Effectiveness and safety of ultrasound-guided foam sclerotherapy for recurrent varicose veins: immediate results.

Abstract

PURPOSE:

To evaluate the effectiveness and safety of ultrasound-guided foam sclerotherapy in treating recurrent varicose veins.

METHODS:

Between July 2003 and January 2005, 38 outpatients (25 women; median age 59 years, interquartile range 53.5-66.0) with recurrent varicose veins in 45 legs were treated. Ultrasound was used to identify sites of reflux. The Tessari method was used to produce foam using 3% sodium tetradecyl sulphate; up to 6 mL of foam was injected per session under ultrasound control. Results are shown as median (interquartile range).

RESULTS:

A single sclerotherapy session was adequate in 26 (58%) legs. In 87% of all legs, complete elimination of both varicose veins and all reflux points was achieved. A positive association between the amount of injected foam and CEAP class (r=0.45, p=0.002) and venous clinical severity score (r=0.37, p=0.012) was found. There was a trend for more sclerotherapy sessions [median 2 (1-2)] in legs with incomplete saphenofemoral junction/ great saphenous vein (GSV) ligation or accessory GSV (n=16) to achieve varicose vein ablation versus legs with other primary sites of reflux [median 1 (1-2), p=0.12]. There were no instances of deep vein thrombosis or systemic complications; superficial thrombophlebitis occurred in 6 (8.2%) of the 73 injection sessions. Legs with proximal reflux due to previous incomplete ligation or fed by an incompetent pelvic vein experienced superficial thrombophlebitis more frequently (4/12, 33%) than legs without proximal reflux [1/33 (3%); OR 16, 95% CI 1.6-164, p=0.014].

CONCLUSION:

In most patients, ultrasound-guided foam sclerotherapy is a safe treatment for recurrent varicose veins, with an excellent immediate result. However, the presence of proximal reflux may decrease the immediate results and predispose to superficial thrombophlebitis.

• Authors: Stavros K Kakkos, Dimitrios G Bountouroglou, Mustafa Azzam, Evi Kalodiki, Marios Daskalopoulos, George Geroulakos
• Journal: Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists (J Endovasc Ther) Vol. 13 Issue 3 Pg. 357-64 (Jun 2006) ISSN: 1526-6028 [Print] United States
• PMID: 16784324 (Publication Type: Journal Article)

Chemical References

• Sclerosing Solutions
• Sodium Tetradecyl Sulfate

Topics

• Aged
• Female
• Humans
• Incidence
• Male
• Middle Aged
• Recurrence
• Retrospective Studies
• Sclerosing Solutions (adverse effects, therapeutic use)
• Sclerotherapy
• Severity of Illness Index
• Sodium Tetradecyl Sulfate (adverse effects, therapeutic use)
• Thrombophlebitis (epidemiology, etiology)
• Treatment Outcome
• Ultrasonography, Interventional
• Varicose Veins (diagnostic imaging, prevention & control, therapy)