Treatment of severe chronic venous insufficiency with ultrasound-guided foam sclerotherapy: A two-year series in a single center in Brazil

2013 ◽  
Vol 30 (2) ◽  
pp. 113-118 ◽  
Author(s):  
F Coelho Neto ◽  
GR de Araújo ◽  
I Moraes Kessler ◽  
R Fernandes Batista de Amorim ◽  
D Pinheiro Falcão
Keyword(s):  
Ulcer Healing ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Low Cost ◽  
Federal District ◽  
P Value ◽  
Ultrasound Guided ◽  
Foam Sclerotherapy ◽  
Advanced Stages ◽  
Level Of Significance

Objectives To portray the initial experience at a public health center of the Federal District of Brazil in the treatment of chronic venous insufficiency with ultrasound-guided foam sclerotherapy in patients in advanced stages of the disease. Method Eighty-seven reports of patients in C5 and C6 stages, according to CEAP classification, were evaluated for clinical improvements, ulcer-healing rates, and complications of ultrasound-guided foam sclerotherapy. McNemar test was used for statistical analysis with the level of significance set at 5% ( P-value, 0.05). Results The results showed high rates of ulcer healing (85%) and significant improvement of symptoms after treatment, such as pain, heaviness, fatigue, burning, paresthesia, and itching ( P < 0.0001). Conclusions An outpatient, low-cost and high-resolution technique, without the need for hospitalization and use of the operating room showed to be a safe and effective alternative for the treatment of varicose disease associated with severe chronic venous insufficiency.

scholarly journals Ultrasound-guided foam sclerotherapy for severe chronic venous insufficiency

2017 ◽  
Vol 44 (5) ◽  
pp. 511-520 ◽  
Author(s):  
Guilherme Camargo Gonçalves de-Abreu ◽  
Otacílio de Camargo Júnior ◽  
Márcia Fayad Marcondes de-Abreu ◽  
José Luís Braga de-Aquino
Keyword(s):  
Minimally Invasive ◽  
Lower Limb ◽  
Chronic Venous Insufficiency ◽  
Thermal Ablation ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Venous Hypertension ◽  
Ultrasound Guided ◽  
Foam Sclerotherapy ◽  
New Techniques

ABSTRACT Chronic venous insufficiency is characterized by cutaneous alterations caused by venous hypertension; in severe forms, it progresses to lower limb ulcers. Lower limb varicose veins are the main cause of chronic venous insufficiency, and the classic treatment includes surgery and compressive therapy. Minimally invasive alternative treatments for varicose veins include new techniques such as venous thermal ablation using laser or radiofrequency. The use of different methods depends on clinical and anatomical factors. Ultrasound-guided foam sclerotherapy is the venous injection of sclerosing foam controlled by Doppler ultrasound. Sclerotherapy is very useful to treat varicose veins, and probably, is cheaper than other methods. However, until the present, it is the less studied method.

scholarly journals Association of great saphenous vein diameter and clinical severity score after treatment of severe chronic venous insufficiency with foam sclerotherapy

2021 ◽  
Vol 11 (4) ◽  
pp. 102-107
Author(s):  
Melissa Andreia De Moraes Silva ◽  
Luiz Henrique Silva de Sordi ◽  
Lara Camargo Rezende Grillo ◽  
Elisa de Paula Garcia ◽  
Luisa Resende Silva ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Ulcer Healing ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Healing Rate ◽  
Clinical Severity ◽  
Foam Sclerotherapy ◽  
Ulcer Healing Rate ◽  
Ceap Classification

