Technical Feasibility and Early Results of Radiologically Guided Foam Sclerotherapy for Treatment of Varicose Veins

Abstract

Duplex ultrasound guidance of foam sclerotherapy has been established as a routine and standard treatment of varicose veins, but duplex-guided technique is not perfect because of its inherent shortcomings, and correlative complications have been reported. Moreover, not every country or region of the world can use duplex ultrasound guidance for foam sclerotherapy. To describe an original technique of using radiologically guided foam sclerotherapy for the treatment of leg varicose veins and to evaluate the technical feasibility and early results. Fifty-nine legs of 41 patients (23 male, 18 female; median age 47, range 25-75) with leg varicose veins treated using radiologically guided foam sclerotherapy were assessed. Polidocanol 1% was foamed 1:4 with air using the Tessari method. Foam sclerotherapy of the superficial varicosities and the great saphenous veins (GSVs) were performed using the filling-defects technique under radiologic guidance. Postoperative compression was maintained for 15 days. Clinical outcome was assessed according to clinical criteria. The procedure was technically successful in all 59 legs. At a median 9.0 months (range 6-12 months) of follow-up, the clinical outcome was full success in 53 legs (89.8%), and partial success in six legs (10.2%). There was no evidence of recurrence of varices or GSV reflux during follow-up. Minor complications included skin pigmentation in 27 legs (45.8%), and superficial thrombophlebitis in 18 legs (30.5%). No major complications or systemic events occurred. Radiologically guided foam sclerotherapy could be a safe, effective, and technically feasible treatment for varicose veins.