2014

Foam sclerotherapy combined with saphenofemoral ligation procedure: long-term results

Objective: To evaluate the clinical effect of the foam sclerotherapy combined with saphenofemoral ligation(FS-SFL) in a selected group of patients with varicose disease and present the long-term results of ten-yearultrasonographic follow-up.Methods: Sixty-five patients with primary varicose veins due to the great saphenous vein incompetence whohad been treated with FS-SFL were retrospectively reviewed over a period of ten years. The patients wereassessed before and after the treatment by Doppler ultrasonography and clinical examination.Results: The mean age of the patients was 44.6 ± 11 years (range: 19 to 87 years), and 51 were females and14 were males. Follow-up for all patients was ten years. The most common complication was skin pigmentation.There were no major complications. No recanalization of the great saphenous vein was seen in any patient.Conclusions: FS-SFL is a safe and effective method of treating varicose veins. This treatment have a low rateof recanalization in their long-term follow-up.

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[1] Labropoulos N, Leon L, Kwon S, Tassiopoulos A, Gonzalez-Fajardo JA, et.al. Study of the venous reflux progression. J Vasc Surg 2005;41:291-5.
[2] Fiebig A, Krusche P, Wolf A, Krawczak M, Timm B, Nikolaus S, et.al. Heritability of chronic venous disease. Hum Genet 2010;127:669- 74.
[3] Brand FN, Dannenberg AL, Abbott RD, Kannel WB. The epidemiology of varicose veins: the Framingham Study. Am J Prev Med 1988;4:96-101.
[4] Heit JA, Rooke TW, Silverstein MD, Mohr DN, Lohse CM, Petterson TM, et.al. Trends in the incidence of venous stasis syndrome and venous ulcer: a 25-year population-based study. J Vasc Surg 2001;33:1022-7.
[5] Caggiati A, Rosi C, Heyn R, Franceschini M, Acconcia MC. Agerelates variations of varicose veins anatomy. J Vasc Surg 2006;44:1291-5.
[6] Araújo AL, Ferreira RCA, Oliveira CAB. Semelhança morfológica entre lesões vasculares: varizes dos membros inferiores aterosclerose. Rev Angiol Cir Vasc 2007;6:29-33.
[7] Rudgers PH, Kirslaar PJ. Randomised trial of stripping versus high ligation combined with sclerotherapy in the treatment of the incompetent greater saphenous vein. Am J Surg 1994;168:311-5.
[8] Jones L, Braithwaite BD, Selwyn D, Cooke S, Earnshaw JJ. Neovascularisation is the principal cause of varicose vein recurrence: results of a randomised trial of stripping the long saphenous vein. Eur J Vasc Endovasc Surg 1996;12:442-5.
[9] Sarin S, Scurr JH, Coleridge Smith PD. Stripping of the long saphenous vein in the treatment of primary varicose veins. Br J Surg 1994;81:1455-8.
[10] Dwerryhouse S, Davies B, Harradine K, Earnshaw JJ. Stripping the long saphenous vein reduces the rate of reoperation for varicose veons: five-year results of a randomizer trial. J Vasc Surg 1999;29:589-92.
[11] Tong Y. Royle J. Recurrent varicose veins following high ligation of long saphenous vein; a duplex ultrasound study. Cardiovasc Surg 1995;3:485-7.
[12] Ricci S, Caggiati A. Does a double long saphenous vein exist? Phlebology 1999;14:59-64.
[13] Orbach E. Sclerotherapy of varicose veins: utilisation of an intravenous air-block. Am J Surgery 1944;66:362-6.
[14] Tessari L. Nouvelle technique d’obtention de la sclero-mousse [A new technique for producing sclerosing foam]. Phlebologie 2000;53:129-33. [Article in French]
[15] Yamaki T, Nozaki M, Iwasaka S. Comparative study of duplexguided foam sclerotherapy and duplex-guided liquid sclerotherapy for the treatment of superficial venous insufficiency. Dermatol Surg 2004;30:718-22.
[16] Hamel-Desnos C, Desnos P, Wollmann JC, Ouvry P, Mako S, Allaert FA. Evaluation of the efficacy of pilodocanol in the form of foam compared with liquid form in sclerotherapy of the greater saphenous vein: initial results. Dermatol Surg 2003;29:1170-75.
[17] Hobbs JT. Surgery or sclerotherapy for varicose veins: 10-year results of a random trial. In: Tesi M, Dormandy JA, eds. Superficial and Deep Venous Diseases of the Lower Limbs. Turin, Italy: Panminerva Medica, 1984, pp. 243-48.
[18] Cavezzi A, Mosti G, Di Paolo S, Tessari L, Campana F, Urso SU. Re: 'catheter-directed foam sclerotherapy of great saphenous veins in combination with pre-treatment reduction of the diameter employing the principals of perivenous tumescent local anesthesia'. Eur J Vasc Endovasc Surg 2014;48:597.
[19] Lurie F, Creton D, Eklof B, Kabnick LS, Kistner RL, Pichot O, et.al. Prospective randomized study of endovenous radiofrequency obliteration (closure procedure) vs ligation and stripping in a selected patient population (EVOLVES Study). J Vasc Surg 2003;38:207-14.
[20] Sarvananthan T, Shepherd AC, Willenberg T, Davies AH. Neurological complications of sclerotherapy for varicose veins. J Vasc Surg 2012;55:243-51.