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A Journal on Phlebology
Acta Phlebologica 2012 December;13(3):135-40
Failures of sclerotherapy of the great saphenous vein: clinical and subclinical recurrencies
Private Practice, Acerra, Naples, Italy
Aim. In a former analysis we have shown that only half of all Duplex-proven failures develop into a clinical recurrency; the aim of this work is to determine which conditions enhance this tendency. Subclinical recurrencies show just a reflux at Duplex-examination, while clinical recurrencies are obvious. The time-lap between first reflux and clinical appearance is the preclinical interval.
Methods. One thousand sapheno-femoral junctions measuring between 5 and 18 mm (at 3 cm below the junction) have been treated in one session applying Sigg’s method. The Duplex-controls were done at 2-4-6-8-10 years. Persistent reflux at Duplex-examination meant therapeutic failure. All recurrancies, clinical and subclinical, were divided into two GROUPS. α-GROUP had a reduction of the initial diameter of less than 30%, β-GROUP of more of 30%.
Results. We had 116 clinical recurrencies and 230 Subclinical recurrencies. Successful cases (clinically and at Duplex-examination) showed a decrease in diameter of more than 70%. Clinical recurrencies had a reduction of less than 30% Subclinical recurrencies had a reduction between 30% and 70%.
Conclusion. A reduction of diameter at the sapheno-femoral junction of less than 30% could be a predictive sign of clinical recurrency. We think that this could be the limit above which a recurrency could keep its subclinical status. A reduction of less than 30% would be insufficient to prevent the varicous veins to reappear.