Incidence of Side Effects Using Carbon Dioxide–Oxygen Foam for Chemical Ablation of Superficial Veins of the Lower Extremity

Abstract

Objectives To determine the incidence of side effects following treatment of varicose veins with carbon dioxide–oxygen (CO 2/O 2) foam sclerotherapy, and to compare results with historical controls using CO 2- or air-based foams. Design Cohort study with prospective data collection, private clinic setting. Patients The patient population consisted of one hundred patients, 95% women, age 52 SD 13 years-old, CEAP class C 2EpAsPr. Methods Patients underwent ultrasound-guided foam sclerotherapy following thermal ablation of saphenous trunks; 1–3% polidocanol and 70%CO 2–30%O 2 gas were mixed in a 1:4 proportion. Volume injected averaged 22 SD 11 (range: 2–46) mL. Vital signs were monitored for 1 h; side effects were recorded up to 24 h post treatment. Incidence of side effects was compared to CO 2- and air-based foam data. Results Heart rate decreased from 73 SD 11 at the start to 68 SD 9 bpm ( p < 0.001, paired t-test) following the procedure. Systolic and diastolic pressures, 127/75 SD 18/14 mmHg, respiratory rate, 15 SD 4 rpm and pO 2, 98 SD 2%, did not change significantly. Itching (7) or leg pain (24) reporting was similar to that for air-based foam ( p = NS). Lack of reported chest tightness and/or dry cough was superior to our previous data with CO 2 or air foam ( p < 0.05). Reporting of dizziness (1) was less than that for air-based foam ( p = 0.002). The incidence of visual disturbance (2%), was comparable with that for CO 2 (3%) or air (8%) foam, but too few cases were available for meaningful statistical analysis. Conclusions Foam sclerotherapy using CO 2/O 2 foam was well tolerated by patients and resulted in fewer side effects than similar treatment using air foams.