Microfoam Sclerotherapy for Varicose Veins: a Retrospective Analysis of a Modified Technique - PubMed (original) (raw)

Microfoam Sclerotherapy for Varicose Veins: a Retrospective Analysis of a Modified Technique

N Radhakrishnan et al. Indian J Surg. 2015 Dec.

Abstract

Varicose veins (VVs) are generally characterized by their elongated, twisted, bulging, superficial appearance on the lower extremities and usually present with acute or chronic venous diseases. Despite diagnostic and surgical advances in the management of VV, patients suffer from post-therapeutic complications and recurrence. We present findings from a retrospective study of a modified treatment modality in patients with varicose veins who attended St. Thomas Institute of Research on Venous Diseases, Changanassery, Kerala. The hospital caters to patients from India and outside. Out of 14,707 patients treated from 1997 till May 2013, 6,350 patients from January to March 2011 were selected for the study from the routine clinical practice (mid-segment) to facilitate follow-up. They were categorized according to Clinical Etiologic Anatomic Pathophysiologic (CEAP) clinical classification system. Baseline data were accrued using a questionnaire. Patients were treated by microfoam sclerotherapy giving a maximum importance to smaller veins, depicting a modified technique of microfoam sclerotherapy (MMFST). This is based on the significance of microscopic venous valves (MVVs) in the development of chronic venous disease (CVD). Follow-up was according to a predefined schedule, and improvements and complications were recorded. A positive family history of VVs was reported in 85.23 % of patients. Half the study population belonged to CEAP clinical class IV. There were no significant complications in patients throughout the 2 to 6 years of follow-up. Recurrence was rarely reported during follow-up and was corrected by repeating the procedure as required during follow-up. MMFST is an innovation in the treatment of VVs based on new principles, with the potential to control and revert the symptoms of CVD, with minimal complications.

Keywords: Chemical bombing; Complications; Microfoam; Microscopic venous valves; Modified sclerotherapy; Recurrence; Varicose veins.

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Figures

Fig. 1

Fig. 1

Patient acceptance graph showing the number of varicose vein patients treated till date

Fig. 2

Fig. 2

ae Pre- and post-procedural images of varicose veins representing gradual healing of the lesions. a The limb bearing conspicuous lesions before the sclerotherapy. b The limb just after sclerotherapy. ce Gradual amelioration of the lesions on subsequent days following sclerotherapy. The affected area has been indicated by an arrow

Fig. 3

Fig. 3

a Surgical anatomy of varicose veins, b modified microfoam sclerotherapy, and c the preference hierarchy of the veins for the modified microfoam sclerotherapy

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