Consensus for Sclerotherapy

Weiss, Margaret A.; Hsu, Jeffrey T.S.; Neuhaus, Isaac M.; Sadick, Neil S.; Duffy, David M.

doi:10.1097/dss.0000000000000225

Cited by 56 publications

(47 citation statements)

References 42 publications

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“…Concomitant foam sclerotherapy was performed for distal incompetence in all patients with symptomatic visible varicosities or tortuous areas in the saphenous trunk. Other inclusion criteria were: disease clinical class C2eC4 according to the Clinical, Etiologic, Anatomic and Pathophysilogic classification; 15 patient suitability for RFA 16 and foam sclerotherapy; 17 and provided written informed consent. Exclusion criteria included a history of pulmonary embolism or deep venous thrombosis; antithrombotics, other than acetylsalicylic acid (ASA); BMI > 35; truncal vein diameter > 12 mm, measured 5 cm from the saphenofemoral or saphenopopliteal junction; and pregnancy.…”

Section: Enrolmentmentioning

confidence: 99%

Post-procedural Compression vs. No Compression After Radiofrequency Ablation and Concomitant Foam Sclerotherapy of Varicose Veins: A Randomised Controlled Non-inferiority Trial

Pihlaja

Romsi

Ohtonen

et al. 2020

European Journal of Vascular and Endovascular Surgery

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This randomised controlled, non-inferiority trial compared post-procedural compression with no compression applied to the leg after radiofrequency ablation of a truncal vein and concomitant foam sclerotherapy to tributaries. In terms of safety and efficacy, results were similar with and without post-operative compression. Objective: To compare post-operative compression with no compression, after radiofrequency endothermal ablation (RFA) of a truncal varicose vein and concomitant foam sclerotherapy of the tributaries. Methods: This prospective randomised controlled, non-inferiority trial recruited patients from two centres in Northern Ostrobothnia, Finland. Patients with clinical class C2eC4 chronic venous disease were randomised to receive no compression after the operation, or to receive compression stockings continuously for two days, and then, during the daytime for five days. In follow up visits, additional foam sclerotherapy was performed for symptoms of distal incompetence. Patients were followed up for six months. The primary outcome was occlusion of the RFA treated truncal vein at six months. Secondary outcomes were return to full activity within 14 days, Aberdeen Varicose Vein Questionnaire (AVVQ) score, post-operative pain, need for painkillers, and postprocedural complications. Results: Of 177 included patients, 90 were allocated to post-operative compression and 87 to no compression. At six months, both groups showed 100% occlusion rates in RFA treated truncal veins (95% confidence interval À0.043e0.042). Within 14 days of treatment, full physical activity was achieved by 87% of the compression group and 81% of the no compression group, (p ¼ .29). At six months, the AVVQ scores were comparable and significantly improved in both groups, compared with baseline. Pain scores were comparable between groups, in day to day analyses, and they were significantly lower in both groups on day 10, compared with pre-operative pain caused by varicose veins. On average, post-operative pain medication was used for 2.3 days and for 2.8 days in the compression and no compression groups, respectively (p ¼ .28). Complications throughout the six month follow up were comparable between groups, although skin rash/ blisters occurred more often in the compression group (p ¼ .01). Conclusion: After treating C2eC4 varicose veins with RFA and concomitant foam sclerotherapy, no postoperative compression was non-inferior to post-operative compression, in terms of safety and efficacy. ClinicalTrials.gov Identifier: NCT02890563

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Section: Enrolmentmentioning

confidence: 99%

Post-procedural Compression vs. No Compression After Radiofrequency Ablation and Concomitant Foam Sclerotherapy of Varicose Veins: A Randomised Controlled Non-inferiority Trial

Pihlaja

Romsi

Ohtonen

et al. 2020

European Journal of Vascular and Endovascular Surgery

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“…Contraindications for sclerotherapy per the European guidelines for sclerotherapy include known allergies to sclerosants, acute deep vein thrombosis and/or pulmonary embolism, local infection in the area of treatment, severe arterial occlusive disease, and immobility (Grade 1C) [1,3]. In addition, a patient with a known symptomatic patent foramen ovale should not be treated with foam sclerotherapy.…”

