Sonographically guided, transcatheter foam sclerotherapy of the great saphenous vein

Phlebologie ◽  
2007 ◽  
Vol 36 (06) ◽  
pp. 309-312 ◽  
Author(s):  
T. Schulz ◽  
M. Jünger ◽  
M. Hahn
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Clinical Stage ◽  
Clinical Signs ◽  
Cost Effective ◽  
Duplex Sonography ◽  
Foam Sclerotherapy ◽  
Average Loss ◽  
One Year ◽  
The Cost

Summary Objective: The goal of the study was to assess the effectiveness and patient tolerability of single-session, sonographically guided, transcatheter foam sclerotherapy and to evaluate its economic impact. Patients, methods: We treated 20 patients with a total of 22 varicoses of the great saphenous vein (GSV) in Hach stage III-IV, clinical stage C2-C5 and a mean GSV diameter of 9 mm (range: 7 to 13 mm). We used 10 ml 3% Aethoxysklerol®. Additional varicoses of the auxiliary veins of the GSV were sclerosed immediately afterwards. Results: The occlusion rate in the treated GSVs was 100% one week after therapy as demonstrated with duplex sonography. The cost of the procedure was 207.91 E including follow-up visit, with an average loss of working time of 0.6 days. After one year one patient showed clinical signs of recurrent varicosis in the GSV; duplex sonography showed reflux in the region of the saphenofemoral junction in a total of seven patients (32% of the treated GSVs). Conclusion: Transcatheter foam sclerotherapy of the GSV is a cost-effective, safe method of treating varicoses of GSV and broadens the spectrum of therapeutic options. Relapses can be re-treated inexpensively with sclerotherapy.

Cost-utility analysis of great saphenous vein ablation with radiofrequency, foam and surgery in the emerging health-care setting of Thailand

2016 ◽  
Vol 31 (8) ◽  
pp. 573-581 ◽  
Author(s):  
Boonying Siribumrungwong ◽  
Pinit Noorit ◽  
Chumpon Wilasrusmee ◽  
Pattara Leelahavarong ◽  
Ammarin Thakkinstian ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Cost Effective ◽  
Quality Adjusted Life Year ◽  
Cost Utility ◽  
Ultrasound Guided ◽  
Foam Sclerotherapy ◽  
One Year ◽  
Quality Adjusted Life

Objectives To conduct economic evaluations of radiofrequency ablation, ultrasound-guided foam sclerotherapy and surgery for great saphenous vein ablation. Method A cost-utility and cohort analysis from societal perspective was performed to estimate incremental cost-effectiveness ratio. Transitional probabilities were from meta-analysis. Direct medical, direct non-medical, indirect costs, and utility were from standard Thai costings and cohort. Probabilistic sensitivity analysis was performed to assess parameter uncertainties. Results Seventy-seven patients (31 radiofrequency ablation, 19 ultrasound-guided foam sclerotherapy, and 27 surgeries) were enrolled from October 2011 to February 2013. Compared with surgery, radiofrequency ablation costed 12,935 and 20,872 Baht higher, whereas ultrasound-guided foam sclerotherapy costed 6159 lower and 1558 Bath higher for outpatient and inpatient, respectively. At one year, radiofrequency ablation had slightly lower quality-adjusted life-year, whereas ultrasound-guided foam sclerotherapy yielded additional 0.025 quality-adjusted life-year gained. Because of costing lower and greater quality-adjusted life-year than other compared alternatives, outpatient ultrasound-guided foam sclerotherapy was an option being dominant. Probabilistic sensitivity analysis resulted that at the Thai ceiling threshold of 160,000 Baht/quality-adjusted life-year gained, ultrasound-guided foam sclerotherapy had chances of 0.71 to be cost-effective. Conclusions Ultrasound-guided foam sclerotherapy seems to be cost-effective for treating great saphenous vein reflux compared to surgery in Thailand at one-year results.

