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International Angiology 2001 December;20(4):322-9


language: English

Sclerosants in microfoam. A new approach in angiology

Cabrera J., Cabrera J. Jr., Garcia-Olmedo M. A.

From the Vascular Surgery Clinic, Tejeiro, Granada, Spain


Background. The aim of this work was to study the out­comes of echos­cler­o­sis using scler­o­sants in micro­foam incom­pe­tent long saph­e­nous veins, hyper­ten­sive ­venous ­ulcers and inop­er­able ­venous mal­for­ma­tions and to ­record any sec­on­dary ­effects.
Methods. We exam­ined the ­records, pre- and post-treat­ment and fol­low-up ­colour pho­to­graphs, and echo Doppler imag­es for: 415 ­patients with incom­pe­tent long saph­e­nous veins of diam­e­ter more than 9 mm in 265 ­patients suf­fer­ing from postsur­gi­cal recur­rence of var­i­cose saph­e­nous veins; 72 ­patients with ­venous ­ulcers; and 31 with ­venous mal­for­ma­tions. All ­patients had been treat­ed with ultra­sound-guid­ed injec­tions of scler­o­sants in micro­foam.
Results. After 4-6 years fol­low-up, 80% of the long saph­e­nous veins were oblit­er­at­ed and all super­fi­cial branch­es had dis­ap­peared in 95% of legs. In the post-sur­gi­cal recur­rence group, 81% of recur­rent veins were oblit­er­at­ed and 90% of the branch­es had dis­ap­peared. Among the ­patients with ­ulcers, the lat­ter ­remain ­closed after a mean of 2.5 years treat­ment in 77% of the cases; recur­rence in the remain­der was due to rec­a­nal­isa­tion of per­fo­rat­ing veins. All ­venous mal­for­ma­tions were ­reduced in size and 9 of them had dis­ap­peared com­plete­ly. Minor tran­sient ­adverse ­effects includ­ed cough­ing, inflam­ma­tion and pho­to­psia. There were no seri­ous com­pli­ca­tions, such as deep vein throm­bo­sis or pul­mo­nary embo­lism or sco­to­ma.
Conclusions. The qual­ity and stabil­ity of the out­comes and the low com­pli­ca­tion rate ­observed in this pre­lim­i­nary study may make scle­ro­ther­a­py with micro­foam the ther­a­peu­tic ­approach of ­choice for the ana­tom­i­cal and func­tion­al elim­i­na­tion of an exten­sive range of ­venous pathol­o­gy. Controlled ­trials on a stan­dar­dised scler­o­sant micro­foam are now ­required to con­firm these ­results to make the meth­od wide­ly avail­able.

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