Sclerotherapy in the management of varicose veins and its dermatological complications

Subbarao, Nagesh Tumkur; Aradhya, Sacchidanand Sarvajnamurthy; Veerabhadrappa, Nataraja H

doi:10.4103/0378-6323.110746

Cited by 10 publications

(7 citation statements)

References 11 publications

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“…Sclerotherapy (endovenous chemical ablation) represents the treatment of choice for telangiectasia and is also indicated in the treatment of reticular and short saphenous varicose veins. 2,3 However, this procedure could induce several possible side effects such as postsclerosis hyperpigmentation, matting, or ulceration, [4][5][6][7] which should be avoided for both clinical and esthetic reasons. [7][8][9] So far no strategy has aimed to limit the inflammatory response induced by the sclerotherapeutic process.…”

Section: Introductionmentioning

confidence: 99%

Beneficial effects of the micronized purified flavonoid fraction (MPFF, Daflon® 500 mg) on microvascular damage elicited by sclerotherapy

et al. 2014

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Section: Introductionmentioning

confidence: 99%

Beneficial effects of the micronized purified flavonoid fraction (MPFF, Daflon® 500 mg) on microvascular damage elicited by sclerotherapy

et al. 2014

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“…Among the study subjects, 36.61% were found to have post-foam sclerotherapy complications, immediately after the procedure/within 3-6 months of procedure, which goes in hand with the findings in study conducted by Subbarao.et.al, in which 64% had postfoam sclerotherapy complications like bruising-38%, pigmentation-10%, recurrence-4% ,DVT-2%. 10 This study showed a higher incidence of complications possibly due to inclusion of thrombophlebitis, which is considered as a part of mode of action of sclerosant and not taken into account in the present study.…”

Section: Discussionmentioning

confidence: 56%

“…Whereas the above study had not reported any case of skin necrosis. 10 Mostly observed post procedural complication was skin pigmentation (19%) which lasted for more than 1 week after the procedure and for which patient had to revisit the general surgery outpatient department(OPD) and had undergone either repeat foam sclerotherapy or other treatment. Next most common complication found was ulcer at the injection site, majority of which had associated pain at the injection site.…”

Section: Discussionmentioning

confidence: 99%

Complications, Indication and Tolerance of Foam Sclerotherapy in Varicose Vein Management Done in A Tertiary Care Centre in South India

Oli¹,

Mc²

2021

IHRJ

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INTRODUCTION: Foam sclerotherapy is used for treating varicose veins in our institution for patients who are not willing for surgery, debilitated patients, recurrent ulcers, cosmetic & in SFV (Sapheno Femoral Vein) <6 mm size. AIM: The aim of this study was to find and assess the rate and pattern of post–sclerotherapy complications in our institution compared with international standards. MATERIALS AND METHOD: The present study was retrospective in nature and case records of patients who underwent foam sclerotherapy [2009-2013, lower limb-Ultrasound (USG) guided and blind] in our hospital [10% Sodiumtetradecylsulfate (STS), Tessari technique] were assessed to look for indication, tolerance to the procedure and immediate outcomes. A pre-tested and pre-validated questionnaire was used and physical examination were done to assess post-procedural complications. Statistical significance was p< 0.05. RESULTS: Among 112 patients, 62.5 % were aged >50 years and 69% were males. It was observed that 22% had indication as recurrence; 43% had mild pain during procedure and 36.6% developed post-foam sclerotherapy complications. 47.6% of patients whose age were <50 years had CEAP(Clinical Etiological Anatomical Pathological) criteria C2(p=0.007). 48.8% with complications had multiple criteria(p=0.012) and 57.7% C2 had least complication (p=0.000). Cosmetic indication showed least tolerance. Use of 10% STS was found to have lesser complication rate (36%), compared to study which had 76% success with STS 3% and complication-64%. CONCLUSION: Foam sclerotherapy is less invasive and its efficacy could be improved by performing under USG guidance, selection of sclerosant, appropriate candidate (age>50 years, multiple CEAP criteria, without pre-existing co-morbidities).

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“…Most of the complications were minor, which resolved over a period of few weeks. 10 There is evidence that 3% polidocanol foam is no more effective than 1% polidocanol foam. The optimum ratio of gas to liquid is 4:1, although a range of ratios is reported in the published work.…”

Section: Discussionmentioning

confidence: 99%

A study to compare outcomes of Sodium tetra-decyl sulphate and Polidocanol in the treatment of varicosities due to incompetent tributaries of superficial vein of leg: a randomized controlled trial

et al. 2018

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Background: Various options for treatment of varicosities of tributaries are mini-phlebectomy, hook phlebectomy, Trivex and sclerotherapy. Sodium tetra-decyl sulphate (STD) and polidocanol (POL) are most commonly used sclerosants. Adverse events caused by sclerosants are pain, thrombophlebitis, hyperpigmentation, allergy, anaphylactic shock, cutaneous necrosis, deep venous thrombosis, headache, visual disturbances and chest tightness. Foam sclerotherapy has been considered to be better than liquid sclerosant. In this study we have compared foam prepared by STD versus POL in the treatment of varicosities of tributaries of superficial vein of Leg.Methods: Patients treated for SFJ or SPJ incompetency post their primary admission and management were attended and evaluated in outpatient department. Patients having varicosities were enrolled for study and treated in OPD by foam sclerotherapy. Patients were randomized to two groups - A or B. Patients were followed up for one month and various clinical outcomes were analyzed.Results: In group A (STD) out of n=20 patients pain, hyperpigmentation and skin necrosis was present in n1=18 patients, n2=14 patients and in n3=2 patients respectively on the first post-operative day while in group B (POL) out of 24 patients it was present in n1=14, n2=8 and n3=1 patient respectively. Post sclerotherapy at one month follow up, in Group A pain and hyperpigmentation decreased to n1=08 and n2=04 patients respectively but skin necrosis was persisting in all n3=02 patients. In-group B pain and hyperpigmentation was present in patients each n1= n2=02 and skin necrosis was present in n3=01 patient.Conclusions: Polidocanol is better than Sodium tetra-decyl sulphate for foam sclerotherapy in terms of better cosmetic outcomes.

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Sclerotherapy in the management of varicose veins and its dermatological complications

Cited by 10 publications

References 11 publications

Beneficial effects of the micronized purified flavonoid fraction (MPFF, Daflon® 500 mg) on microvascular damage elicited by sclerotherapy

Beneficial effects of the micronized purified flavonoid fraction (MPFF, Daflon® 500 mg) on microvascular damage elicited by sclerotherapy

Complications, Indication and Tolerance of Foam Sclerotherapy in Varicose Vein Management Done in A Tertiary Care Centre in South India

A study to compare outcomes of Sodium tetra-decyl sulphate and Polidocanol in the treatment of varicosities due to incompetent tributaries of superficial vein of leg: a randomized controlled trial

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