Catheter-directed foam sclerotherapy for insufficiency of the great saphenous vein: occlusion rates and patient satisfaction after one year

2013 ◽  
Vol 28 (2) ◽  
pp. 80-85 ◽  
Author(s):  
C Williamsson ◽  
P Danielsson ◽  
L Smith
Keyword(s):  
Patient Satisfaction ◽  
Side Effects ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Technical Development ◽  
Single Treatment ◽  
Foam Sclerotherapy ◽  
Vein Occlusion ◽  
Occlusion Rate ◽  
One Year

Objectives This study aims to describe a technique for catheter-directed foam sclerotherapy (CDS) of great saphenous vein (GSV) insufficiency and report occlusion rate and patient satisfaction after a single treatment. Methods About 100 patients were included. The GSV was accessed at knee level. With the method of Tessari 10 mL sclerosant foam was made (2 mL 3% polidocanol and 8 mL air) and delivered along the GSV while the catheter was withdrawn. At two weeks and at one year after treatment the patients were evaluated. Results CDS was successfully performed in 94 of the 100 patients. After one year, 84% of the patients were satisfied. Seventy percent of the GSV were completely occluded, 14% were partly occluded and 15% were recanalized. No serious side-effects occurred. Conclusions CDS is safe. Patient satisfaction is very satisfying and the occlusion rate is promising after a single treatment. Repeated treatments and technical development may achieve higher occlusion rates.

Outcome four years after transcatheter foam sclerotherapy of the greater saphenous vein

Phlebologie ◽  
2008 ◽  
Vol 37 (05) ◽  
pp. 237-240 ◽  
Author(s):  
T. Schulz ◽  
M. Jünger ◽  
M. Hahn
Keyword(s):  
Saphenous Vein ◽  
Clinical Symptoms ◽  
Clinical Stage ◽  
Clinical Signs ◽  
Vessel Diameter ◽  
Long Term Results ◽  
Single Session ◽  
Foam Sclerotherapy ◽  
Clinical Recurrence

SummaryThe aim of the study was to evaluate the long-term results 4 years after a single-session, sonographically guided, transcatheter foam sclerotherapy. Patients, methods: We treated 20 patients with a total of 22 legs with varicoses of the greater saphenous vein (GSV, EpAsPr). Additional varicoses of the auxiliary veins of the GSV were sclerosed immediately afterwards. 20 legs or 91% in Hach stage III-IV, clinical stage C2-C5 and a mean GSV diameter of 9 mm (range: 7 to 13 mm) could be followed up 4 years later. Results: During the follow up period one leg showed clinical signs of recurrence and underwent surgery, two legs received a single additional sclerotherapy during the four years period. Examination four years after showed in 6 legs clinical signs of recurrence without notice of clinical symptoms by the patients. This gives a clinical recurrence rate of 40% (8 of 20 patients). Duplex sonography showed flow in the region of the saphenofemoral junction in a total of 13 legs (65% of the reexamined GSVs) with an average vessel diameter of 3.7 ± 1.6mm (range 2 to 7 mm). Retreatments in 3 GSV of the 6 clinically relapsed GSV by a single injection of sclerosing foam showed an occlusion in 100% two weeks after. Conclusion: Transcatheter foam sclerotherapy of the GSV shows better clinical long-term results compared to known data of liquid sclerotherapy. Sonographically detected recurrency of the GSV could easily be retreated by a single session of foam sclerotherapy. Foam sclerotherapy is a promising and seriously to be taken option in the treatment of the insufficient GSV.

