Chemical Superficial Vein Ablation

Morrison, Nick

doi:10.1007/978-3-319-01812-6_11

Cited by 1 publication

(1 citation statement)

References 58 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…29 Some authors advise to limit the volume per injection to 0.5-3 mL, others to 3-5 mL. 30,31 Guex 29 supplied a detailed table with requested volumes according to venous diameter and length. Fegan 27 only injected 0.5 mL aliquots in 5 cm segments that were isolated by finger pressure during 30-60 s after the injection had been delivered.…”

Section: Discussionmentioning

confidence: 99%

Fatal pulmonary embolism following ultrasound-guided foam sclerotherapy combined with multiple microphlebectomies

Bruijninckx¹

2016

Phlebology

View full text Add to dashboard Cite

Ambulatory ultrasound-guided foam sclerotherapy (UGFS) for refluxing saphenous veins is considered a safe therapy. Venous thromboembolic complications after UGFS as well as after all other ambulatory ablative venous interventions are rarely reported. This paper reports a fatal pulmonary embolism (PE) following UGFS in combination with an extended phlebectomy, and questions what measures should be taken to minimize the risk for thromboembolic complications after these procedures. In the reported case (unsuspected), extensive non-occluding atherosclerosis as well as obesity in combination with use of an oral contraceptive might have contributed to the development of the PE while the use of a β-blocker might have increased its fatal course considerably. Routine measurement of the ankle-brachial pressure index reduces the risk for undetected atherosclerosis. It appears that 'in the real world' of ambulatory phlebological treatments thromboembolic complications are more common (2.4-4.7%) and appear accompanied by post-procedural mortality. It is concluded therefore that pharmacological thromboprophylaxis appears warranted in selected cases, perhaps even routine application could be considered. Attention is drawn to the highly thrombogenic but not uncommon combination of overweight and use of oral contraceptive. Apart from applying some form of pharmacological thromboprophylaxis, technical adaptations that might prevent or reduce spill over of foam into the deep venous system should be considered. Firstly, next to adherence to the generally accepted maximum of 10 mL of foam per session, it seems prudent to maximize the injected volume of foam per site. Secondly, it seems best to inject the foam in an elevated leg without groin compression. The concentration of the sclerosant does not appear decisive in this respect, although higher concentrations appear more effective and therefore might be injected in lower volumes without compromising efficacy.

show abstract

Section: Discussionmentioning

confidence: 99%

Fatal pulmonary embolism following ultrasound-guided foam sclerotherapy combined with multiple microphlebectomies

Bruijninckx¹

2016

Phlebology

View full text Add to dashboard Cite

show abstract

Chemical Superficial Vein Ablation

Cited by 1 publication

References 58 publications

Fatal pulmonary embolism following ultrasound-guided foam sclerotherapy combined with multiple microphlebectomies

Fatal pulmonary embolism following ultrasound-guided foam sclerotherapy combined with multiple microphlebectomies

Contact Info

Product

Resources

About