Efficacy and safety of ultrasound guided foam sclerotherapy with sodium tetradecyl sulphate for residual and minor varicosities (original) (raw)
Related papers
International Journal of Medical Research and Review, 2016
Objective:The purpose of this study was to determine the outcome and rate of recurrence for varicose veins treated with ultrasound-guided foam sclerotherapy (UGFS). Methods: Data was collected from hospital records. Patients treated with UGFS for superficial venous insufficiency were included in the study. Total 361 legs in 241 patients, out of which 121 patients with unilateral limbs and 120 patients with bilateral limbs were found to be treated by this method. Results: Out of these 361 legs great saphenous vein (GSV) varicosity was found in 88 legs, short saphenous vein (SSV) in 76, GSV & SSV both in 63, others 134. 264 legs with primary varicosity while 97 were with recurrent. In 294 legs clinical CEAP was 2-3 while in 67 legs it was 4-6. Saphenofemoral junction (SFJ) incompetence was found 60 legs, saphenopopliteal junction (SPJ) incompetence in 68, only perforator's incompetence was in 56, SFJ with perforator's incompetence 61, SPJ with perforator's 29 and no incompetence was noted in 87 legs.Outcome at 6 months was 96.23% while treatment failure and recurrences were noted in 2.77 % of legs. Complications which were noted at 1 week were superficial skin necrosis in 3.04%, pain at injection sites in 15.23%, superficial thrombophlebitis in 16.62%, bruising in 12.18%, skin staining in 11.08%, superficial vein thrombosis (SVT) in 9.97% while no DVT was noted in any of the treated legs. Conclusion: On conclusion it was found that UGFS is a popular office based treatment modality, safe, effective, easy and improvement in venous signs and symptoms. Even on recurrence patients easily accepts retreatment with this method. Furthermore it is associated with lesser pain, anesthesia requirements; time off work and driving gives it additional advantages.
Ultrasound Guided Foam Sclerotherapy for the Treatment of Primary Varicose Vein of Lower Limb
International Journal of Medical Arts, 2020
Background: Veins have one-way valves that prevent blood from backing up into the legs when we stand or sit. When the valves become incompetent [or begin to have reflux], blood pools and causes an increase in pressure in the leg veins. Leg veins become enlarged and twisted. Aim of the work: The aim of the current study was to evaluate safety and efficacy of ultrasound guided foam sclerotherapy for the treatment of primary varicose vein. Patients and methods: The current trial is a prospective observational cohort study. It had been carried out at Al-Azhar University Hospital [New Damietta], Egypt. It included Fifty patients who had great saphenous vein [GSV] reflux associated with saphenofemoral junction [SFJ] incompetence. They had been offered foam sclerotherapy as an alternative to standard surgical treatment or conservative management. The duration of the study extended between November 2019 to January 2020. Results: results revealed that post intervention; duplex assessment revealed a radiologic success with complete obliteration of GSV and collaterals in 40 patients [80%]. six patients [12%] underwent direct re-injection for further one or two injection sessions over the following two weeks until complete occlusion of GSV and collaterals was obtained. Conclusion: Foam sclerotherapy is effective & safe in treatment of primary varicose veins.
The role of ultrasound guided foam sclerotherapy in treatment of truncal varicose veins
Egyptian Journal of Radiology and Nuclear Medicine, 2015
The aim of this study was to evaluate the role of ultrasound guided foam sclerotherapy in the treatment of lower limb truncal varicose veins. Subjects and methods: The study included 30 patients (9 males and 21 females) ranging from 20 to 40 y, with various degrees of varicose veins chosen from the vascular surgery department from April 2013 to April 2014. All patients are evaluated with color Doppler ultrasound system. Results: The study included nine males (30%) and 21 females (70%) with various degrees of varicose veins. Each case had foam injection under duplex guidance. All patients suffered from cosmetic disfigurement, whereas 24 patients (80%) complained of leg pain. In the first phase (after 2 weeks) 28 patients (93.3%) showed complete clinical improvement of the pre-interventional symptoms, while only 2 patients (6.7%) showed no improvement. Four patients (13.3%) suffered from complications in the form of thrombophlebitis. The 2nd phase follow up demonstrated the final patient's outcomes. 86.7% of the subjected sample (26 patients) showed further improvement. Conclusion: Foam sclerotherapy is an effective, simple and safe technique for the treatment of truncal varicose veins with minimal complications.
