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Acta Phlebologica 2001 December;2(2-4):71-6
Copyright © 2001 EDIZIONI MINERVA MEDICA
language: English
Sclerotherapy of reticular varices and telangiectasias. Therapeutic strategy and results
Mariani F. 1, Izzo M. 1, Trapassi S. 2, Mancini S. 1
1 Institute of General Surgery and Surgical Specializations, Interdepartmental Centre of Research, Treatment and Phlebolymphological Rehabilitation, Siena University, Siena, Italy; 2 Institute of Plastic and Reconstructive Surgery, Parma University, Parma, Italy
Therapy of isolated reticular varices is successful in all patients, whereas therapy of telangiectasias of the inferior limbs presents even today considerable difficulties for owing to the variableness of the results and a certain incidence of complications such as haemosiderin pigmentations. The results demonstrate that, in most treated patients, therapy is more effective when the strategy provides for the abolition of the major refluxes, particularly if they have been located before the sclerosing injection. The principle is the same as that guiding the treatment of the largest varices: accurate mapping of venous insufficiency determined the result of the treatment. In conclusion, this study provides some practical guidelines:
— in CVI all teleangectasias are accompanied by reticular varices, even when these are not visible on clinical examination;
— in most cases, the sources of refluxes are distinguishable as incompetent perforating veins and are situated beneath teleangiectactic efflorescences;
— correct diagnosis is therefore essential for a good result of the treatment;
— sclerosing injections must therefore first be given in the reticular varices beneath the telangiectasias;
— the elimination of the reflux is essential for a good long-term result. This reduces the number of sessions needed and the incidence of complications, in particular haemosiderin pigmentation, telangiectactic matting and the extension of the telangiectasias treated.