This study aimed to investigate the efficacy of foam sclerotherapy in the treatment of tortuous Great Saphenous Vein (GSV) insufficiency.
Methods
In this prospective non-randomized study 62 patients with tortuous GSV insufficiency were included. All patients were delivered sclerosant agent in the form of foam into the GSV through a cannula above the knee level. Characteristics of patients, diameter of veins, reflux grades, Venous Clinical Severity Score (VCSS) and Clinical, Etiological, Anatomical, Pathological (CEAP) scores, concentration of sclerosant agent, complications and follow-up results were recorded.
Results
Foam sclerotheraphy was performed with 100% technical success in all patients at operative room. There were no allergic reactions or neurological complications during and after the operations. Ecchymosis was the most common complication with 37.1% frequency. . VCSS scores significantly decreased from 6.43% to 2.53%, during follow-up from initial admission to sixth months, respectively (P<0.05).In the first month parameters, successful occlusion rate was 88.7%, whereas its rate was 82.3% in sixth month. Recanalization rate significantly increased from 11.3% to 17.7% during follow-up from first to sixth months, respectively (P<0.05).
Conclusions
Due to its low complication rate, low cost, acceptable total occlusion rate and reproducibility; Foam sclerotherapy can be considered a reliable treatment for patients with tortuous GSV insufficiency.
Beebe-DimmerJLPfeiferJREngleJS, et al.The epidemiology of chronic venous insufficiency and varicose veins. Ann Epidemiology2005; 15(3): 175–184.
2.
TeruyaTHBallardJL. New approaches for the treatment of varicose veins. Surg Clin North America2004; 84(5): 1397–1417.
3.
NavarroLMinRJBonéC. Endovenous laser: a new minimally invasive method of treatment for varicose veins—preliminary observations using an 810 nm diode laser. Dermatol Surgery2001; 27(2): 117–122.
4.
EklöfBRutherfordRBBerganJJ, et al.Revision of the CEAP classification for chronic venous disorders: consensus statement. J Vasc Surg2004; 40(6): 1248–1252.
5.
RutherfordRBPadbergFTJrComerotaAJ, et al.Venous severity scoring: an adjunct to venous outcome assessment. J Vasc Surg2000; 31(6): 1307–1312.
6.
LurieFCretonDEklofB, et al.Prospective randomized study of endovenous radiofrequency obliteration (closure procedure) versus ligation and stripping in a selected patient population (EVOLVeS Study). J Vascular Surgery2003; 38(2): 207–214.
7.
BiemansA A MKockaertMAkkersdijkG P, et al.Comparing endovenous laser ablation, foam sclerotherapy, and conventional surgery for great saphenous varicose veins. J Vasc Surg2013; 58(3): 727–734.
8.
Hamel-DesnosC. Etude 3/1. Mousse de polidocanol 3% versus 1% dans la grande veine saphene: premiers resultants= Study 3/J. Poudocanol foam 3% versus 1% in the great saphenous vein: early results. Phlébologie2005; 58: 165–173.
9.
BelcaroGCesaroneM RDi RenzoA, et al.Foam-sclerotherapy, surgery, sclerotherapy, and combined treatment for varicose veins: a 10-year, prospective, randomized, controlled, trial (VEDICO trial). Angiology2003; 54(3): 307–315.
10.
MyersK AJolleyDCloughA, et al.Outcome of ultrasound-guided sclerotherapy for varicose veins: medium-term results assessed by ultrasound surveillance. Eur Journal Vascular Endovascular Surgery2007; 33(1): 116–121.
11.
Coleridge SmithP. Sclerotherapy and foam sclerotherapy for varicose veins. Phlebology: J Ven Dis2009; 24(6): 260–269.
12.
TessariLCavezziAFrulliniA. Preliminary experience with a new sclerosing foam in the treatment of varicose veins. Dermatol Surgery2001; 27(1): 58–60.
13.
