequency has been described. Complications ranging from pulmonary embolus, deep venous thrombosis, saphenous neuralgia, and skin burns have been reported, although less now with more experience.…”

Section: Discussionmentioning

confidence: 99%