scholarly journals ULTRASOUND GUIDED FOAM SCLEROTHERAPY AS A PREFERRED TREATMENT OPTION FOR VARICOSE VEINS IN TERMS OF SAFETY, EFFICACY AND COST EFFECTIVENESS

2021 ◽  
Vol 71 (4) ◽  
pp. 1332-35
Author(s):  
Muhammad Jamil ◽  
Rashid Usman ◽  
Muhammad Irfan Khan ◽  
Muhammad Afzal Randhawa ◽  
Aaiza Aman ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Varicose Veins ◽  
Duplex Ultrasound ◽  
Military Hospital ◽  
Venous Reflux ◽  
Ultrasound Guided ◽  
Foam Sclerotherapy ◽  
Vein Thrombosis ◽  
Ceap Classification ◽  
Deep Vein

Objective: To assess the safety, efficacy and cost effectiveness of ultrasound-guided foam sclerotherapy in superficial venous reflux in Clinical, Etiological, Anatomical and Pathological (CEAP) classification grade 2-6 disease. Study Design: Retrospective observational study. Place and Duration of Study: Combined Military Hospital Rawalpindi, from Sep 2018 to Feb 2020. Methodology: One thousand and sixty-seven patients (1312 legs) with varicose veins were treated by ultrasound-guided foam sclerotherapy using 3% sodium tetradecyl sulphate for truncal veins and 1% for smaller veins in 1:4 ratio with air. After 7 days, leg was assessed clinically and radiologically with Duplex ultrasound for occlusion of veins and complications. Second, third and fourth sclerotherapy sessions were performed for residual/recurrence/new varicosities. Compression bandage was used for at least 3 months after treatment. Results: The overall eradication of superficial venous reflux and healing of ulcers, was seen in 92.1% (1208 legs). It was 83.5% (1095 legs) after 1st session of UGFS. Second, 3rd and 4th session of UGFS further increases this percentage of benefitted patients Deep vein thrombosis developed post procedure in 2 (0.18%) patients and pulmonary embolus in one patient. Three (0.28%) patients had transient visual disturbances within half an hour of treatment. Retreatment was required due to formation of new superficial venous reflux in 39 (2.9%) legs and recurrence in 93 (7.1%) legs. Conclusion: Ultrasound guided foam sclerotherapy is a better option of treatment in varicose veins in terms of safety, efficacy and cost effectiveness.

The incidence and characterization of deep vein thrombosis following ultrasound-guided foam sclerotherapy in 1000 legs with superficial venous reflux

2013 ◽  
Vol 1 (3) ◽  
pp. 231-238 ◽  
Author(s):  
Sachin R. Kulkarni ◽  
David E. Messenger ◽  
Fiona J.A. Slim ◽  
Lorraine G. Emerson ◽  
Richard A. Bulbulia ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Venous Reflux ◽  
Ultrasound Guided ◽  
Foam Sclerotherapy ◽  
Vein Thrombosis ◽  
Deep Vein

scholarly journals Efficacy and safety of ultrasound guided foam sclerotherapy with sodium tetradecyl sulphate for residual and minor varicosities

2017 ◽  
Vol 4 (2) ◽  
pp. 751
Author(s):  
Madhu B. S. ◽  
Shashi Kumar H. B. ◽  
Naveen Kumar Reddy M. ◽  
Sangeetha Kalabhairav ◽  
Abilash Reddy V.
Keyword(s):  
Varicose Veins ◽  
Single Session ◽  
Ultrasound Guided ◽  
Foam Sclerotherapy ◽  
Medical College ◽  
Vein Thrombosis ◽  
Post Surgery ◽  
Sodium Tetradecyl Sulphate ◽  
Deep Vein ◽  
Symptoms And Signs

Background: Ultrasound-guided foam sclerotherapy (UGFS) is becoming an accepted standard of treatment varicose veins. It is a relatively safe, effective inexpensive method in limited, small varicose veins.This study aims to assess the safety and efficacy of UGFS using sodium tetradecyl sulphate (setrol) in patients presenting with minor varicosities and residual varicosities of lower limb.Methods: 78 patients with minor varicosities or residual varicosities post-surgery who presented between January2015 and June2016 at KR hospital attached to Mysore Medical College and Research Institute, Mysuru, underwent ultrasound-guided foam sclerotherapy with 0.5ml (at a single session) setrol prepared as a foam by Tessari technique. The efficacy criterion was the disappearance of the varicosities and improvement in symptoms and signs: 1 week, and 1, 3, 6 and 12 months after the treatment. Complications of sclerotherapy were reported during follow-up.Results: Decrease or withdrawal of complaints was reported in 96% of cases (74 patients). Disappearance or decrease of varicose veins was observed in all patients (100%). Phlebitis and pigmentation as a complication was noted in 5 (7%) and 9 (11.5%) cases respectively. Major complications, such as deep vein thrombosis, pulmonary embolism, dyspnoea, anaphylaxis, or neurological abnormalities, were not reported.Conclusions: Ultrasound-guided foam sclerotherapy for minor varicosities and residual varicosities with sodium tetra decyl sulphate is a safe and satisfactory method of treatment of minor and residual varicosities.