Indian Journal of Vascular and Endovascular Surgery, 2015
Objective:The purpose of this study was to determine the outcome and rate of recurrence for varicose veins treated with ultrasound-guided foam sclerotherapy (UGFS). Methods: Data was collected from hospital records. Patients treated with UGFS for superficial venous insufficiency were included in the study. Total 361 legs in 241 patients, out of which 121 patients with unilateral limbs and 120 patients with bilateral limbs were found to be treated by this method. Results: Out of these 361 legs great saphenous vein (GSV) varicosity was found in 88 legs, short saphenous vein (SSV) in 76, GSV & SSV both in 63, others 134. 264 legs with primary varicosity while 97 were with recurrent. In 294 legs clinical CEAP was 2-3 while in 67 legs it was 4-6. Saphenofemoral junction (SFJ) incompetence was found 60 legs, saphenopopliteal junction (SPJ) incompetence in 68, only perforator's incompetence was in 56, SFJ with perforator's incompetence 61, SPJ with perforator's 29 and no incompetence was noted in 87 legs.Outcome at 6 months was 96.23% while treatment failure and recurrences were noted in 2.77 % of legs. Complications which were noted at 1 week were superficial skin necrosis in 3.04%, pain at injection sites in 15.23%, superficial thrombophlebitis in 16.62%, bruising in 12.18%, skin staining in 11.08%, superficial vein thrombosis (SVT) in 9.97% while no DVT was noted in any of the treated legs. Conclusion: On conclusion it was found that UGFS is a popular office based treatment modality, safe, effective, easy and improvement in venous signs and symptoms. Even on recurrence patients easily accepts retreatment with this method. Furthermore it is associated with lesser pain, anesthesia requirements; time off work and driving gives it additional advantages.
Ultrasound-guided foam sclerotherapy for the treatment of varicose veins
British Journal of Surgery, 2006
Background The aim was to assess the early efficacy and complications of ultrasound-guided foam sclerotherapy (UGFS) in a cohort of patients with varicose veins. Methods Of 192 consecutive patients referred with varicose veins over 15 months, only 11 chose surgery; the rest underwent UGFS treatment. Polidocanol was foamed 1:3 with air. Under ultrasound control via butterfly or Seldinger cannulation, 1 per cent foam was injected into superficial veins and 3 per cent foam into saphenous trunks, up to a total volume of 14 ml. Outcome was defined as complete when occlusion of the saphenous trunk and/or over 85 per cent of the varicosities was achieved, and partial closure when less. Results In 163 legs, complete occlusion occurred after one intervention, a further 32 after a second, and one after a third (overall 91 per cent). Of the remainder, all other legs achieved partial occlusion after up to three interventions, apart from two legs with great saphenous vein (GSV) incompetence, whi...
Ultrasound guided foam sclerotherapy in Varicose veins -Is it necessary?
IOSR Journals , 2019
Varicose veins affect up to 25% of women and 15% of men in the western world 3 and incidence is apparently low in India. 4 Male preponderance was observed with male to female ratio 14:1 in Indian scenario. 5 Sclerotherapy involves the injection of a sclerosing agent directly into the superficial veins. The most commonly used is sodium tetradecyl sulphate. The direct contact with detergent causes cellular death and initiates an inflammatory response, aiming to result in thrombosis, fibrosis and obliteration (sclerosis). Blood deactivates the action of the sclerosing agent and the doses administered need to be limited to avoid adverse effects, causing a trade-off between poor efficacy and safety. 11 In this study outcomes of non usg guided injection sclerotherapy were studied and analyzed among patients coming to RIMS, Ranchi which is a tertiary care centre in Jharkhand. A total of 50 cases who underwent non usg guided foam sclerotherapy were studied out of which, all had obliteration of Varicose Veins. The secondary outcomes were symptomatic improvement, ulcer healing, recurrence, and adverse events. Adverse effects were pain (86%), pruritis (32%), swelling (14%), thrombophlebitis (16%) and skin ulceration (2%). Complete obliteration was achieved after one injection in all cases. Thrombosis and neurologic events were not seen. Hence, Foam Sclerotherapy, even non USG guided, appears to be a safe and effective outpatient therapy for the treatment of Varicose Veins and hence can be used even in setups lacking the facility of USG.
