Ultrasound-guided foam sclerotherapy of great saphenous vein with 2% polidocanol - one-year follow-up results.

Abstract

IntroductionUltrasound-guided foam sclerotherapy (UGFS) of varicose veins is a useful treatment option. It is a relatively safe method in the case of limited, small varicose veins. In theory, a justified concern could be raised that the injection of an active drug into the large superficial venous vessels may potentially cause life-threatening consequences.AimTo assess the safety and efficacy of UGFS using a 2% solution of polidocanol (Aethoxysklerol 2%) in the case of great saphenous vein incompetence.Material and methodsFifty-two patients with great saphenous vein incompetence underwent ultrasound-guided foam sclerotherapy. The efficacy criterion was the elimination of reflux measured ultrasonographically and withdrawal or decrease of complaints: 1 week, and 1, 3, 6 and 12 months after the treatment. Complications of sclerotherapy were reported during follow-up.ResultsDecrease or withdrawal of complaints of chronic venous insufficiency was reported in 96% of cases (50 patients). Disappearance or decrease of varicose veins was noted in all patients (100%). During examination after 12 months, full success of ultrasound was achieved in 38 (73%) cases, and 11 (21%) patients presented a partial desired effect according to the consensus from Tegernsee. Persistence of reflux longer than 1 s in the treated great saphenous vein was reported in 3 (6%) cases. Serious complications, such as deep vein thrombosis, pulmonary embolism, dyspnea, anaphylaxis, or neurological abnormalities, were not recorded.ConclusionsUltrasound-guided foam sclerotherapy of incompetent great saphenous vein and varicosities with 2% polidocanol was found to be an effective and safe method of treatment during 1 year of observation. However, longer observation is necessary.

Escleroterapia com espuma de polidocanol em veias safenas magnas e suas tributárias bilateralmente em tempo único

“…In this study, there was a high rate of retained coagula, observed in 19 (34.5%) patients. Similar results were observed by Ceratti et al, 24 who reported 11%, Nael and Rathbun 25 with 17%, and Kurnicki et al, 26 with 21%. Tremaine et al 27 assessed sclerotherapy in upper limbs and observed a 61.9% rate of retained coagula.…”

“…The guidelines recommend that it should be used and can be applied with elastic stockings or bandages. 26 Hamel-Desnos conducted a randomized clinical trial of 60 patients either wearing elastic stockings or not using compression after saphenous closure and did not observe differences in the rate of occlusion of the saphenous veins, complications, or quality of life questionnaire responses. 31 …”

Catheter-directed foam sclerotherapy, an alternative to ultrasound-guided foam sclerotherapy for varicose vein treatment: A systematic review and meta-analysis

“…After full text evaluation, 62 studies discussing sclerotherapy management of varicose veins were included involving 3689 patients (CDFS 789 and FS 2900). 11,16,19,20,28–84 Of these, there were 48 studies for UGFS and 15 studies for CDFS. There was only one randomized controlled trial directly comparing these two alternatives.…”

Ultrasound-guided catheter-directed foam sclerotherapy can be safely applied for the treatment of great saphenous varicose veins in elderly patients

“…6,7 The choice of the best approach depends on many factors, such as the stage of the venous lesion according to the CEAP classification, location of this lesion, cost of the treatment, symptoms and age-dependent concomitant diseases (hypertension, arterial diseases and coronary disease). 8 In addition, vein diameter, anatomical location and tortuosity At present, UGCDFS is a minimally invasive treatment for varicose veins that has been widely accepted, with several large case series reported. 3,4,9 In one study about UGCDFS for venous insufficiency, Smith 10 reported that closure rate of GSV and small saphenous veins was 88% and 83%, respectively.…”

“…6,7 The choice of the best approach depends on many factors, such as the stage of the venous lesion according to the CEAP classification, location of this lesion, cost of the treatment, symptoms and age-dependent concomitant diseases (hypertension, arterial diseases and coronary disease). 8 In addition, vein diameter, anatomical location and tortuosity are important. Because UGCDFS does not require general, spinal and tumescent anaesthesia, it may be preferred by patients with venous insufficiency.…”