Section: Choosing the Right Patient And The Right Veinsmentioning

confidence: 99%

“…Relative contraindications include pregnancy, breastfeeding (can consider interrupting breastfeeding for 2-3 days), mild arterial occlusive disease, strong history of multiple allergies, high thromboembolic risk, acute superficial venous thrombosis [1,3]. Patients with a history of migraines especially following previous foam sclerotherapy should be treated with caution.…”

Section: Choosing the Right Patient And The Right Veinsmentioning

confidence: 99%

“…The advantage of hypertonic saline is its lack of allergenicity and low cost. While it was widely used prior to the availability of detergent based solution, its use is less favored due to the increased risk of ulcerations from extravasation and hyperpigmentation and the intense burning sensation upon injection from its irritant effect on nerve endings [3].…”

Section: Types Of Sclerosantmentioning

confidence: 99%

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Sclerotherapy – How to Achieve a Spectacular Outcome

Mann

2020

Phlebologie

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AbstractWhen performed correctly, sclerotherapy results in fibrous occlusion that is not amenable to recanalization. Paramount to success is adequate contact time of a sclerosant to the endothelial cells to cause sufficient damage to the vein while minimizing side effects. To optimize sclerotherapy results, one needs to choose the right patient and the right vein and then use the proper sclerosing agent and injection techniques. This paper will review current literature on sclerotherapy, as well as tips and tricks to optimize outcome and minimize complications.

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“…Варикозно расширенные вены наблюдаются у 25 % женщин и 10 % мужчин [5,9], а основным клиническим проявлением венозно-го варикоза нижних конечностей является боль в ни-жних конечностях, исчезновение или степень умень-шения выраженности которой относятся к критериям эффективности лечения заболевания [2,11].…”

Section: Introductionunclassified

Болевой Синдром При Варикозной Болезни Под Влиянием Эндовенозной Лазерной Абляции

Siniachenko¹,

Melekhovets²

2022

PJS

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Параллельное с эндовазальной (эндовенозной) лазерной абляцией проведение кроссэктомии повышает аналгетическую эффективность оперативного лечения варикозной болезни нижних конечностей на начальных этапах наблюдения за больными (через 1 неделю). Интегральная динамика физико-химических показателей адсорбционно-реологических свойств венозной крови у больных с кроссэктомией и без таковой не отличается, причем независимо от выполненной кроссэктомии к первому месяцу после лазерной эндовенозной коагуляции происходит нормализация параметров поверхностной вязкости и упругости, модуля вязкоэластичности, улучшение значений объемной вязкости и поверхностной релаксации. Маломощная эндовенозная лазерная абляция с излучением 10 ватт и менее через 4 недели после операции превосходит по аналгетической эффективности выполненное хирургическое лечение варикозной болезни нижних конечностей с излучением в 15 ватт, при этом способствует уменьшению релаксационных свойств сыворотки венозной крови, а интегральные параметры адсорбционно-реологических свойств сыворотки зависят от влияния энергии лазера на длину и площадь просвета стриппинга.

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Consensus for Sclerotherapy

Abstract: The ASDS consensus documents on sclerotherapy will be helpful in educating their members on safe and effective sclerotherapy of varicose and telangiectatic leg veins.

Cited by 56 publications

References 42 publications

Post-procedural Compression vs. No Compression After Radiofrequency Ablation and Concomitant Foam Sclerotherapy of Varicose Veins: A Randomised Controlled Non-inferiority Trial

Post-procedural Compression vs. No Compression After Radiofrequency Ablation and Concomitant Foam Sclerotherapy of Varicose Veins: A Randomised Controlled Non-inferiority Trial

Sclerotherapy – How to Achieve a Spectacular Outcome

Болевой Синдром При Варикозной Болезни Под Влиянием Эндовенозной Лазерной Абляции

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