Outcome of ultrasound guided foam sclerotherapy (UGFS) treatment for varicose veins: A four years retrospective study at a tertiary care hospital in north India
Keywords:
Foam Sclerotherapy, Superficial Venous Insufficiency, Ultrasound Guided Sclerotherapy, UGFS Outcome, Varicose veins
Abstract
Objective:The purpose of this study was to determine the outcome and rate of recurrence for varicose veins treated with ultrasound-guided foam sclerotherapy (UGFS).
Methods:Data was collected from hospital records. Patients treated with UGFS for superficial venous insufficiency were included in the study. Total 361 legs in 241 patients, out of which 121 patients with unilateral limbs and 120 patients with bilateral limbs were found to be treated by this method.
Results:Out of these 361 legs great saphenous vein (GSV) varicosity was found in 88 legs, short saphenous vein (SSV) in 76, GSV & SSV both in 63, others 134. 264 legs with primary varicosity while 97 were with recurrent. In 294 legs clinical CEAP was 2-3 while in 67 legs it was 4-6. Saphenofemoral junction (SFJ) incompetence was found 60 legs, saphenopopliteal junction (SPJ) incompetence in 68, only perforator’s incompetence was in 56, SFJ with perforator’s incompetence 61, SPJ with perforator’s 29 and no incompetence was noted in 87 legs.Outcome at 6 months was 96.23% while treatment failure and recurrences were noted in 2.77 % of legs. Complications which were noted at 1 week were superficial skin necrosis in 3.04%, pain at injection sites in 15.23%, superficial thrombophlebitis in 16.62%, bruising in 12.18%, skin staining in 11.08%, superficial vein thrombosis (SVT) in 9.97% while no DVT was noted in any of the treated legs.
Conclusion:On conclusion it was found that UGFS is a popular office based treatment modality, safe, effective, easy and improvement in venous signs and symptoms. Even on recurrence patients easily accepts retreatment with this method. Furthermore it is associated with lesser pain, anesthesia requirements; time off work and driving gives it additional advantages
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References
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19. Brzoza Z, Kasperska-Zajac A, Rogala E, Rogala B. Anaphylactoid reaction after the use of sodium tetradecyl sulfate: a case report. Angiology. 2007 Oct-Nov;58(5):644-6.
20. Guex JJ, Schliephake DE, Otto J, Mako S, Allaert FA. The French polidocanol study on long-term side effects: a survey covering 3,357 patient years. Dermatol Surg. 2010 Jun;36 Suppl 2:993-1003. doi: 10.1111/j.1524-4725.2009.01407.x.
21. Morrison N, Neuhardt DL, Rogers CR, McEown J, Morrison T, Johnson E, Salles-Cunha SX. Comparisons of side effects using air and carbon dioxide foam for endovenous chemical ablation. J Vasc Surg. 2008 Apr;47(4):830-6. doi: 10.1016/j.jvs.2007.11.020. Epub 2008 Feb 1.
22. Blaise S, Bosson JL, Diamand JM. Ultrasound-guided sclerotherapy of the great saphenous vein with 1% vs. 3% polidocanol foam: a multicentre double-blind randomised trial with 3-year follow-up. Eur J Vasc Endovasc Surg. 2010 Jun;39(6):779-86. doi: 10.1016/j.ejvs.2010.01.022. Epub 2010 Mar 4.
23. Lurie F, Creton D, Eklof B, Kabnick L, Kistner R, Pichot O, et al. Prospective randomized study of endovenous radiofrequency obliteration (Closure procedure) versus ligation and stripping in a selected patient population (EVOLVeS Study). Journal of Vascular Surgery 2003;38(2):207-214.
24. Subramonia S, Lees T.Sensoryabnormalities and bruisingafterlongsaphenous veinstripping: impact on short-termquality of life. J Vasc Surg. 2005 Sep;42(3):510-4.
25. Vasquez MA, Wang J, Mahathanaruk M, Buczkowski G, Sprehe E, Dosluoglu HH. The utility of the venous clinical severity score in 682 limbs treated by radiofrequency saphenous vein ablation. Journal of Vascular Surgery 2007;45(5):1008-1015.
