Foam Sclerotherapy Augmented Phlebectomy (SAP) Procedure for Varicose Veins: Report of a Novel Technique

Kolluri, Raghu; Hays, Katherine; Gohel, Manjit

doi:10.1016/j.ejvssr.2018.10.007

Cited by 4 publications

(5 citation statements)

References 14 publications

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“…In 2018, Kolluri described the potential technical benefit of injecting foam sclerotherapy before an ultrasound guided phlebectomy. 179 In the last 10 years, a few publications reported a higher saphenous occlusion rate following foam sclerotherapy by means of a long catheter. Furthermore, the combination of catheter foam sclerotherapy with ultrasound-guided peri-saphenous tumescence infiltration and vein irrigation, prior to foam delivery, resulted in an up to 96.5% reflux-free rate at three years' followup in two prospective studies published in 2017.…”

Section: Significant New Data Reported At the Meetingmentioning

confidence: 99%

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Global guidelines trends and controversies in lower limb venous and lymphatic disease

et al. 2019

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Guidelines are fundamental in addressing everyday clinical indications and in reporting the current evidence-based data of related scientific investigations. At the same time, a spatial and temporal issue can limit their value. Indeed, variability in the recommendations can be found both among the same nation different scientific societies and among different nations/continents. On the other side, Garcia already published in 2014 data showing how, after three years in average, one out of five recommendations gets outdated (Martinez Garcia LM, Sanabria AJ, Garcia Alvarez E, et al. The validity of recommendations from clinical guidelines: a survival analysis. CMAJ 2014;186(16):1211–1219). The present document reports a narrative literature revision on the major international recommendations in lower limb venous and lymphatic disease management, focusing on the different countries’ guidelines, trends and controversies from all the continents, while identifying new evidence-based data potentially influencing future guidelines. World renowned experts’ opinions are also provided. The document has been written following the recorded round tables scientific discussions held at the vWINter international meeting (22–26 January 2019; Cortina d’Ampezzo, Italy) and the pre- and post-meeting literature search performed by the leading experts.

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Section: Significant New Data Reported At the Meetingmentioning

confidence: 99%

“…In 2018, Kolluri described the potential technical benefit of injecting foam sclerotherapy before an ultrasound guided phlebectomy. 179…”

Section: Sclerotherapy For Varicose Veinsmentioning

confidence: 99%

Global guidelines trends and controversies in lower limb venous and lymphatic disease

et al. 2019

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“…Как можно улучшить результаты лечении варикозно расширенных притоков и снизить количество нежелательных явлений? В мировой литературе есть единичные публикации, в которых говорится об эффективности и безопасности комбинации МПСТ с минифлебэкто мией [12], но конкретных исследований, сравниваю щих комбинированное пособие по устранению варикозного синдрома с изолированным использованием каждой из методик, не описано.…”

Section: флебологияunclassified

Combined microfoam sclerotherapy and miniphlebectomy as an optimal method of treating varicose vein tributaries after endovenous laser ablation

