Abstract
Background Varicose veins are dilated, tortuous, superficial veins usually seen on lower limbs. Various surgical modalities are available for varicose veins including open surgery (Trendelenburg operation), Endovenous Laser Ablation (EVLA), Radiofrequency Ablation (RFA) and Sclerotherapy. The aim of this study is to look for the outcome of adjunct sclerotherapy for varicose veins done as an adjunct with Radio Frequency Ablation. Objective To know the possible outcome regarding benefits and complications of adjunct sclerotherapy with Radio Frequency Ablation. MethodologyWe combined Radio Frequency Ablation of varicose veins with necessary phlebectomy and perforator ligation and performed adjunct sclerotherapy for residual significant varicosities with polidocanol (2%) mixed with 2 ml NS and 2 cc of air (Tessari method) to patients undergoing varicose vein surgery in between 2016 and 2017. Records on complications were enquired immediately following surgery and on 1st follow up done within 3–5 days of the procedure. ResultsAmong 256 limbs subjected to varicose veins surgery 51 limbs were given adjunct sclerotherapy. Among them, five limbs had perivenous spillage with some localized swelling while there was allergic reaction in one patient as immediate postprocedural complication. Nine limbs had painful thrombosed veins during early follow-up. ConclusionsAdjunct sclerotherapy showed complication rate of roughly one tenth and one fifth of the treated cases in immediate and early postoperative follow-up.
Highlights
Varicose veins are the dilated and tortuous super cial veins characterized by pain, itchiness, heavy sensation, pigmentation and sometimes ulceration [1]. ey are part of chronic venous disease spectrum along with telangiectasia and reticular veins, and possess high burden on health care resources [2]
In this study we aim to look at the occurrence of complications in patients undergoing adjunct sclerotherapy at Dhulikhel Hospital
Between January, 2016 and December, 2017 all cases subjected to Radiofrequency Ablation (RFA) were combined with necessary phlebectomy and perforator ligation, and for residual significant varicosities adjunct sclerotherapy was performed with polidocanol (2%) mixed with 2 ml NS and 2 cc of air (Tessari method) [20]
Summary
Varicose veins are the dilated and tortuous super cial veins characterized by pain, itchiness, heavy sensation, pigmentation and sometimes ulceration [1]. ey are part of chronic venous disease spectrum along with telangiectasia and reticular veins, and possess high burden on health care resources [2]. Minimal invasive surgeries in the form of laser and radiofrequency ablation (RFA) have higher clinical outcomes and patient satisfaction when compared to ligation surgery [5]. During such surgeries, a er RFA along with necessary perforator ligation and phlebectomy, if there are signi cant residual veins adjunct sclerotherapy is an additional modality that helps to reduce residual varicosities [6, 7]. Concomitant use of foam sclerotherapy and Endovenous Laser ablation (EVLA) have reduced reoperation rates and increased early quality of life [9] Despite this foam sclerotherapy is known for its complication rate and poor outcomes [10, 11]. Adjunct sclerotherapy showed complication rate of roughly one tenth and one h of the treated cases in immediate and early postoperative follow-up
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