Catheter-directed foam sclerotherapy treatment of saphenous vein incompetence

VASA ◽  
2012 ◽  
Vol 41 (2) ◽  
pp. 120-124 ◽  
Author(s):  
Asciutto ◽  
Lindblad
Keyword(s):  
Saphenous Vein ◽  
Short Term ◽  
Foam Sclerotherapy ◽  
Results Of Treatment ◽  
Ulcer Healing Rate ◽  
Complete Obliteration ◽  
Ceap Classification ◽  
One Year ◽  
The One

Background: The aim of this study is to report the short-term results of catheter-directed foam sclerotherapy (CDFS) in the treatment of axial saphenous vein incompetence. Patients and methods: Data of all patients undergoing CDFS for symptomatic primary incompetence of the great or small saphenous vein were prospectively collected. Treatment results in terms of occlusion rate and patients’ grade of satisfaction were analysed. All successfully treated patients underwent clinical and duplex follow-up examinations one year postoperatively. Results: Between September 2006 and September 2010, 357 limbs (337 patients) were treated with CDFS at our institution. Based on the CEAP classification, 64 were allocated to clinical class C3 , 128 to class C4, 102 to class C5 and 63 to class C6. Of the 188 patients who completed the one year follow up examination, 67 % had a complete and 14 % a near complete obliteration of the treated vessel. An ulcer-healing rate of 54 % was detected. 92 % of the patients were satisfied with the results of treatment. We registered six cases of thrombophlebitis and two cases of venous thromboembolism, all requiring treatment. Conclusions: The short-term results of CDFS in patients with axial vein incompetence are acceptable in terms of occlusion and complications rates.

scholarly journals LEV 3. Outcomes of Ultrasound-Guided Catheter-Directed Foam Sclerotherapy With or Without Perivenous Tumescent Enhancement in the Treatment of Great Saphenous Vein Reflux

2018 ◽  
Vol 68 (5) ◽  
pp. e127
Author(s):  
Pharawee Prayoonhong ◽  
Suthas Horsirimanont ◽  
Wiwat Tirapanich ◽  
Sopon Jirasiritum ◽  
Surasak Leela-Udomlipi ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Ultrasound Guided ◽  
Foam Sclerotherapy ◽  
Vein Reflux

Prospective five-year study of ultrasound-guided foam sclerotherapy in the treatment of great saphenous vein reflux

2009 ◽  
Vol 24 (4) ◽  
pp. 183-188 ◽  
Author(s):  
P Chapman-Smith ◽  
A Browne
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Duplex Ultrasound ◽  
Adverse Outcomes ◽  
Patient Acceptance ◽  
Ultrasound Guided ◽  
Foam Sclerotherapy ◽  
Clinical Recurrence ◽  
Over Time

Objectives The purpose of this study was to determine the long-term efficacy, safety and rate of recurrence for varicose veins associated with great saphenous vein (GSV) reflux treated with ultrasound-guided foam sclerotherapy (UGFS). Methods A five-year prospective study was performed, recording the effect on the GSV and saphenofemoral junction (SFJ) diameters, and reflux in the superficial venous system over time. UGFS was the sole treatment modality used in all cases, and repeat UGFS was performed where indicated following serial annual ultrasound. Results No serious adverse outcomes were observed – specifically no thromboembolism, arterial injection, anaphylaxis or nerve damage. There was a 4% clinical recurrence rate after five years, with 100% patient acceptance of success. Serial annual duplex ultrasound demonstrated a significant reduction in GSV and SFJ diameters, maintained over time. There was ultrasound recurrence in 27% at 12 months, and in 64% at five years, including any incompetent trunkal or tributary reflux even 1 mm in diameter being recorded. Thirty percent had pure ultrasound recurrence, 17% new vessel reflux and 17% combined new and recurrent vessels on ultrasound. Of all, 16.5% required repeat UGFS treatment between 12 and 24 months, but less than 10% in subsequent years. The safety and clinical efficacy of UGFS for all clinical, aetiological, anatomical and pathological elements classes of GSV reflux was excellent. Conclusion The popularity of this outpatient technique with patients reflects ease of treatment, lower cost, lack of downtime and elimination of venous signs and symptoms. Patients accept that UGFS can be repeated readily if required for recurrence in this common chronic condition. The subclinical ultrasound evidence of recanalization or new vein incompetence needs to be considered in this light.

Sign in / Sign up

Export Citation Format

Share Document