Ultrasound-guided foam sclerotherapy is a safe and clinically effective treatment for superficial venous reflux

Bradbury, Andrew W.; Bate, Gareth; Pang, Karl H.; Darvall, Katy; Adam, Donald J.

doi:10.1016/j.jvs.2010.04.077

Cited by 84 publications

(81 citation statements)

References 38 publications

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“…Our data consistently demonstrated that there was an improvement in symptoms after treatment and confirm findings reported by Bradbury et al 11 The portion of the questionnaire related to symptoms (VEINES-Sym) identified improvements in all nine items 45 days after treatment, with statistical significance for the following items: pain, heavy legs, swelling, burning sensation, restless legs, and throbbing (p<0.0001). The portion of the questionnaire related to quality of life (VEINES-QOL) confirmed these data, since it showed that 100% of patients reported being somewhat better (6%) or much better (94%) than one year before treatment.…”

supporting

confidence: 91%

Evaluation of quality of life and photoplethysmography in patients with chronic venous insufficiency treated with foam sclerotherapy

Neto

Araújo²,

Kessler

2015

J. vasc. bras.

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Background: Ultrasound-guided foam sclerotherapy plays a major role in treatment of chronic venous insufficiency, providing clinical and hemodynamic improvement to patients undergoing treatment. Objectives: To examine the relationships between venous refilling time and impact of venous disease on quality of life and between changes in venous refilling time and improvement of symptoms after ultrasound-guided foam sclerotherapy for chronic venous insufficiency. Methods: Thirty-two patients classified as C4, C5 or C6 answered a questionnaire on quality of life and symptoms and their venous filling time was measured using photoplethysmography before and 45 days after treatment of chronic venous insufficiency with ultrasound-guided foam sclerotherapy. Results: Statistically significant improvements were observed in quality of life scores and in venous filling time and in the following symptoms: aching, heavy legs, restless legs, swelling, burning sensations, and throbbing (p<0.0001). A similar improvement was also seen in the work and social domains of quality of life (p<0.0001). Conclusions: As confirmed by questionnaire scores and venous refilling times, ultrasound-guided foam sclerotherapy demonstrated efficacy and resulted in high satisfaction levels and low rates of major complications.

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supporting

confidence: 91%

Evaluation of quality of life and photoplethysmography in patients with chronic venous insufficiency treated with foam sclerotherapy

Neto

Araújo²,

Kessler

2015

J. vasc. bras.

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“…17,18 Foam sclerotherapy combined with SFL involves a shorter treatment time, less postoperative discomfort, and results in more rapid recovery compared with conventional GSV stripping under general anesthesia. [19][20][21] Bradbury et al 22 suggested that patients should be kept under review because they are at risk of developing recurrent and new superficial venous reflux. This denotes that sclerotherapy could be based on a dental care model; that is, the recurrent nature of VV may be analogous to the recurrent nature of dental caries.…”

Section: Discussionmentioning

confidence: 99%

Long-term results of a randomized controlled trial on ultrasound-guided foam sclerotherapy combined with saphenofemoral ligation vs standard surgery for varicose veins

Kalodiki

Lattimer

Azzam

et al. 2012

Journal of Vascular Surgery

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At 3 and 5 years of follow-up, the treatment was equally effective in the surgical and foam groups, as demonstrated with VCSS, VSDS, and the SF-36 physical component score. At 5 years, the AVVQ was significantly better in the surgical group. The additional foam sessions were also similar. Because traditional surgery for varicose veins does not provide a definitive treatment, foam sclerotherapy could be offered as in a dental care treatment model: "treat as and when the problem appears."

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“…UGFS on one side, and hook-phlebectomy on the other side represent mini-invasive treatments, which have undergone a growing diffusion as well. [22][23][24] In a recent meta-analysis , on the effectiveness of endovenous therapies for lower limb varices found, after 3 years, the estimated pooled success rates for stripping, UGFS, radiofrequency ablation, and laser therapy was 78%, 77%, 84% and 94% respectively. 25 Also in Rasmussen's randomized clinical trial at one year 5.8%, 4.8%, 16.3% and 4.8% of the GSVs were patent and refluxing in the laser, radiofrequency, foam and stripping groups respectively (P<0.001).…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-guided perisaphenous tumescence infiltration improves the outcomes of long catheter foam sclerotherapy combined with phlebectomy of the varicose tributaries

Cavezzi

Mosti²,

Paolo

et al. 2015

Veins and Lymphatics

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A prospective comparative observational study was performed to assess the short--term efficacy and safety of the peri-saphenous infiltration of tumescence solution (PST) in great saphenous vein (GSV) long catheter foam sclerotherapy (LCFS) combined with phlebectomy of the varicose tributaries. Since November 2006 through November 2010 fifty-one consecutive patients (16 males and 35 females, mean age 51.5 years) who underwent LCFS of GSV + multiple phlebectomies were prospectively enrolled, without any pre-selection criteria, in three different groups (17 patients per group) and reviewed as to their outcomes: i) patients without additional PST; ii) with PST under visual control; iii) with ultrasound-guided PST. All procedures were performed in local anesthesia and an average of 7 mL [interquartile range (IQR) 6.5-7.5] of 3% sodiumtetradecylsulfate CO2+O2-based sclerosant foam was injected in the diseased segment of GSV (median caliber 7) (IQR 6-8) by means of a 4F long catheter. Clinical and color-duplex ultrasound (CDU) follow-up was performed at regular intervals, the last of which 14 months after the treatment.At 14 months follow-up no varicose veins were visible in 94%, 94% and 100% of the cases in group I, II and III respectively. The CDUbased outcomes were the following: 71%, 71% and 84% GSV occlusion rate in group I, II and III respectively; reflux was found in 5, 4 and 1 cases in group I, II and III respectively. Clinical and CDU morphologic and hemodynamic results were assembled and scored through an arbitrary system. The relative statistical analysis showed a significant (P<0.0001) improvement of the results for patients who received ultrasound guided PST over the other two groups. No relevant complications were recorded in all 51 cases.GSV treatment by means of LCFS + phlebectomy of varicose tributaries proved to be effective and safe in this prospective observational study. The addition of ultrasound guided PST resulted in a significant improvement of GSV occlusion rate and of varicose vein clinical resolution.

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Ultrasound-guided foam sclerotherapy is a safe and clinically effective treatment for superficial venous reflux

Abstract: UGFS for CEAP 2-6 SVR is associated with a low complication and retreatment rate. However, as patients are at risk of developing recurrent and new SVR they should be kept under review. Further UGFS for new or recurrent disease is simple, safe, and effective.

Cited by 84 publications

References 38 publications

Evaluation of quality of life and photoplethysmography in patients with chronic venous insufficiency treated with foam sclerotherapy

Evaluation of quality of life and photoplethysmography in patients with chronic venous insufficiency treated with foam sclerotherapy

Long-term results of a randomized controlled trial on ultrasound-guided foam sclerotherapy combined with saphenofemoral ligation vs standard surgery for varicose veins

Ultrasound-guided perisaphenous tumescence infiltration improves the outcomes of long catheter foam sclerotherapy combined with phlebectomy of the varicose tributaries

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