Objectives: to evaluate the association of the greater saphenous vein (GSV) diameter in the treatment of patients with severe chronic venous insufficiency (C6 CEAP classification) with ultrasound-guided polidocanol foam sclerotherapy (UGFS).  Methods: A prospective, descriptive and analytical study of 28 patients (30 limbs) that underwent UGFS. Patients were divided into 2 subgroups by GSV diameter (< 8 mm and ≥ 8 mm). Variables analyzed were ulcer healing, clinical intercurrences, clinical CEAP classification, Venous Clinical Severity Score (VCSS), diameter of the treated vein and presence of occlusion or recanalization by Doppler ultrasound. Patients were analyzed at the 1st, 3rd, and 6th months post-treatment. Results: The average age was 68.7 ± 10.5 years, 23 (82,1%) were women, and the average body mass index was 29.2 kg/m2. Although an improvement in VCSS score was observed during follow-up, no significant intergroup difference was noted. Seventeen (56%) limbs presented occlusion of the treated vein at the 1st month, 11 (36%) at the 3rd month, and 9 (30%) at the 6th month of follow-up. The ulcer healing rate was 56,6%. The average ulcer healing time was 90 days. Three (10%) patients presented with ulcer recurrence at the 6th month.  Survival analysis showed no significant difference in ulcer healing rate between subgroups after one year of follow-up (log-rank, p = 0,178). Conclusion: There was no difference between the subgroups of large and small VSM diameter in terms of symptom severity. However, significant reduction of VCSS and pain relief was observed after foam sclerotherapy.

Ultrasound-guided foam sclerotherapy within a rolling treatment programme is an effective low-cost treatment for superficial venous insufficiency

2012 ◽  
Vol 28 (4) ◽  
pp. 195-200 ◽  
Author(s):  
N Abbassi-Ghadi ◽  
H Hafez
Keyword(s):  
Venous Insufficiency ◽  
Low Cost ◽  
Treatment Session ◽  
Lower Limbs ◽  
Maximum Diameter ◽  
Treatment Programme ◽  
Ultrasound Guided ◽  
Foam Sclerotherapy ◽  
Superficial Venous Insufficiency

Aims To review the results and cost of a rolling ultrasound-guided foam sclerotherapy (UGFS) treatment programme for patients with chronic superficial venous insufficiency. Method A prospective study of a rolling treatment programme where patients were offered unlimited follow-up at intervals of 6–8 weeks and further (top up) UGFS when necessary, until occlusion criteria were met. Results A total of 213 lower limbs with complete follow-up were included in the study. Median (range) age was 57 (16–94) years, maximum diameter of varicose vein was 10 (3–18) mm, C of CEAP (clinical, aetiological, anatomical and pathological elements) was 4 (2–6), number of treatment sessions was one (1–4) and follow-up was three (1.5–33) months. Satisfactory occlusion could not be achieved in nine (4%) limbs. The ratio of odds (95% CI) for requiring more than one treatment session was 3.58 (1.46–8.77), P = 0.002 for great saphenous varicosity and 2.11 (1.13–3.94), P = 0.015 for age 50 or more. There were 20 (9.3%) immediate and 63 (29.5%) delayed adverse effects. All were minor except for one cutaneous nerve injury, one pulmonary embolism and one infected haematoma. The ratio for odds (95% CI) for post-treatment skin discolouration was 2.59 (1.14–5.87), P = 0.017 for women and 1.32 (1.02–1.71), P = 0.032 for increasing sclerosant volume used. Service line costing per completed treatment episode was £115.22 (€130.07, $188.60). Conclusion UGFS in a rolling treatment programme is safe and can achieve high occlusion rates at a low cost. Patients above the age of 50 with great saphenous varicosity are likely to require more than one treatment session.

scholarly journals Evaluation of quality of life and photoplethysmography in patients with chronic venous insufficiency treated with foam sclerotherapy

2015 ◽  
Vol 14 (2) ◽  
pp. 145-152 ◽  
Author(s):  
Felipe Coelho Neto ◽  
Gilson Roberto Araújo ◽  
Iruena Moraes Kessler
Keyword(s):  
Quality Of Life ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Venous Disease ◽  
Ultrasound Guided ◽  
Foam Sclerotherapy ◽  
High Satisfaction ◽  
Filling Time ◽  
Venous Filling