26. Christenson JT, Gueddi S, Gemayel G, Bounameaux H.Prospectiverandomizedtrialcomparingendovenouslaser ablation and surgery for treatmentofprimarygreatsaphenousvaricose veins with a 2-yearfollow-up.J Vasc Surg. 2010 Nov;52(5):1234-41. doi: 10.1016/j.jvs.2010.06.104.
27. Evi Kalodiki, Christopher R Lattimer, Mustapha Azzam, Emad Shawish, Dimitris Bountouroglou, George Geroulakos. Long-term results of a randomized controlled trial on ultrasound-guided foam sclerotherapy combined with saphenofemoral ligation vs standard surgery for varicose veins. Journal of Vascular Surgery 2012;55(2):451–7.
28. Shadid N, Ceulen R, Nelemans P, C Dirksen, J Veraart, GW Schurink, et al. Randomized clinical trial of ultrasound-guided foam sclerotherapy versus surgery for the incompetent great saphenous vein. Br J Surg. 2012 Aug;99(8):1062-70. doi: 10.1002/bjs.8781. Epub 2012 May 25.
29. Myers KA, Jolley D, Clough A, Kirwan J. Outcome of ultrasound-guided sclerotherapy for varicose veins: medium-term results assessed by ultrasound surveillance. Eur J Vasc Endovasc Surg. 2007 Jan;33(1):116-21. Epub 2006 Oct 24.
30. Gillet JL, Guedes JM, Guex JJ, Hamel-Desnos C, Schadeck M, Lausecker M, et al. Side-effects and complications of foam sclerotherapy of the great and small saphenous veins: A controlled multicentre prospective study including 1025 patients. Phlebology 2009;24(3):131–8.
31. Hamahata A, Yamaki T, Sakurai H. Outcomes of ultrasound-guided foam sclerotherapy for varicose veins of the lower extremities: a single center experience. Dermatol Surg. 2011 Jun;37(6):804-9. doi: 10.1111/j.1524-4725.2011.02003..x.
32. Myers KA, Jolley D. Factors affecting the risk of deep venous occlusion after ultrasound-guided sclerotherapy for varicose veins. Eur J Vasc Endovasc Surg. 2008 Nov;36(5):602-5. doi: 10.1016/j.ejvs.2008.06.026. Epub 2008 Aug 20.
33. Hamel-Desnos C, Allaert FA. Liquid versus foam sclerotherapy. Phlebology. 2009 Dec;24(6):240-6. doi: 10.1258/phleb.2009.009047.
34. Maurya AK, Singh S, Sachdeva V, Nath B, Verma SC, Gupta PK. Outcome of Ultrasound Guided Foam Sclerotherapy Treatment for Varicose Veins: Procedure is Standard and Need No Further Study. Indian J Vasc Endovasc Surg 2015;2:96-100.
2. Tessari L, Cavezzi A, Frullini A. Preliminary experience with a new sclerosing foam in the treatment of varicose veins. Dermatol Surg. 2001 Jan;27(1):58-60.
3. Coleridge Smith P. Foam and liquid sclerotherapy for varicose veins. Phlebology. 2009;24 Suppl 1:62-72. doi: 10.1258/phleb.2009.09s007.
4. Winterborn RJ, Foy C, Heather BP, Earnshaw JJ. Randomised trial of flush saphenofemoral ligation for primary great saphenous varicose veins. Eur J Vasc Endovasc Surg. 2008 Oct;36(4):477-84. doi: 10.1016/j.ejvs.2008.06.022. Epub 2008 Aug 20.
5. Abbassi-Ghadi N, Hafez H. Ultrasound-guided foam sclerotherapy within a rolling treatment programme is an effective low-cost treatment for superficial venous insufficiency. Phlebology. 2013 Jun;28(4):195-200. doi: 10.1258/phleb.2011.011099. Epub 2013 May 6.
6. Chapman-Smith P, Browne A. Prospective five-year study of ultrasound-guided foam sclerotherapy in the treatment of great saphenous vein reflux. Phlebology. 2009 Aug;24(4):183-8. doi: 10.1258/phleb.2009.008080.
7. Brunken A, Rabe E, Pannier F. Changes in venous function after foam sclerotherapy of varicose veins. Phlebology. 2009 Aug;24(4):145-50. doi: 10.1258/phleb.2009.008068.