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.

The frequency and clinical significance of nontarget superficial and deep vein occlusion after physician compounded foam sclerotherapy of varicose tributaries

2020 ◽  
Vol 35 (6) ◽  
pp. 430-439 ◽  
Author(s):  
Kirill Lobastov ◽  
Athena Vorontsova ◽  
Astanda Bargandzhiya ◽  
Sergey Tsaplin ◽  
Ilya Schastlivtsev ◽  
...  
Keyword(s):  
Medical Records ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Duplex Ultrasound ◽  
Lower Limbs ◽  
Foam Sclerotherapy ◽  
Vein Occlusion ◽  
Deep Vein ◽  
Observation Period ◽  
Time Point

Objective To evaluate the incidence and clinical relevance of silent nontarget occlusion (NTO) of superficial and deep veins occurring after ultrasound-guided foam sclerotherapy (UGFS) that can be detected by serial duplex ultrasound scan (DUS). Methods This retrospective analysis evaluated the medical records of patients treated with UGFS at a private clinic in Moscow, Russia from 2015 to 2017. All patients underwent serial DUS at 1 to 2 weeks and 1, 3, 6, and 12 months after UGFS. Results During the observation period, 268 patients were treated with UGFS, using physician compounded polidocanol foam 257 lower limbs of 196 patients (73%) with varicose veins who underwent DUS at 1 to 2 weeks after the last session of UGFS (inclusion time-point): 139 women and 57 men (mean age: 44.2 ± 12.2 years) with the following CEAP clinical class distribution: C2, 74.0%; C3, 20.0%; C4, 4.5%; and C5, 1.5%. NTO at the inclusion time-point occurred in 60 limbs (23.3%) of 57 patients (28.5%) and was symptomatic only in three limbs (1.2%). Most occlusions were localized in the untreated great saphenous vein trunk ( n = 28) and the calf muscle veins ( n = 23). Overall, 72%, 44%, 29%, and 10% of all limbs and 77%, 45%, 28%, and 12% of limbs with NTO were followed up by DUS at 1, 3, 6, and 12 months, respectively. There were no cases of thrombus progression or symptomatic venous thromboembolism (VTE). At six months, no deep vein occlusions persisted. Conclusions The frequency of nontarget vein occlusion after UGFS revealed by serial DUS may be as high as 23.3%. These occlusions tend to resolve within six months and are not associated with symptomatic VTE.

Successful ultrasound-guided foam sclerotherapy for vulval and leg varicosities secondary to ovarian vein reflux: a case study

2010 ◽  
Vol 26 (1) ◽  
pp. 29-31 ◽  
Author(s):  
P Paraskevas
Keyword(s):  
Varicose Veins ◽  
Duplex Ultrasound ◽  
Symptomatic Improvement ◽  
Ovarian Vein ◽  
Ultrasound Guided ◽  
Foam Sclerotherapy ◽  
Pelvic Congestion Syndrome ◽  
Vein Reflux ◽  
Pelvic Congestion

Pelvic varicose veins secondary to ovarian vein reflux are common and can present with clinical pelvic congestion syndrome (PCS). After assessment with duplex ultrasound and venography, treatment often involves surgical ovarian vein ligation and more recently embolization of the ovarian vein(s) followed by ultrasound-guided foam sclerotherapy (UGFS) of the pelvic tributaries. This paper presents one out of many PCS patients treated with UGFS of the pelvic tributaries alone, with clinically symptomatic improvement.

Haemorrhoids are associated with internal iliac vein reflux in up to one-third of women presenting with varicose veins associated with pelvic vein reflux

2014 ◽  
Vol 30 (2) ◽  
pp. 133-139 ◽  
Author(s):  
JM Holdstock ◽  
SJ Dos Santos ◽  
CC Harrison ◽  
BA Price ◽  
MS Whiteley
Keyword(s):  
Varicose Veins ◽  
Strong Association ◽  
Duplex Ultrasound ◽  
Iliac Vein ◽  
Venous Reflux ◽  
Foam Sclerotherapy ◽  
Pelvic Vein ◽  
Internal Iliac Vein ◽  
Internal Iliac ◽  
Vein Reflux