European Journal of Vascular and Endovascular Surgery, 2009
This study aims to compare venous clinical severity scores in patients with healed venous ulcers due to varicose veins of the lower limbs (the clinical, etiologic, anatomic, and pathophysiologic data (CEAP) classification: C 5 EpAsPr) treated by saphenous stripping and phlebectomy or by ultrasound-guided foam sclerotherapy. Method: Sixty patients were included: 29 underwent saphenous stripping and phlebectomy for varices in saphenous tributaries and 27 were treated by ultrasound-guided foam sclerotherapy; four cases were lost to follow-up. The main outcome measure was venous clinical severity scores (pain, oedema, inflammation, hyperpigmentation and lipodermatosclerosis). An ultrasound examination was carried out prior to treatment and 30, 60 and 180 days after the procedure to assess the relative efficacy of the methods in obliterating the saphenous trunk. Results: The mean venous clinical severity scores measured before and after 180 days were as follows: Surgery group e pain: before 1.97 standard deviation (SD) 0.19, 180 days 0.72 SD 0.53; oedema: before 1.66 SD 0.48, 180 days 0.55 SD 0.63; inflammation: before 1.55 SD 0.63, 180 days 0.72 SD 0.45. Foam sclerotherapy group e pain: before 1.81 SD 0.40, 180 days 0.56 SD 0.51; oedema: before 1.70 SD 0.47, 180 days 0.48 SD 0.64; inflammation: before 1.67 SD 0.68, after 0.89 SD 0.32. All scores showed statistically significant reductions in both patient groups. The saphenous vein had been obliterated, 180 days after treatment, in 78% of the surgery group, compared with 90% in the foam sclerotherapy group. Conclusions: Ultrasound-guided foam sclerotherapy is a safe and effective option for patients with chronic venous disorders.
Journal of Ayub Medical College, Abbottabad : JAMC, 2019
Background Ultrasound guided foam sclerotherapy is an outdoor, office based and minimally invasive procedure for the treatment of varicose veins. This study was carried out to highlight the potential of foam sclerotherapy as a first line treatment for varicose vein. Methods This prospective observational study was conducted at CMH Rawalpindi, form 1 Aug 2017 to 30 Aug 2018The demographic and outcome data of the patients, who underwent ultrasound guided foam sclerotherapy, were collected and analysed. Results A total of 662 patients and 752 legs were treated with foam sclerotherapy. Four hundred and ten (61.93%) were males and 252 (38.06%) were females. Their ages ranged from 17 to 68 years with the mean age of 43.21 years. Six hundred and sixty-eight (88.82%) legs were having Great Saphenous Vein while 84 (11.17%) legs were having short saphenous vein disease. Maximum legs 256 (34.04%) had C3 disease. single session of Foam sclerotherapy was enough in 511 (67.95%) legs, while 197 (2...
Ultrasound guided foam sclerotherapy for varicose veins using two needle technique — A case series
Indian Journal of Surgery, 2010
Introduction Varicose veins are one of the most common vascular problems encountered. Ultrasound guided foam sclerotherapy is one such option it was introduced in 2001. We present our two needle technique of ultrasound guided foam sclerotherapy along with our short term results. Materials and methods Patients presenting us between January 2009 to October 2009 with symptomatic primary varicose veins were selected for this procedure.Ultrasound guided foam sclerotherapy was done using the two needle technique using sodium tetra decyl sulphate. Results Fifteen patients and 19 legs were treated. Complete closure of veins was achieved with a single injection at 1 month follow up in 17 legs. One leg required one additional injection and one leg required two injections. No recurrence has been noted at the end of a follow up of 1-6 months. Conclusion Foam sclerotherapy is an effective, less expensive day care procedure with minimal complication rates.
Role of foam sclerotherapy in management of varicose veins
IOSR Journals , 2019
Varicose veins affect up to 25% of women and 15% of men in the western world3 and incidence is apparently low in India.4Male preponderance was observed with male to female ratio 14:1 in Indian scenario.5 Sclerotherapy is a medical procedure used to eliminate varicose veins and spider veins which involves an injection of a solution (generally a salt solution) directly into the vein. The most commonly used is sodium tetradecyl sulphate. The solution irritates the lining of the blood vessel, causing it to swell and stick together, and the blood to clot.10 In this study various outcomes of injection sclerotherapy were studied and analyzed among patients coming to RIMS, Ranchi which is a tertiary care centre in Jharkhand. A total of 40 cases who underwent foam sclerotherapy were studied out of which, all had obliteration of VaricoseVeins. The secondary outcomes were symptomatic improvement, ulcer healing, recurrence, and adverse events. Adverse effects were pain (85%), pruritis (40%), swelling (17.5%) and thrombophlebitis (15%). Complete obliteration was achieved after one injection in all cases. Thrombosis and neurologic events were not seen. Hence,Foam Sclerotherapy appears to be a safe and effective outpatient therapy for the treatment of VaricoseVeins and hence can be used routinely.