Duplex Ultrasonography–Guided Foam Sclerotherapy of Incompetent Perforator Veins in a Patient with Bilateral Venous Leg Ulcers

Abstract

background Recent advances in the form of foam sclerotherapy have extended the indications for sclerotherapy in the treatment of varicose veins. objectives (1) To see if perforator veins can be closed by using foam sclerotherapy; (2) to evaluate whether using foam sclerotherapy for treatment of incompetent perforator veins has an influence on venous leg ulcer healing. methods Incompetent perforator veins above bilateral venous leg ulcers were treated with duplex ultrasonography–guided sclerotherapy using polidocanol foam. results After 4 days, significant improvement in the ulcers was visible; after 10 days, one ulcer had closed; and within 3 weeks, both ulcers were closed. Control duplex ultrasonography showed closed perforator veins. conclusion This case illustrates that duplex ultrasonography–guided foam sclerotherapy is an effective and minimally invasive way of treating incompetent perforator veins. The fast healing of the venous leg ulcers in this case report indicates that foam sclerotherapy could be a promising addition in the treatment of venous leg ulceration with incompetent perforator veins.