VARICOSE VEINS STAGE DOWN BEFORE SURGERY

Abstract

Background: For many people, varicose veins and spider veins are simply a cosmetic concern. For other people, varicose veins can cause aching pain and discomfort. Sometimes varicose veins lead to more-serious problems. Objective: To evaluate the effect of staging down of the lower limb varicose veins by injection sclerotherapy before surgical treatment in comparison with the standard procedure. Patients and Methods: Included 40 patients, aged 25–42 years (Range), who were recruited from the outpatient clinic of the Department of Vascular Surgery, Al-Hussein University Hospital. All patients were followed up monthly for 6 months. The duration of the study had been from 6 to 12 months from July 2018 to July 2019. Patients were divided into 2 groups: group I: In this group patients with varicose veins were treated stage down before surgery and control group: This was an age and sex matched group of patients with the first group. The clinical and hemodynamic assessments were carried on. Duplex ultrasound was done at the end of follow up period to detect the degree of improvement. Results: Mean duration of varicose veins was 3.0 ±0.2 with a range of (1.5-5) years. Varicose veins were distributed in leg in 50% of group I and 70% of group II. Median baseline anatomical extent of varicose veins was 5 and 6 in group I and II respectively with range of 4-9. As regard symptoms, aching was present in 5% of cases,, heaviness was in 5%, itching in 10% of cases, cosmetic concerns was in 5%, swelling in 0% of cases. Regarding post intervention complications, pain was present in 15% of cases, swelling in 5%, bruising in 10% of cases, and discoloration in 0%, and pigmentation in 10% of cases. As regard comparison of the two groups regarding the patient satisfaction score, 40% of cases were highly satisfied in group one, compared with 25% of cases of group II. There was a high significant improvement of anatomical extent of varicose veins over 6 months follow up period. Conclusion: Sclerotherapy before surgical treatment provided symptomatic relief and significant improvements and patient satisfaction in patients diagnosed with uncomplicated varicose veins.