Periprocedural management of sclerotherapy in patients with telangiectasias of the lower extremities

Abstract

Objective — to reveal the effect of certain medicinal and non­medicinal factors that can be applied before and after the sclerotherapy procedure on the final result of the treatment. Materials and methods. The study included 104 patients aged 18 to 60 years who underwent sclerotherapy for the treatment of telangiectasias and reticular varicosities of the lower extremities. Patients were divided into subgroups depending on the appointment of phlebotonics and external means after the procedure. Results were evaluated 1, 3, and 6 months after treatment. Results and discussion. According to the self-assessment of patients, the best cosmetic result was achieved in the subgroup that used phlebotonics in combination with external therapy with heparin sodium gel, compared to the subgroups in which phlebotonics were not prescribed (p < 0.01). In the subgroup where only phlebotonics were used, the result was also better compared to the subgroups in which phlebotonics were not prescribed (p = 0.03; p < 0.01). Self-administration of sodium heparin gel did not provide a statistically significant improvement when comparing the subgroups (p = 0.26). No statistically significant difference in disease recurrence was found between the subgroups (p = 0.729). Conclusions. Ultrasound Doppler mapping with a detailed definition of the feeding sources of the reticular veins and telangiectasias allows determining the optimal stages of treatment to prevent the recurrence of the disease. The appointment of phlebotonics in the post­procedure period has a positive effect on the cosmetic result of sclerotherapy, especially in combination with external therapy with heparin sodium salt gel (p < 0.01). The use of phlebotonics and gel with heparin sodium salt does not affect the number of relapses of the disease (p = 0,729), which is probably due to the technical impossibility of detecting feeding sources in the pre­procedural period.