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.

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.

Rapid healing of chronic venous ulcers following ultrasound-guided foam sclerotherapy

2007 ◽  
Vol 22 (1) ◽  
pp. 34-39 ◽  
Author(s):  
P A Hertzman ◽  
R Owens
Keyword(s):  
Venous Insufficiency ◽  
Ultrasound Guided ◽  
Foam Sclerotherapy ◽  
Venous Ulcers ◽  
Long Term Follow Up ◽  
Rapid Healing ◽  
Saphenofemoral Junction ◽  
Term Response

Objective: To measure the short term response of venous ulcers in patients treated with ultrasound-guided foam sclerotherapy (UGFS) at a two-week clinic in Honduras. Methods: Nine females (ages 25-86; mean 48.1 years) with 13 venous ulcers and saphenofemoral junction reflux were treated with UGFS (polidocanol 3% foam; 1–4 injections; 2–11 cc; Mean Volume 5.4 cc). The dimensions of each ulcer and of the great saphenous vein (GSV) were measured before treatment and one week later. Results: At one week follow-up 2 ulcers healed, 2 GSVs closed, and there was significant improvement in ulcer dimensions (p=0.00) and size of GSV (p=0.00). Conclusions: Venous ulcers in patients with serve venous insufficiency responded quickly to UGFS. Long-term follow-up will be important to determine the sustainability of these results.

scholarly journals Klippel–Trénaunay Syndrome – A Very Rare and Interesting Syndrome

2015 ◽  
Vol 9 ◽  
pp. CCRPM.S21645 ◽  
Author(s):  
Deepak Sharma ◽  
Sachin Lamba ◽  
Aakash Pandita ◽  
Sweta Shastri
Keyword(s):  
Soft Tissue ◽  
Vascular Malformation ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Lower Limbs ◽  
Port Wine ◽  
Bone Deformity ◽  
Klippel Trenaunay Syndrome

Klippel–Trénaunay syndrome (KTS or KT) is an infrequently seen dermatological syndrome, which is often viewed as a triad of vascular malformation (capillary malformations or port-wine brands), venous varicosity, and soft tissue and/or bony hypertrophy. We report a case of a 12-year-old male who presented to us with the symptoms of varicose plaques over both lower limbs and was diagnosed as a case of KTS. Management is normally conservative and includes stockings for compression of the branches to reduce edema because of chronic venous insufficiency; modern devices that cause on and off pneumatic compression; and rarely, surgical correction of varicose veins with lifelong follow-up. The orthopedic abnormalities are treated with epiphysiodesis in order to prevent (stop) overgrowing of limb and correction of bone deformity.

Chronic venous leg ulcers: Effects of foam sclerotherapy on healing and recurrence

2014 ◽  
Vol 31 (1) ◽  
pp. 34-41 ◽  
Author(s):  
G Grover ◽  
A Tanase ◽  
A Elstone ◽  
S Ashley
Keyword(s):  
Ulcer Recurrence ◽  
Ultrasound Guided ◽  
Foam Sclerotherapy ◽  
Invasive Treatment ◽  
Recurrence Rates ◽  
Venous Ulceration ◽  
Kaplan Meier ◽  
Before And After ◽  
One Year

Introduction Ultrasound-guided foam sclerotherapy is a minimally invasive treatment option used for ablation of axial and perforator reflux for chronic venous ulceration. Active ulceration presents a significant health burden in both the primary and secondary care setting. The objective of this study is to determine ulcer healing rates at 24 weeks and 12 months, and ulcer recurrence rates at one year for chronic venous ulcers after ultrasound-guided foam sclerotherapy. Methods Between 2007 and 2012, 54 patients underwent ultrasound-guided foam sclerotherapy for clinical, aetiological, anatomical and pathological C6 ulcers. All patients were followed up clinically, and venous duplex was performed on all legs before and after treatment. A prospectively maintained database was analysed to determine venous truncal occlusion rates, 24-week and 12-month healing and recurrence rates (using Kaplan–Meier survival analysis). Results Fifty-seven ulcerated legs, 39 primary and 18 with recurrent superficial venous reflux were analysed. Median time of active ulceration at presentation was 15.2 months (range 5 months to 17 years). At a median follow-up of 2.7 months, 90% (51 legs) achieved full truncal occlusion after one session, 4% (2) short segment occlusion and 5% (3) failed to occlude and one patient died and was lost to follow-up; 13/57 (23%) required a second session of treatment for completion of treatment, recanalisations and to treat perforator disease, 88% (50/57) ulcers healed at a median of 5.3 months (interquartile range 2.9–8.4 months) following their first ultrasound-guided foam sclerotherapy treatment. The 24-week and 12-month estimated healing rates were 53% and 72%, respectively. The estimated 12-month recurrence rate was 9.2%. There were no reported incidences of deep venous thrombosis or neurological symptoms. Conclusion This study affirms the role of ultrasound-guided foam sclerotherapy as a safe and effective option for abolition of superficial reflux.

Foam Sclerotherapy for the Treatment of Superficial Venous Insufficiency

2007 ◽  
Vol 87 (5) ◽  
pp. 1285-1295 ◽  
Author(s):  
Kathleen D. Gibson ◽  
Brian L. Ferris ◽  
Daniel Pepper
Keyword(s):  
Venous Insufficiency ◽  
Foam Sclerotherapy ◽  
Superficial Venous Insufficiency
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