Abstract
ObjectiveTo assess changes in the great saphenous vein (GSV) after foam sclerotherapy for varicose veins.Materials and MethodsThis was a prospective study of 33 patients who were treated with polidocanol foam sclerotherapy after having had varicose veins with a clinical severity-etiology-anatomy-pathophysiology classification of C4-C6 for three months. The patients were evaluated by ultrasound before, during, and after the procedure (on post-procedure days 7, 15, 30, 60, and 90). The GSV diameter, the rate of venous occlusion, and the rate of reflux elimination were determined. Two patients were excluded for having a history of deep vein thrombosis history, and one was excluded for having bronchial asthma.ResultsThirty patients (26 females and 4 males, with mean age of 62 years) completed the protocol. The mean pre-procedure GSV diameter was 6.0 ± 0.32 mm (range, 3.6-11.2 mm). During the sclerotherapy, the mean GSV diameter was reduced to 1.9 ± 0.15 mm (range, 0.6-3.8 mm). On post-procedure day 7, the mean GSV diameter increased to 6.3 ± 0.28 mm (range, 3.9-9.7 mm). On post-procedure day 90, the mean GSV diameter was 4.0 ± 0.22 mm (range, 1.9-8.2 mm). The rate of GSV reflux was significantly lower in the assessment performed on post-procedure day 90 than in the pre-procedure assessment (p < 0.0028).ConclusionOn the basis of our ultrasound analysis, we can conclude that foam sclerotherapy for varicose veins results in a significant reduction in GSV diameter, as well as in the elimination of GSV reflux.
Highlights
The ideal treatment for primary varicose veins in the lower extremities should be minimally invasive, repeated when necessary, and free from significant complications
Materials and Methods: This was a prospective study of 33 patients who were treated with polidocanol foam sclerotherapy after having had varicose veins with a clinical severity-etiology-anatomy-pathophysiology classification of C4–C6 for three months
The inclusion criteria were being ≥ 18 years of age; having lower-limb chronic venous insufficiency (CVI) classified as clinical stage C4, C5, or C6 according to the clinical severity-etiology-anatomypathophysiology (CEAP) classification[6]; and proximal, multisegmental, or diffuse reflux in the great saphenous vein (GSV)[7]
Summary
The ideal treatment for primary varicose veins in the lower extremities should be minimally invasive, repeated when necessary, and free from significant complications. It should be effective for eliminating points of reflux and reducing venous hypertension at the extremities, as well as being affordable, providing esthetic improvement, and requiring patients to take little time off from work[1]. The advent of Doppler vascular ultrasound has driven new endovascular treatment methods, such as laser photocoagulation, radiofrequency ablation, and foam sclerotherapy, the last having proven to be an attractive technique, 0100-3984 © Colégio Brasileiro de Radiologia e Diagnóstico por Imagem. Oliveira RG et al / Impact of foam sclerotherapy on saphenous vein diameter because anesthesia, hospital admission, and post-treatment bed rest are unnecessary[2]. Doppler vascular ultrasound is indispensable for performing the procedure and for follow up, because it can monitor occlusion of the vein and detect reflux relapses[5]
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