Fluoroscopy-Guided Endovenous Sclerotherapy Using a Microcatheter Prior to Endovenous Laser Ablation: Comparison between Liquid and Foam Sclerotherapy for Varicose Tributaries

Abstract

ObjectiveTo compare the efficacy and adverse effects of endovenous foam sclerotherapy (EFS) and liquid sclerotherapy (ELS) using a microcatheter for the treatment of varicose tributaries.Materials and MethodsFrom December 2007 to January 2009, patients with venous reflux in the saphenous vein were enrolled. The foam or liquid sclerosant was injected through a microcatheter just before endovenous laser ablation (EVLA). Patients were evaluated for the technical success, clinical success, and procedure-related complications during the procedure and follow-up visits.ResultsA total of 94 limbs were included: 48 limbs (great saphenous vein [GSV], 35; small saphenous vein [SSV], 13) were managed using EFS and EVLA (foam group; FG), and 46 limbs (GSV, 37; SSV, 9) were treated by ELS and EVLA (liquid group; LG). Varicose tributaries demonstrated complete sclerosis in 92.7% with FG and in 71.8% with LG (p = 0.014). Bruising (78.7% in FG vs. 73.2% in LG, p > 0.05), pain or tenderness (75.6% in FG vs. 51.2% in LG, p = 0.0237) were noted. Hyperpigmentation (51.2% in FG vs. 46.2% in LG, p > 0.05) was found.ConclusionEndovenous foam sclerotherapy using a microcatheter is more effective than ELS for eliminating remnant varicose tributaries prior to EVLA. However, EFS is more commonly associated with local complications such as pain or tenderness than ELS. Furthermore, both techniques seem to prolong the duration of hyperpigmentation along with higher costs.

A modified Tessari method for producing more foam

“…Owing to its high efficiency, safety and economical advantages, foam sclerotherapy was widely used in treatment of vascular abnormalities (Luebke and Brunkwall 2008 ; Myers and Roberts 2009 ; Park et al 2014 ; Van der Vleuten et al 2014 ; Wolmann 2010 ). The high efficiency of foam sclerotherapy was closely related to the physical obstruction of blood flow and the displacing the intravascular blood, which extended extent of contaction between the sclerosants and the vessel wall (Ikponmwosa et al 2010 ; Wolmann 2010 ; Eckmann 2009 ; Van Deurzen et al 2011 ).…”

Localized scleroderma, which developed as a result of phlebosclerosis: case report

“…Описано развитие таких осложнений данной процедуры, как выраженная болезненность, повышенная чувстви-тельность, гиперпигментация [14]. У нашей пациент-ки непосредственно после флебосклерозирования не наблюдалось каких-либо осложнений.…”

Clinical Observation of Foam Sclerotherapy Combined with Ligation of Great Saphenous Vein in the Treatment of Great Saphenous Varicose Veins

“…Sclerotherapy, that is to inject the chemical sclerosing agent to make intracutaneous, subcutaneous, and (or) intra-fascial varicose vein, and infra-fascial varicose vein of the Li et al 9 veneous malformation patients develop the venous wall secondary inflammation. At the same time, which is local compressed, after a period of time, the granulation tissue, and secondary fibrosis may form, and grow in the collapse vein lumen, then eventually forming fibrous stripes, as to achieve the aim of treatment the varicose vein (13,14). But the previous liquid sclerosing agents had not been used for large dosage, side effects, and high recurrence rate, which had been replaced by wide used foam sclerosing agent.…”