8. Islamoglu F. An alternative treatment for varicose veins: ligation plus foam sclerotherapy. Dermatol Surg. 2011 Apr;37(4):470-9. doi: 10.1111/j.1524-4725.2011.01927.x.
9. M Figueiredo, S Araújo, N Barros Jr, F Miranda Jr. Results of surgical treatment compared with ultrasound-guided foam sclerotherapy in patients with varicose veins: a prospective randomized study. Eur J Vasc Endovasc Surg. 2009 Dec;38(6):758-63. doi: 10.1016/j.ejvs.2009.07.015. Epub 2009 Sep 9.
10. Bradbury AW, Bate G, Pang K, Darvall KA, Adam DJ. Ultrasound-guided foam sclerotherapy is a safe and clinically effective treatment for superficial venous reflux. J Vasc Surg. 2010 Oct;52(4):939-45. doi: 10.1016/j.jvs.2010.04.077. Epub 2010 Jul 17.
11. Jia X, Mowatt G, Burr JM, Cassar K, Cook J, Fraser C. Systematic review of foam sclerotherapy for varicose veins. Br J Surg. 2007 Aug;94(8):925-36.
12. Guex JJ, Allaert FA, Gillet JL, Chleir F. Immediate and midterm complications of sclerotherapy: report of a prospective multicenter registry of 12,173 sclerotherapy sessions. Dermatol Surg. 2005 Feb;31(2):123-8; discussion 128.
13. Hahn M, Schulz T, Junger M. Outcome four years aftertranscatheter foam sclerotherapy of the greater saphenous vein. Phlebologie 2008;37:237‑40.
14. Leopardi D, Hoggan BL, Fitridge RA, Woodruff PW, Maddern GJ. Systematic review of treatments for varicose veins. Ann Vasc Surg. 2009 Mar;23(2):264-76. doi: 10.1016/j.avsg.2008.10.007. Epub 2008 Dec 6.
15. Pang KH, Bate GR, Darvall KA, Adam DJ, Bradbury AW.Healing and recurrence rates following ultrasound‑guided foam sclerotherapy of superficial venous reflux in patientswith chronic venous ulceration. Eur J Vasc Endovasc Surg 2010;40:790‑5.
16. Rasmussen LH, Lawaetz M, Bjoern L, Vennits B, Blemings A,Eklof B. Randomized clinical trial comparing endovenous laser ablation, radiofrequency ablation, foam sclerotherapy and surgical stripping for great saphenous varicose veins. Br J Surg 2011;98:1079‑87. DOI: 10.1002/bjs.7555.
17.Figueiredo M, de Araujo SP, Figueiredo MF. Late follow‑upof saphenofemoral junction ligation combined with ultrasound‑guided foam sclerotherapy in patients with venous ulcers. Ann Vasc Surg. 2012 Oct;26(7):977-81. doi: 10.1016/j.avsg.2012.03.013.
18. Scurr JR, Fisher RK, Wallace SB, Gilling‑Smith GL. Anaphylaxisfollowing foam sclerotherapy: A life threatening complication of non‑invasive treatment for varicose veins. Eur J Vasc Endovasc Surg Extra 2007;13:87‑9.
19. Brzoza Z, Kasperska-Zajac A, Rogala E, Rogala B. Anaphylactoid reaction after the use of sodium tetradecyl sulfate: a case report. Angiology. 2007 Oct-Nov;58(5):644-6.
20. Guex JJ, Schliephake DE, Otto J, Mako S, Allaert FA. The French polidocanol study on long-term side effects: a survey covering 3,357 patient years. Dermatol Surg. 2010 Jun;36 Suppl 2:993-1003. doi: 10.1111/j.1524-4725.2009.01407.x.
21. Morrison N, Neuhardt DL, Rogers CR, McEown J, Morrison T, Johnson E, Salles-Cunha SX. Comparisons of side effects using air and carbon dioxide foam for endovenous chemical ablation. J Vasc Surg. 2008 Apr;47(4):830-6. doi: 10.1016/j.jvs.2007.11.020. Epub 2008 Feb 1.
22. Blaise S, Bosson JL, Diamand JM. Ultrasound-guided sclerotherapy of the great saphenous vein with 1% vs. 3% polidocanol foam: a multicentre double-blind randomised trial with 3-year follow-up. Eur J Vasc Endovasc Surg. 2010 Jun;39(6):779-86. doi: 10.1016/j.ejvs.2010.01.022. Epub 2010 Mar 4.
