Sclerosants in Microfoam: A New Approach in Angiology

Cabrera, Juan; Garcia-Olmedo, María Antonia

doi:10.1016/b978-012369515-4/50025-9

Cited by 38 publications

(42 citation statements)

References 7 publications

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“…Feasibility, effectiveness, efficacy 4,6,[17][18][19]21,[23][24][25][26][27][28][29]31,34,[37][38][39] and comparative 5,7,10,[12][13][14][15][16]20,22,[40][41] studies have been conducted in many countries and distinct continents. The transition from air to a physiologic gas has been supported by the experience of Cabrera in Spain and by the international trials conducted by Provensis to test the physiologic mix Varisolve.…”

Section: Discussionmentioning

confidence: 99%

“…4,6,7,[9][10][11][12][13][14][15][16] Patients of all abnormal, clinical, CEAP classes have been treated with UGFS. 1,2,4,6,7,[11][12][13][14][16][17][18][19][20][21][22][23][24][25][26][27][28] Foam sclerotherapy has been used to successfully treat: (1) saphenous veins primarily, (2) to complement, complete, or extend stripping or thermal ablation by laser or radiofrequency, (3) recurrent veins, (4) venous malformations, (5) venous aneurysms, (6) sciatic nerve varices, and (7) saphenous or nonsaphenous perforating veins. Side effects and adverse events have been described not only for UGFS but for all methods of treating the superficial veins of the lower extremity, surgical or nonsurgical.…”

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confidence: 99%

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Comparisons of side effects using air and carbon dioxide foam for endovenous chemical ablation

Morrison

Neuhardt²,

Rogers

et al. 2008

Journal of Vascular Surgery

109

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Comparisons of side effects using air and carbon dioxide foam for endovenous chemical ablation

Morrison

Neuhardt²,

Rogers

et al. 2008

Journal of Vascular Surgery

109

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“…Recurrent varicose veins were found in 3 patients (8.1%) in the duplex-guided foam sclerotherapy group and in 10 (25%) in the duplex-guided liquid sclerotherapy group at 1 year (P ϭ .048). Cabrera et al 333 reported an 80% occlusion rate at 4 to 6 years when they used microfoam to treat incompetent GSV in 415 limbs.…”

Section: Sclerotherapymentioning

confidence: 98%

The care of patients with varicose veins and associated chronic venous diseases: Clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum

Gloviczki

Comerota²,

Dalsing

et al. 2011

Journal of Vascular Surgery

1,298

952

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The Society for Vascular Surgery (SVS) and the American Venous Forum (AVF) have developed clinical practice guidelines for the care of patients with varicose veins of the lower limbs and pelvis. The document also includes recommendations on the management of superficial and perforating vein incompetence in patients with associated, more advanced chronic venous diseases (CVDs), including edema, skin changes, or venous ulcers. Recommendations of the Venous Guideline Committee are based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system as strong (GRADE 1) if the benefits clearly outweigh the risks, burden, and costs. The suggestions are weak (GRADE 2) if the benefits are closely balanced with risks and burden. The level of available evidence to support the evaluation or treatment can be of high (A), medium (B), or low or very low (C) quality. The key recommendations of these guidelines are: We recommend that in patients with varicose veins or more severe CVD, a complete history and detailed physical examination are complemented by duplex ultrasound scanning of the deep and superficial veins (GRADE 1A). We recommend that the CEAP classification is used for patients with CVD (GRADE 1A) and that the revised Venous Clinical Severity Score is used to assess treatment outcome (GRADE 1B). We suggest compression therapy for patients with symptomatic varicose veins (GRADE 2C) but recommend against compression therapy as the primary treatment if the patient is a candidate for saphenous vein ablation (GRADE 1B). We recommend compression therapy as the primary treatment to aid healing of venous ulceration (GRADE 1B). To decrease the recurrence of venous ulcers, we recommend ablation of the incompetent superficial veins in addition to compression therapy (GRADE 1A). For treatment of the incompetent great saphenous vein (GSV), we recommend endovenous thermal ablation (radiofrequency or laser) rather than high ligation and inversion stripping of the saphenous vein to the level of the knee (GRADE 1B). We recommend phlebectomy or sclerotherapy to treat varicose tributaries (GRADE 1B) and suggest foam sclerotherapy as an option for the treatment of the incompetent saphenous vein (GRADE 2C). We recommend against selective treatment of perforating vein incompetence in patients with simple varicose veins (CEAP class C(2); GRADE 1B), but we suggest treatment of pathologic perforating veins (outward flow duration ≥500 ms, vein diameter ≥3.5 mm) located underneath healed or active ulcers (CEAP class C(5)-C(6); GRADE 2B). We suggest treatment of pelvic congestion syndrome and pelvic varices with coil embolization, plugs, or transcatheter sclerotherapy, used alone or together (GRADE 2B).

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“…Sclerotherapy remains a cost-effective way of treating varicose veins particularly for recurrent veins, patients with tortuous veins, and those unable to tolerate anesthesia or sedation, and allows treatment to be performed with minimal discomfort, rapid recovery times, and high levels of patient satisfaction in many cases. [37][38][39] Uniformity in the reporting standards of studies using sclerotherapy, such as including details of the type and form of sclerosant used, the gas mixture, details of the preparation technique, and the volumes used would be helpful in allowing comparisons between studies, which at present is difficult due to the heterogeneity of the reported data. There is also a need for clinicians to report all major complications to the regulatory authorities so that an accurate picture of complication rates is reported, as there is often a tendency to report only positive results.…”

Section: Discussionmentioning

confidence: 98%