Papers reviewed in July 2015

Posted on by Mike

Kurdal A.T et al
Ultrasound-guided catheter-directed foam sclerotherapy for great saphenous vein.
Minerva Chir. 2015 Feb;70(1):33-6.

Aim: The problem of varicose veins in the lower leg is a common disease and associated with long-term morbidity. It has usually been treated using high ligation with stripping and endovenous ablation surgery of the great saphenous vein. The aim of this paper is to report our own series of patients treated by ultrasound guided catheter directed foam sclerotherapy for the chemical ablation of great saphenous vein.
Method: The study involved 108 legs with symptomatic varicose veins (C2-4) secondary to great saphenous vein insufficiency. The great saphenous vein was accessed at knee level. With the method of Tessari sclerosant foam was made (2 mL 3% polidocanol and 8 mL air) and delivered along the great saphenous vein while the catheter was withdrawn. At two and fifty two weeks after treatment the patients were evaluated.
Results: Catheter-directed foam sclerotheraphy was successfully performed in all of the patients. Venous Clinic Severity Score was reduced significantly (P<0.05). Eighty nine percent of the GSV were completely occluded, 4% were partly occluded and 7% were recanalized. No serious side-effects occurred.
Conclusion: Catheter-directed foam sclerotheraphy is a safe, simple and minimally invasive procedure. Patient satisfaction was good and the occlusion rate is promising after a single treatment.

 

Neto F.C et al
Treatment of severe chronic venous insufficiency with ultrasound-guided foam sclerotherapy: a two-year series in a single center in Brazil.
Phlebology. 2015 Mar;30(2):113-8.

Objective: 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.

 

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