Ambulatory and haemodynamic treatment of venous insufficiency by ultrasound-guided sclerotherapy (ESEC cure)

Abstract

SummaryOptimal treatment for venous insufficiency is still conflicting. Aim of this study was to assess long term outcome of a new method of sclerosis for treatment of primary varicose veins. Methods: ESEC (Echo-Sclerosis haEmodynamic Conservative) technique is a new treatment for varicose veins that combines sclerotherapy and haemodynamic principles. Super-selective sclerosis of a saphenous branch or saphenous trunk interrupts venous pressure column (primary cause of venous stasis) over a reentry confluence. Advantageous new drainages into deep circulation through saphenous junctions and perforating veins follow. Results: A total of 146 ESECs (107 great, 24 small, and 15 accessory saphenous veins) with at least two years follow up were analysed. There was no treatment failure. At 14 years, 100% of visible varicosities were successfully clinically treated (complete absence, or minor varicosities or symptoms after treatment). Cosmetic outcome was assessed by the patients as good (excellent or fair cosmesis). Over 14 years, repeated treatment was required with a mean of 2.16/case. Mean vein diameter decrease was 52%. Conclusion: ESEC technique is efficient, safe, in-office manageable and easily repeatable. It might be considered as the primary treatment for most varicose patients. Large comparative study assessing cost-efficacy and patient satisfaction from a life-long point of view are needed.