Danelyan

Manjikian

Adyrkhaev

et al. 2022

Ambulatornaya khirurgiya

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Introduction. The development of phlebology and mainstreaming of ultrasonic techniques has led to the emergence of microfoam sclerotherapy, which proved itself as a more effective technique. In the world literature, there are isolated publications that say about the effectiveness and safety of the microfoam sclerotherapy combined with mini-phlebectomy, but no specific studies comparing the combination treatment for the elimination of varicose syndrome with separate use of each of the techniques are described.Aim. To increase the effectiveness of invasive treatment and to reduce the rate of complications in patients with varicose veins using a combination of microfoam sclerotherapy and mini-phlebectomy of tributaries after endovenous laser ablation.Material and methods. Simple single- center, non-randomized, retrospective study was conducted at the A.K. Eramishantsev Moscow State Hospital. It included 52 patients with varicose veins (a total of 77 lower limbs, 22 patients had bilateral disease), who had no previous invasive treatment for this disease. They underwent endovenous laser ablation of truncal vein combined with microfoam sclerotherapy and mini-phlebectomy of tributaries. Microfoam sclerotherapy was performed with 0.5–2.0% of polidocanol foam, and mini-phlebectomy per Varady technique. The patients had a postprocedural follow-up clinical examination and duplex ultrasound the day after the intervention, then at 1, 6, and 12 months.Results. Endovenous laser ablation of truncal veins was acutely successful in all cases. No cases of great saphenous vein recanalization were detected in follow-up period. In the early postprocedural period, the combined microfoam sclerotherapy and miniphlebectomy also showed 100% success rate, however redo sclerotherapy was required in 4 (5.2%) cases for new varicose tributaries developed in late postprocedural period.Conclusion. Combined microfoam sclerotherapy and mini-phlebectomy, as a method of treatment for various veins syndrome, can provide additional benefit such as reducing the volume of mini-phlebectomy and the resultant tissue damage, the varicosity recurrence rate, the number of subcutaneous hematomas and ecchymoses, the discomfort of the tumescent anesthesia, the risk of postprocedural varicose veins thrombosis and pigmentation rate.

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“…More recently, a novel technique known as sclerotherapy augmented phlebectomy (SAP) has been developed, which combines venous stripping of large varicose segments with sclerotherapy of smaller segments (Kolluri, Hays, & Gohel, 2018). Sclerotherapy is reported to be 32% cheaper than surgery (Belcaro et al, 2000).…”

Section: Foam Sclerotherapymentioning

confidence: 99%

“…The benefits of UGFS include accurate placement of the needle within the venous lumen, demonstration of the path travelled by the foam plug, and the potential to observe spasm within treated vessels (Gibson & Gunderson, 2018). More recently, a novel technique known as sclerotherapy augmented phlebectomy (SAP) has been developed, which combines venous stripping of large varicose segments with sclerotherapy of smaller segments (Kolluri, Hays, & Gohel, 2018). Sclerotherapy is reported to be 32% cheaper than surgery (Belcaro et al, 2000).…”

Section: Foam Sclerotherapymentioning

confidence: 99%

Foam‐in‐vein: A review of rheological properties and characterization methods for optimization of sclerosing foams

et al. 2020

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Varicose veins are chronic venous defects that affect >20% of the population in developed countries. Among potential treatments, sclerotherapy is one of the most commonly used. It involves endovenous injection of a surfactant solution (or foam) in varicose veins, inducing damage to the endothelial layer and subsequent vessel sclerosis. Treatments have proven to be effective in the short-term, however recurrence is reported at rates of up to 64% 5-year post-treatment. Thus, once diagnosed with varicosities there is a high probability of a permanently reduced quality of life. Recently, foam sclerotherapy has become increasingly popular over its liquid counterpart, since foams can treat larger and longer varicosities more effectively, they can be imaged using ultrasound, and require lower amounts of sclerosing agent. In order to minimize recurrence rates however, an investigation of current treatment methods should lead to more effective and long-lasting effects. The literature is populated with studies aimed at characterizing the fundamental physics of aqueous foams; nevertheless, there is a significant need for appropriate product development platforms. Despite successfully capturing the microstructural evolution of aqueous foams, the complexity of current models renders them inadequate for pharmaceutical development. This review article will focus on the physics of foams and the attempts at optimizing them for sclerotherapy. This takes the form of a discussion of the most recent numerical and experimental models, as well as an overview of clinically relevant parameters. This holistic approach could contribute to better foam characterization methods that patients may eventually derive long term benefit from.

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Foam Sclerotherapy Augmented Phlebectomy (SAP) Procedure for Varicose Veins: Report of a Novel Technique

Cited by 4 publications

References 14 publications

Global guidelines trends and controversies in lower limb venous and lymphatic disease

Global guidelines trends and controversies in lower limb venous and lymphatic disease

Combined microfoam sclerotherapy and miniphlebectomy as an optimal method of treating varicose vein tributaries after endovenous laser ablation

Foam‐in‐vein: A review of rheological properties and characterization methods for optimization of sclerosing foams

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