Re: ‘Catheter-directed Foam Sclerotherapy of Great Saphenous Veins in Combination with Pre-treatment Reduction of the Diameter Employing the Principals of Perivenous Tumescent Local Anesthesia’

Cavezzi, Attilio; Mosti, Giovanni; Paolo, Sonia Di; Tessari, L; Campana, Fausto; Urso, S

doi:10.1016/j.ejvs.2014.07.012

Cited by 11 publications

(15 citation statements)

References 3 publications

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“…We reported a lower the great saphenous vein recanalization rate than that of Cavezzi et al [18] , who in their study, used a technique which was similar, but did not include the saphenofemoral junction ligation. Admittedly, they used a technique which was different than ours.…”

Section: Discussionmentioning

confidence: 49%

Foam sclerotherapy combined with saphenofemoral ligation procedure: long-term results

Soylu

Aydın

2019

The European Research Journal

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Objective: To evaluate the clinical effect of the foam sclerotherapy combined with saphenofemoral ligation (FS-SFL) in a selected group of patients with varicose disease and present the long-term results of ten-year ultrasonographic follow-up. Methods: Sixty-five patients with primary varicose veins due to the great saphenous vein incompetence who had been treated with FS-SFL were retrospectively reviewed over a period of ten years. The patients were assessed before and after the treatment by Doppler ultrasonography and clinical examination. Results: The mean age of the patients was 44.6 ± 11 years (range: 19 to 87 years), and 51 were females and 14 were males. Follow-up for all patients was ten years. The most common complication was skin pigmentation. There were no major complications. No recanalization of the great saphenous vein was seen in any patient. Conclusions: FS-SFL is a safe and effective method of treating varicose veins. This treatment have a low rate of recanalization in their long-term follow-up.

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Section: Discussionmentioning

confidence: 49%

Foam sclerotherapy combined with saphenofemoral ligation procedure: long-term results

Soylu

Aydın

2019

The European Research Journal

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“…The concept of application of tumescent solution perivenously is currently well known and widely used during treatment of patients managed with thermal ablations. As has been previously mentioned, the use of tumescent solution was also proposed to augment sclerotherapy [34,35]. A fluid injected perivenously compresses the vein, removes blood from its lumen and leads to significant shrinking of the target vein that allows a reduction of foam volume.…”

Section: Discussionmentioning

confidence: 99%

“…Alternatively to the use of MOCA, it is possible to administer tumescent solution around the treated vein in order to decrease volume of foam, which is needed for successful sclerotherapy. Potentially, an external compression along the entire vein can improve contact of foam with the venous wall (due to blood removal) and protect the sclerosant from being deactivated by blood compounds [34,35]. In this paper, the authors present their own experiences with US-guided, catheter-directed, tumescent supported foam obliteration (TAES) of incompetent saphenous veins.…”

Section: Tumescent-assisted Echosclerotherapy (Taes) In the Treatmentmentioning

confidence: 99%

Tumescent-assisted echosclerotherapy (TAES) in the treatment of great saphenous vein incompetence

Hawro¹,

Urbanek²,

Mikusek³

2017

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Objectives: Despite encouraging results of saphenous vein sclerotherapy this method is not free of potential complications and does not guarantee a 100% rate of occlusion. In this paper, the author's own experiences with catheter-directed, tumescent solution-supported echo-guided foam sclerotherapy of the saphenous vein are presented. Material and methods: Thirty-four incompetent great saphenous veins were treated with foam sclerotherapy involving the use of long catheters and perivenous tumescent solution injection prior to foam administration. The mean length of incompetent saphenous veins was 25.5cm (range 14-39 cm). The diameters of the proximal part of the saphenous veins ranged from 5.0 to 15.0 mm. In 25 patients (71.4%), primary varicose veins were diagnosed, and in other patients either post-surgical (recurrent) or post-thrombotic saphenous veins were treated. Results: At 30-day follow up total occlusion of the entire segment of treated vein was achieved in 79.4% of cases. In one case the vein was not occluded, and in 6 patients (17.6%) a partial occlusion was revealed. In the group of 6 patients with partial vein occlusion, a repeated sclerotherapy with the use of a short catheter and ultrasound guided puncture was performed. 6 and 12 months after the procedure, 32 out of 34 obliterated veins (94.1%) remained fully occluded. The mean foam volume used for saphenous vein obliteration was 2.6 ml. No serious adverse events were reported. Conclusions: Tumescent-assisted echo-guided foam sclerotherapy is a safe and clinically effective method of saphenous vein obliteration, particularly for veins with no history of a previous thrombosis or surgical treatment.

