Fluoroscopy-guided foam sclerotherapy for varicose veins in the legs: A retrospective cohort analysis with long-term follow-up

Abstract

ObjectiveTo examine the long-term effectiveness of fluoroscopy-guided foam sclerotherapy for varicose veins in the legs. MethodsThis retrospective cohort study included consecutive patients who underwent fluoroscopy-guided foam sclerotherapy for varicose veins in the legs at the authors’ center during a period from August 1, 2011, to May 31, 2016. The last follow-up was conducted by a telephone/WeChat interactive interview in May 2022. Recurrence was defined as the presence of varicose veins regardless of symptoms. ResultsThe final analysis included 94 patients (58.3 ± 7.8 years of age; 43 men; 119 legs). The median Clinical-Etiology-Anatomy-Pathophysiology (CEAP) clinical class was 3.0 (interquartile range [IQR]: 3.0, 4.0). C5 and C6 accounted for 5.0% (6/119) of the legs. The average total amount of the foam sclerosant used during the procedure was 35 ± 12 mL (range: 10-75 mL). No patients developed stroke, deep vein thrombosis, or pulmonary embolism after the treatment. At the last follow-up, the median CEAP clinical class reduction was 3.0. All 119 legs except for class 5 achieved the CEAP clinical class reduction by at least one grade. The median venous clinical severity score was 2.0 (IQR: 1.0, 5.0) at the last follow-up vs 7.0 (IQR: 5.0, 8.0) at the baseline (P < .001). The recurrence rate was 30.9% (29/94) in the overall analysis, 26.6% (25/94) for the great saphenous vein and 4.3% (4/94) for the small saphenous vein (P < .001). Five patients received subsequent surgical treatment, and the remaining patients opted to receive conservative treatments. Among the two C5 legs at the baseline, ulcer recurred in one leg at 3 months after the treatment and healed after conservative treatments. In the four C6 legs at the baseline, ulcer healed within a month in all patients. The rate of hyperpigmentation was 11.8% (14/119). ConclusionsLong-term outcomes in patients undergoing fluoroscopy-guided foam sclerotherapy are satisfying, with minimal short-term safety concerns.