BACKGROUND: Ultrasound-guided foam sclerotherapy plays a major role in treatment of chronic venous insufficiency, providing clinical and hemodynamic improvement to patients undergoing treatment.OBJECTIVES: To examine the relationships between venous refilling time and impact of venous disease on quality of life and between changes in venous refilling time and improvement of symptoms after ultrasound-guided foam sclerotherapy for chronic venous insufficiency.METHODS: Thirty-two patients classified as C4, C5 or C6 answered a questionnaire on quality of life and symptoms and their venous filling time was measured using photoplethysmography before and 45 days after treatment of chronic venous insufficiency with ultrasound-guided foam sclerotherapy.RESULTS: Statistically significant improvements were observed in quality of life scores and in venous filling time and in the following symptoms: aching, heavy legs, restless legs, swelling, burning sensations, and throbbing (p<0.0001). A similar improvement was also seen in the work and social domains of quality of life (p<0.0001).CONCLUSIONS: As confirmed by questionnaire scores and venous refilling times, ultrasound-guided foam sclerotherapy demonstrated efficacy and resulted in high satisfaction levels and low rates of major complications.

scholarly journals Pattern of Presentation of Chronic Venous Insufficiency in CVI Clinic of CMCH

2018 ◽  
Vol 30 (1) ◽  
pp. 26-29
Author(s):  
Md Salim ◽  
GM Zakir Hossain ◽  
Mahmudur Rahman ◽  
Md Monirul Alam ◽  
Muallem Al Farukh Khan ◽  
...  
Keyword(s):  
Chronic Venous Insufficiency ◽  
Prospective Observational Study ◽  
Venous Insufficiency ◽  
Medical College ◽  
Advanced Stages ◽  
Ceap Classification ◽  
Male Patients ◽  
Common Sign ◽  
The Impact ◽  
Chronic Ulceration

Chronic venous insufficiency (CVI) is a common but often ignored problem in primary health care, sign and symptoms may ranges from mild leg heaviness or aching, dilated or unsightly veins, or troublesome odema to fibroses subcutaneous panniculitis associated with recurrent cellulitis and chronic ulceration. The prospective observational study was carried out department of surgery, Chittagong Medical College & Hospital, Chittagong. The primary purpose of the present study was to evaluate the impact of the diagnostic approach on patient of chronic venous insufficiency, varicose vein to difference primary and secondary venous insufficiency. Most common sign flebedema found in 56 (65.12%) patients was followed by dermo-hypodermatitis in 15(17.44) patients, stasis eczema in 09(10.47) patients and thrombophlebitis in 06(6.98) patients. Most frequent lower leg symptoms are heaviness 82 (95.35%) & the lowest is Throbbing 55(63.95%). The others are according to order of frequency cramps 66 (70.0%), Itching (73.26%), burning 61(70.93%), tiredness (80.23%), restless leg (82.55%), pain aching 76 (88.37%). CVI (chronic venous insufficiency) studied 04 (4.65%) were in C1, 54(62.79%) were in C2, 03(3.49%) were in C3, 11(12.79%) were in C4, 6 (6.98%) were in C5 and 8(9.30%) were in C6 according to clinical CEAP classification. Majority of patients presented with the complains of heaviness of leg and unexplained leg swelling, sex predilection is almost same for male and female but advanced stages are more common in male patients. Increasing age is associated with more advanced stage of the disease.Medicine Today 2018 Vol.30(1): 26-29

Impact of Great Saphenous Vein Foam Sclerotherapy on Quality of Life and Photoplethysmography Findings in Chronic Venous Insufficiency

2020 ◽  
Vol 46 (3) ◽  
pp. 369-375
Author(s):  
Felipe Coelho Neto ◽  
Rodrigo Gomes de Oliveira ◽  
Fernando Thomazinho ◽  
Anna Paula Weinhardt Batista ◽  
Iruena Moraes Kessler
Keyword(s):  
Quality Of Life ◽  
Saphenous Vein ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Great Saphenous Vein ◽  
Foam Sclerotherapy

scholarly journals Study to compare open surgery, endovenous thermal ablation and ultrasound guided foam sclerotherapy for treatment of varicose veins

2016 ◽  
Vol 18 (3) ◽  
pp. 58
Author(s):  
Sandeep Raj Pandey
Keyword(s):  
Clinical Outcome ◽  
Thermal Ablation ◽  
Open Surgery ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Venous System ◽  
Ultrasound Guided ◽  
Foam Sclerotherapy ◽  
Same Day Discharge ◽  
Endovenous Thermal Ablation