Objectives: To determine the prevalence of haemorrhoids in women with pelvic vein reflux, identify which pelvic veins are associated with haemorrhoids and assess if extent of pelvic vein reflux influences the prevalence of haemorrhoids. Methods: Females presenting with leg varicose veins undergo duplex ultrasonography to assess all sources of venous reflux. Those with significant reflux arising from the pelvis are offered transvaginal duplex ultrasound (TVS) to evaluate reflux in the ovarian veins and internal Iliac veins and associated pelvic varices in the adnexa, vulvar/labial veins and haemorrhoids. Patterns and severity of reflux were evaluated. Results: Between January 2010 and December 2012, 419 female patients with leg or vulvar varicose vein patterns arising from the pelvis underwent TVS. Haemorrhoids were identified on TVS via direct tributaries from the internal Iliac veins in 152/419 patients (36.3%) and absent in 267/419 (63.7%). The prevalence of the condition increased with the number of pelvic trunks involved. Conclusion: There is a strong association between haemorrhoids and internal Iliac vein reflux. Untreated reflux may be a cause of subsequent symptomatic haemorrhoids. Treatment with methods proven to work in conditions caused by pelvic vein incompetence, such as pelvic vein embolisation and foam sclerotherapy, could be considered.

Roller coaster reflux: definition and clinical significance

2004 ◽  
Vol 19 (3) ◽  
pp. 143-144
Author(s):  
W S Gradman
Keyword(s):  
Clinical Significance ◽  
Varicose Vein ◽  
Varicose Veins ◽  
Clinical Success ◽  
Duplex Ultrasound ◽  
Reverse Direction ◽  
Direct Compression ◽  
Venous Reflux ◽  
Roller Coaster ◽  
Deep Vein

Objective: Duplex scanning readily identifies typical proximal venous reflux that descends directly to varices. Occasionally, reflux may first descend in a saphenous or deep vein, and then reverse direction to ascend 10 cm or more in a tributary or varicose vein before descending again to clinically evident varicose veins. This pattern, here defined as roller coaster reflux (RCR), can be difficult to establish, since no immediate superior source of reflux feeds the uppermost varices. This study reviews recent clinical experience with RCR and illustrates the phenomenon in two patients. Methods: Over a two-year period in a solo phlebology practice, duplex ultrasound was used on patients with varicose veins to identify the initial descending reflux and the point of reversal where flow began to ascend. A Trendelenburg manoeuvre with direct compression over the point of reversal was used to prove whether the source of venous distention lay 10 cm or more below the most superior varices. Results: A total of 12 patients showed evidence of RCR with flow ascending 10-23 cm to feed the uppermost varices. The sources of descending reflux were the femoral (3), popliteal (2), great saphenous (4), short saphenous (2) and tibial (1) veins. The ascending veins were the great saphenous (3), Giacomini (2) or varices (7). Elimination of the source of reflux along with the varices routinely resulted in clinical success. Conclusions: Roller coaster reflux should be sought in individuals whose reflux does not appear to arise from a superior source.

scholarly journals The incidence of deep vein thrombosis following ultrasound-guided foam sclerotherapy

2009 ◽  
Vol 96 (S1) ◽  
pp. 10-10 ◽  
Author(s):  
R. J. Winterborn ◽  
F. Taiwo ◽  
F. J. A. Slim ◽  
M. R. Whyman ◽  
K. R. Poskitt
Keyword(s):  
Deep Vein Thrombosis ◽  
Ultrasound Guided ◽  
Foam Sclerotherapy ◽  
Vein Thrombosis ◽  
Deep Vein

A Popliteal Vein Aneurysm Accompanied by Lower Persistent Sciatic Vein

2022 ◽  
pp. 153857442110683
Author(s):  
Suh Min Kim
Keyword(s):  
Pulmonary Embolism ◽  
Surgical Treatment ◽  
Duplex Ultrasound ◽  
Fatal Pulmonary Embolism ◽  
Venous Reflux ◽  
Vein Thrombosis ◽  
Saphenous Veins ◽  
Therapeutic Anticoagulation ◽  
Deep Vein

Popliteal venous aneurysms (PVAs) are rare. Surgical treatment is recommended because of the risk of deep vein thrombosis and fatal pulmonary embolism. A persistent sciatic vein (PSV) is also a rare anomaly. We report a case of a PVA accompanied by a lower PSV. A 70-year-old man was admitted due to left leg heaviness. He had undergone ablation of both great saphenous veins 6 years prior to the admission. Duplex ultrasound showed a PVA on his left leg, which was 3.2 × 2.4 cm in size. The patient was treated with tangential aneurysmectomy with lateral venorrhaphy. His symptom gradually resolved. He received warfarin at a therapeutic range for 3 months. Duplex ultrasound at 6 months later showed no evidence of any recurrent aneurysm or venous reflux. His follow-up has revealed no complications for 18 months. Surgical treatment and perioperative therapeutic anticoagulation are recommended for treating PVAs. Tangential aneurysmectomy with venorrhaphy is the most common and the simplest surgical method.

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