Efficacy of Sclerotherapy in Varicose Veins-A Prospective, Blinded, Placebo-Controlled Study

Kahle, Birgit; Leng, Katharina

doi:10.1111/j.1524-4725.2004.30207.x

Cited by 28 publications

(17 citation statements)

References 24 publications

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“…In the United States, sodium morrhuate and STS are approved for treating varicosities. Polidocanol is superior to normal saline in obliterating incompetent varicose veins and improving venous hemodynamics as assessed at 12 weeks of treatment [104]. In Europe, sclerotherapy with polidocanol foam with duplex ultrasound guidance has become standard in the treatment of intracutaneous telangiectasies, subcutaneous varicose veins, transfascial perforating veins and venous malformations [105].…”

Section: Management Of Varicose Veinsmentioning

confidence: 99%

Matrix Metalloproteinases in Venous Tissue Remodeling and Varicose Vein Formation

Raffetto¹,

Khalil²

2008

CVP

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Matrix metalloproteinases (MMPs) play a major role in extracellular matrix (ECM) turnover under both physiological and pathological conditions. Studies on venous tissues from experimental animals and humans identified several MMP subtypes, and showed significant changes in the expression and activity of specific MMPs during vein wall remodeling. Also, significant research has focused on the role of MMPs in chronic venous disease (CVD) and varicose vein formation in the lower extremities and their progression to thrombophlebitis and venous leg ulcer. Several hypotheses have been forwarded regarding the pathophysiological mechanisms underlying the relation between MMPs and the formation, progression and complications of varicose veins. The effects of MMPs on ECM degradation could result in significant venous tissue remodeling and degenerative and structural changes in the vein wall, leading to venous dilation and valve dysfunction. MMPs may also induce early changes in the endothelium and venous smooth muscle function in the absence of significant ECM degradation or structural changes in the vein wall. In addition, evidence suggests increased activity of MMPs in the advanced stages of chronic venous insufficiency (CVI) associated with skin changes and leg ulceration as well as in the wound fluid environment. Several pharmacological therapies and surgical strategies are being utilized in the management of varicose veins, with variable success and recurrence rates. Inhibition of MMPs may represent a novel therapeutic intervention to limit the progression of varicose veins to CVI and leg ulceration.

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Section: Management Of Varicose Veinsmentioning

confidence: 99%

Matrix Metalloproteinases in Venous Tissue Remodeling and Varicose Vein Formation

Raffetto¹,

Khalil²

2008

CVP

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“…Sodium morrhuate and STS are approved for treating varicosities in the United States. Polidocanol is superior to normal saline in obliterating incompetent VVs and improving venous hemodynamics [321]. Sclerotherapy with polidocanol foam under duplex ultrasound guidance is a standard treatment of intracutaneous telagectasies, subcutaneous VVs, transfascial perforating veins and venous malformations in Europe [322].…”

Section: Introductionmentioning

confidence: 99%

Matrix Metalloproteinases as Potential Targets in the Venous Dilation Associated with Varicose Veins

Khalil¹

2013

Current Drug Targets

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Varicose veins (VVs) are a common venous disease of the lower extremity characterized by incompetent valves, venous reflux, and dilated and tortuous veins. If untreated, VVs could lead to venous thrombosis, thrombophlebitis and chronic venous leg ulcers. Various genetic, hormonal and environmental factors may lead to structural changes in the vein valves and make them incompetent, leading to venous reflux, increased venous pressure and vein wall dilation. Prolonged increases in venous pressure and vein wall tension are thought to increase the expression/activity of matrix metalloproteinases (MMPs). Members of the MMPs family include collagenases, gelatinases, stromelysins, matrilysins, membrane-type MMPs and others. MMPs are known to degrade various components of the extracellular matrix (ECM). MMPs may also affect the endothelium and vascular smooth muscle, causing changes in the vein relaxation and contraction mechanisms. ECs injury also triggers leukocyte infiltration, activation and inflammation, which lead to further vein wall damage. The vein wall dilation and valve dysfunction, and the MMP activation and superimposed inflammation and fibrosis would lead to progressive venous dilation and VVs formation. Surgical ablation is an effective treatment for VVs, but may be associated with high recurrence rate, and other less invasive approaches that target the cause of the disease are needed. MMP inhibitors including endogenous tissue inhibitors (TIMPs) and pharmacological inhibitors such as zinc chelators, doxycycline, batimastat and marimastat, have been used as diagnostic and therapeutic tools in cancer, autoimmune and cardiovascular disease. However, MMP inhibitors may have side effects especially on the musculoskeletal system. With the advent of new genetic and pharmacological tools, specific MMP inhibitors with fewer undesirable effects could be useful to retard the progression and prevent the recurrence of VVs.

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“…[7] A study conducted by Kahle et al has shown 76.8% improvement in the disappearance of varicose veins. [12] Cabrera et al have reported complete healing of venous ulcers in 83% of patients. [13] Hence the results of our study correlate well with the above studies.…”

Section: Discussionmentioning

confidence: 98%

Sclerotherapy in the management of varicose veins and its dermatological complications

Subbarao¹,

Aradhya²,

Veerabhadrappa³

2013

Indian J Dermatol Venereol Leprol

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Sclerotherapy is a simple, safe and effective procedure for the treatment of varicose veins and its dermatological complications. The procedure is particularly effective for smaller, early varicosities and also for residual veins after surgery. Hence we recommend more and more of our fellow dermatologists to take up this procedure, which can be an efficient tool to manage patients with varicose veins and its related complications.

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Efficacy of Sclerotherapy in Varicose Veins-A Prospective, Blinded, Placebo-Controlled Study

Abstract: Injection sclerotherapy using polidocanol (Aethoxysklerol) is efficient to obliterate varicose veins and to improve venous hemodynamics.

Cited by 28 publications

References 24 publications

Matrix Metalloproteinases in Venous Tissue Remodeling and Varicose Vein Formation

Matrix Metalloproteinases in Venous Tissue Remodeling and Varicose Vein Formation

Matrix Metalloproteinases as Potential Targets in the Venous Dilation Associated with Varicose Veins

Sclerotherapy in the management of varicose veins and its dermatological complications

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