Introduction and Objective: To compare open surgery, Endovenous thermal ablation(EVTA) and ultrasound(USG) guided foam sclerotherapy for primary superficial venous insufficiency(PVI) with respect to obliteration of superficial venous system at 3 months, clinical outcome and cost.Materials and Methods: Between January 2015 to January 2016, all patients with symptomatic PVI of lower limbs who were willing for definitive management were randomized to open surgery (n=20), EVTA (n=40) or ultrasound guided foam sclerotherapy (n=20). In foam sclerotherapy group, review USG was done at 1 week and if necessary re-injection was done. The patients in all the groups underwent review USG at 3 months. Obliteration of superficial venous system, clinical outcome and costs were registered.Results: 5 patients in foam sclerotherapy group required re-injection at 1 week. Superficial venous system was obliterated in all the patients of all the groups at 3 months. Improvement in clinical score was similar in all groups. The foam sclerotherapy group had less frequent analgesia intake, earlier return to normal activity and lower cost. Local complication rate was slightly higher in foam sclerotherapy group.Conclusion: Foam sclerotherapy is a cheaper alternative to open surgery & EVTA for PVI with respective to early measures of clinical outcome. USG guided sclerotherapy demonstrated to be a safe and effective procedure for the treatment of chronic venous insufficiency. The observed complications were minimal and most of the patients reported satisfaction with the treatment outcomes. If patient have no cost issue, endovenous thermal ablation of varicose veins is better than open surgery & foam sclera in context of minimally invasive, cosmetic, less pain, no incisions, early ambulation & same day discharge.

scholarly journals Pattern of Presentation of Chronic Venous Insufficiency in CVI Clinic of Chittagong Medical College Hospital

2018 ◽  
Vol 16 (2) ◽  
pp. 51-55
Author(s):  
Md Salim ◽  
GM Zakir Hossain ◽  
Mahmudur Rahman ◽  
Md Monirul Alam ◽  
Muallem Al Farukh Khan
Keyword(s):  
Chronic Venous Insufficiency ◽  
Prospective Observational Study ◽  
Venous Insufficiency ◽  
Medical College Hospital ◽  
College Hospital ◽  
Medical College ◽  
Advanced Stages ◽  
Male Patients ◽  
Common Sign ◽  
The Impact

Background: Chronic Venous Insufficiency (CVI) is a common but often ignored problem in primary health care, sign and symptoms may ranges from mild leg heaviness or aching, dilated or unsightly veins, or troublesome odema to fibroses subcutaneous panniculitis associated with recurrent cellulitis and chronic ulceration.Methods: The prospective observational study was carried out Depaertment of Surgery, Chittagong Medical College Hospital, Chittagong. The primary purpose of the present study was to evaluate the impact of the diagnostic approach on patient of chronic venous insufficiency, varicose vein to difference primary and secondary venous insufficiency.Results: Most common sign flebedema found in 56 (65.12%) patients was followed by dermo-hypodermatitis in 15(17.44) patients, stasis eczema in 09(10.47) patients and thrombophlebitis in 06(6.98) patients. Most frequent lower leg symptoms are heaviness 82 (95.35%) & the lowest is throbbing 55(63.95%). The others are according to order of Frequency cramps 66 (70.0%) Itching 63 (73.26%) Burning 61(70.93%) Tiredness 69 (80.23%) Restless leg 71 (82.55%) Pain aching 76 (88.37%). CVI (Chronic Venous Insufficiency) studied 04 (4.65%) were in C1, 54(62.79%) were in C2, 03(3.49%) were in C3, 11(12.79%) were in C4, 6 (6.98%) were in C5 and 8(9.30%) were in C6 according to clinical CEAP classification.Conclusion: Majority of patients presented with the complains of heaviness of leg and unexplained leg swelling, sex predilection is almost same for male and female but advanced stages are more common in male patients. Increasing age is associated with more advanced stage of the disease.Chatt Maa Shi Hosp Med Coll J; Vol.16 (2); July 2017; Page 51-55

Sign in / Sign up

Export Citation Format

Share Document