BreuF-XGuggenbichlerS. European Consensus Meeting on Foam Sclerotherapy, April, 4-6, 2003, Tegernsee, Germany. Dermatol Surg2004; 30(5): 709–717.
14.
Hamel-DesnosCOuvryPBenigniJP, et al.Comparison of 1% and 3% polidocanol foam in ultrasound guided sclerotherapy of the great saphenous vein: a randomised, double-blind trial with 2 year-follow-up. "The 3/1 Study". EJVES2007; 34(6): 723–730.
15.
BlaiseSBossonJLDiamandJM. Ultrasound-guided sclerotherapy of the great saphenous vein with 1% vs. 3% polidocanol foam: a multicentre double-blind randomised trial with 3-year follow-up. EJVES2010; 39(6): 779–786.
16.
ShadidNCeulenRNelemansP, et al.Randomized clinical trial of ultrasound-guided foam sclerotherapy versus surgery for the incompetent great saphenous vein. Br J Surg2012; 99(8): 1062–1070.
17.
CabreraJRedondoPBecerraA, et al.Ultrasound-guided injection of polidocanol microfoam in the management of venous leg ulcers. Arch Dermatology2004; 140(6): 667–673.
RasmussenLHLawaetzMBjoernL, et al.Randomized clinical trial comparing endovenous laser ablation, radiofrequency ablation, foam sclerotherapy and surgical stripping for great saphenous varicose veins. Br J Surg2011; 98(8): 1079–1087.
20.
YANGC-HCHOUH-SLOY-F. Incompetent great saphenous veins treated with endovenous 1,320‐nm laser: results for 71 legs and morphologic evolvement study. Dermatol Surg2006; 32(12): 1453–1457.
21.
FanC-MRox-AndersonR. Endovenous laser ablation: mechanism of action. Phlebology2008; 23: 206–213.
22.
WilliamssonCDanielssonPSmithL. Catheter-directed foam sclerotherapy for insufficiency of the great saphenous vein: occlusion rates and patient satisfaction after one year. Phlebology2013; 28(2): 80–85.
CavezziAMostiGCampanaF, et al.Catheter foam sclerotherapy of the great saphenous vein, with perisaphenous tumescence infiltration and saphenous irrigation. EJVES2017; 54(5): 629–635.
25.
VenermoMSaarinenJEskelinenE, et al.Randomized clinical trial comparing surgery, endovenous laser ablation and ultrasound-guided foam sclerotherapy for the treatment of great saphenous varicose veins. Br J Surg2016; 103(11): 1438–1444.
26.
JiaXMowattGBurrJM, et al.Systematic review of foam sclerotherapy for varicose veins. Br J Surg2007; 94(8): 925–936.
27.
GilletJ-LGuedesJMGuexJ-J, et al.Side-effects and complications of foam sclerotherapy of the great and small saphenous veins: a controlled multicentre prospective study including 1025 patients. Phlebology2009; 24(3): 131–138.
28.
MorrisonNNeuhardtDLRogersCR, et al.Incidence of side effects using carbon dioxide-oxygen foam for chemical ablation of superficial veins of the lower extremity. Eur J Vasc Endovascular Surg2010; 40(3): 407–413.
29.
CeulenRPBullens-GoessensYIPi-VAN DE VenneSJ, et al.. Outcomes and side effects of duplex-guided sclerotherapy in the treatment of great saphenous veins with 1% versus 3% polidocanol foam: results of a randomized controlled trial with 1-year follow-up. Dermatol Surgery2007; 33: 276–281.
30.
OuvryPAllaertF-ADesnosP, et al.Efficacy of polidocanol foam versus liquid in sclerotherapy of the great saphenous vein: a multicentre randomised controlled trial with a 2-year follow-up. EJVES2008; 36(3): 366–370.
31.
AlòsJCarreñoPLópezJ A, et al.Efficacy and safety of sclerotherapy using polidocanol foam: a controlled clinical trial. EJVES2006; 31(1): 101–107.
