Functional Meaning of Different Injection Levels in the Course of Sclerotherapy

Abstract

The successive changes of vein function in the course of sclerotherapy were studied by non-invasive photoplethysmography. The effect of injection at different levels was analysed in 30 patients, 22 with long saphenous varicosis, four with short saphenous varicosis and four with long saphenous varicosis and leg ulcers. The first two groups were treated by injections descending from the *crosse (saphenofemoral or saphenopo-pliteal junction) according to the method of Tournay. The third group (with leg ulcers) were treated by ascending injections, beginning adjacent to the ulcer and ending with crosse injection. Three case-reports are given, of one in each group, to show the typical changes of vein function in the different sclerosing methods. Crosse obliteration proved to be the most important step in improving vein function. It was followed by sclerosing of perforators of the lower leg, which influenced vein function in varying ways. Sclerosing remaining varicose dilations only optimized the cosmetic results without any measurable effect on vein function. According to our observations, failure to correct sapheno-femoral respectively sapheno-popliteal incompetence is inadequate treatment.