23. Lurie F, Creton D, Eklof B, Kabnick L, Kistner R, Pichot O, et al. Prospective randomized study of endovenous radiofrequency obliteration (Closure procedure) versus ligation and stripping in a selected patient population (EVOLVeS Study). Journal of Vascular Surgery 2003;38(2):207-214.
24. Subramonia S, Lees T.Sensoryabnormalities and bruisingafterlongsaphenous veinstripping: impact on short-termquality of life. J Vasc Surg. 2005 Sep;42(3):510-4.
25. Vasquez MA, Wang J, Mahathanaruk M, Buczkowski G, Sprehe E, Dosluoglu HH. The utility of the venous clinical severity score in 682 limbs treated by radiofrequency saphenous vein ablation. Journal of Vascular Surgery 2007;45(5):1008-1015.
26. Christenson JT, Gueddi S, Gemayel G, Bounameaux H.Prospectiverandomizedtrialcomparingendovenouslaser ablation and surgery for treatmentofprimarygreatsaphenousvaricose veins with a 2-yearfollow-up.J Vasc Surg. 2010 Nov;52(5):1234-41. doi: 10.1016/j.jvs.2010.06.104.
27. Evi Kalodiki, Christopher R Lattimer, Mustapha Azzam, Emad Shawish, Dimitris Bountouroglou, George Geroulakos. Long-term results of a randomized controlled trial on ultrasound-guided foam sclerotherapy combined with saphenofemoral ligation vs standard surgery for varicose veins. Journal of Vascular Surgery 2012;55(2):451–7.
28. Shadid N, Ceulen R, Nelemans P, C Dirksen, J Veraart, GW Schurink, et al. Randomized clinical trial of ultrasound-guided foam sclerotherapy versus surgery for the incompetent great saphenous vein. Br J Surg. 2012 Aug;99(8):1062-70. doi: 10.1002/bjs.8781. Epub 2012 May 25.
29. Myers KA, Jolley D, Clough A, Kirwan J. Outcome of ultrasound-guided sclerotherapy for varicose veins: medium-term results assessed by ultrasound surveillance. Eur J Vasc Endovasc Surg. 2007 Jan;33(1):116-21. Epub 2006 Oct 24.
30. Gillet JL, Guedes JM, Guex JJ, Hamel-Desnos C, Schadeck M, Lausecker M, et al. Side-effects and complications of foam sclerotherapy of the great and small saphenous veins: A controlled multicentre prospective study including 1025 patients. Phlebology 2009;24(3):131–8.
31. Hamahata A, Yamaki T, Sakurai H. Outcomes of ultrasound-guided foam sclerotherapy for varicose veins of the lower extremities: a single center experience. Dermatol Surg. 2011 Jun;37(6):804-9. doi: 10.1111/j.1524-4725.2011.02003..x.
32. Myers KA, Jolley D. Factors affecting the risk of deep venous occlusion after ultrasound-guided sclerotherapy for varicose veins. Eur J Vasc Endovasc Surg. 2008 Nov;36(5):602-5. doi: 10.1016/j.ejvs.2008.06.026. Epub 2008 Aug 20.
33. Hamel-Desnos C, Allaert FA. Liquid versus foam sclerotherapy. Phlebology. 2009 Dec;24(6):240-6. doi: 10.1258/phleb.2009.009047.
34. Maurya AK, Singh S, Sachdeva V, Nath B, Verma SC, Gupta PK. Outcome of Ultrasound Guided Foam Sclerotherapy Treatment for Varicose Veins: Procedure is Standard and Need No Further Study. Indian J Vasc Endovasc Surg 2015;2:96-100.
CITATION
DOI: 10.17511/ijmrr.2016.i05.06
Published: 2016-05-31
How to Cite
1.
Singh S, Kumar Maurya A, Singh M, Sachdeva V. Outcome of ultrasound guided foam sclerotherapy (UGFS) treatment for varicose veins: A four years retrospective study at a tertiary care hospital in north India. Int J Med Res Rev [Internet]. 2016May31 [cited 2024Dec.23];4(5):700-6. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/543
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