Color duplex ultrasound-guided foam sclerotherapy: an approach in the management of patients with superficial varicosities of the lower extremity

Abstract

Background Duplex ultrasound-guided foam sclerotherapy (UGFS) is now considered a valuable option in varicose vein treatment; it is conducted as an outpatient procedure, and compared with surgery results in an earlier return to normal activities. Aim The objective of this study was to describe the efficacy, results, and safety of UGFS for treating superficial venous disease of the lower limbs. Patients and methods A total of 80 patients (28 males and 52 females) who were diagnosed to have clinical and radiological evidence of lower extremities venous diseases in the Department of Vascular Surgery at Qena and Assiut University Hospitals from November 2014 to November 2015 were included in the present study. Their ages ranged from 18 to 57 years. As considered suitable for UGFS, the foam was prepared by using Tessari's method. Any residual veins were treated with another session. Results A total of 80 patients presenting with symptomatic varicose veins of superficial system were included in the study. There were 52 (65%) female and 28 (35%) male patients, with a mean age of 55.76 ± 9.67 years. The affected segments of the superficial system that were treated were great saphenous (70.0%), small saphenous (17.5%), great saphenous vein and varices (6.25%), and small saphenous vein and varices (6.25%). After 1 year of follow-up, by using colored duplex ultrasound, 70% patients achieved complete occlusion, 15% had partial occlusion, and 80% showed improvement in the clinical, etiological, anatomical and pathological classification. Conclusion UGFS is a safe and effective treatment for superficial system varicosities, and an alternative to surgical treatment. Complications are few and appear as mostly self-limiting.