Complications, Indication and Tolerance of Foam Sclerotherapy in Varicose Vein Management Done in A Tertiary Care Centre in South India

Abstract

INTRODUCTION: Foam sclerotherapy is used for treating varicose veins in our institution for patients who are not willing for surgery, debilitated patients, recurrent ulcers, cosmetic & in SFV (Sapheno Femoral Vein) <6 mm size. AIM: The aim of this study was to find and assess the rate and pattern of post–sclerotherapy complications in our institution compared with international standards. MATERIALS AND METHOD: The present study was retrospective in nature and case records of patients who underwent foam sclerotherapy [2009-2013, lower limb-Ultrasound (USG) guided and blind] in our hospital [10% Sodiumtetradecylsulfate (STS), Tessari technique] were assessed to look for indication, tolerance to the procedure and immediate outcomes. A pre-tested and pre-validated questionnaire was used and physical examination were done to assess post-procedural complications. Statistical significance was p< 0.05. RESULTS: Among 112 patients, 62.5 % were aged >50 years and 69% were males. It was observed that 22% had indication as recurrence; 43% had mild pain during procedure and 36.6% developed post-foam sclerotherapy complications. 47.6% of patients whose age were <50 years had CEAP(Clinical Etiological Anatomical Pathological) criteria C2(p=0.007). 48.8% with complications had multiple criteria(p=0.012) and 57.7% C2 had least complication (p=0.000). Cosmetic indication showed least tolerance. Use of 10% STS was found to have lesser complication rate (36%), compared to study which had 76% success with STS 3% and complication-64%. CONCLUSION: Foam sclerotherapy is less invasive and its efficacy could be improved by performing under USG guidance, selection of sclerosant, appropriate candidate (age>50 years, multiple CEAP criteria, without pre-existing co-morbidities).