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“…Das trifft nicht zu, denn Tumeszenzlösung wird binnen Tagen resorbiert, woraufhin die Vene erneut ein großes Volumen einnimmt, um sich dann über Monate allmählich zurückzubilden bis zum bindegewebigen Strang. Es ist unerheblich, ob die Tumeszenzflüssigkeit Adrenalin oder andere Zusatzstoffe beinhaltet (7,8), denn sie wird jedenfalls viel zu rasch resorbiert, um symptomatische Verödungsreaktionen vermeiden zu können.…”

Section: Introductionunclassified

Foam sclerotherapy of segments of the saphenous vein with adjuvant hyaluronan compression

Despa¹,

Brüggemann²,

El-Chamali³

et al. 2017

Phlebologie

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SummaryBackground: Thermal, mechano-chemical and chemical methods of vein closure are increasingly less effective in saphenous veins with diameters above 10 mm. Furthermore, increasing vein size is associated with unpleasant inflammatory reactions, in particular in locations close to sensitive structures like the skin. External compression media are not able to prevent these unwanted sequela in a tolerable way. As a possible solution, perivenous hyaluronan compression was evaluated combined with microfoam sclero-therapy.Methods: 34 patients (25 f, 9 m, 43–71 yr/o) with saphenous insufficiency (GSV), dia -meters 10.1–23.1 mm (M: 14.1 mm), distance to skin: >10 mm, received a vein lumen compression oft thigh- or calf segments by perivenous injection of a NASHA gel mediated by a coaxial paravenous catheter prior to catheter-applied microfoam sclerotherapy (aethoxysklerol 1 %). Injection of both, hyaluronan and microfoam, were performed during catheter withdrawal. The aim of hyaluronan compression was a 2/3 reduction oft the native vein cross section. For comparison, adjacent segments were compressed with common tumescent fluid. Segments for both modalities had similar diameter and were randomized. Due to department rules, the junction segment was closed with endovenous lasers to warrant elimination of reflux. No textile compression media were applied. Clinical controls including ultrasound were performed after 2, 8, 26 and 54 weeks.Results: All treated vein segments showed total occlusion after 2 weeks (first visit). The lumen reduction was 54–81 % (M: 68.4 %) in segments with hyaluronan compression and 8–29 % (M: 19.2 %) in segments with tumes-cent fluid. Time needed for hyaluronan compression was 1.1–3.5 min (M: 2.2 min) and for tumescence 0.8–2.7 min (M: 1.8 min) per 10 cm-segment. Clinical investigations up to 8 weeks did not reveal any symptoms, visible inflammations or stainings in segments covered with hyaluronan, while tumescent-compressed segments had such findings in 20/34 cases (58.8 %). Perivenous hyaluronan did not induce any discomfort or side effects during follow-up.Conclusions: Even large saphenous veins can be effectively and safely treated by microfoam sclerotherapy without any postinterventional symptoms when the vein lumen is reduced by perivenous injection of hyaluronan gel. However, it takes additional interventional effort to achieve this goal. Future applications could also include combinations with thermal or gluing device or support novel foams like Varithena or biomatrix sclerofoam when treating very large veins or venous aneurysms, and furthermore serve in vein shaping fort the purpose of establishing laminar flow or modifying pressure relations (venoplasty).

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Re: ‘Catheter-directed Foam Sclerotherapy of Great Saphenous Veins in Combination with Pre-treatment Reduction of the Diameter Employing the Principals of Perivenous Tumescent Local Anesthesia’

Cited by 11 publications

References 3 publications

Foam sclerotherapy combined with saphenofemoral ligation procedure: long-term results

Foam sclerotherapy combined with saphenofemoral ligation procedure: long-term results

Tumescent-assisted echosclerotherapy (TAES) in the treatment of great saphenous vein incompetence

Foam sclerotherapy of segments of the saphenous vein with adjuvant hyaluronan compression

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