Foam Sclerotherapy-Alternative/Adjunct Treatment in Varicose Veins
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 3
Abstract
Varicose veins is a growing menace in general population which commonly present with varicosities , pigmentation and relentless non healing ulceration. Ulcers range from small waxing and waning ulcers to circumferential deep ulcers which are adamant. Common modalities like surgery( including Trendlenburg’s, stripping and microphlebectomy), EVLT and RFA address the problem of main veins leaving behind small veins like reticular veins and ankle flare. This leads to recurrence of varicosities and ulceration. In this study,we evaluated 58 cases of Varicose veins treated with Foam sclerotherapy(FS) either as primary modality (n.34)or as an adjunct to surgery(n.24). Materials and methods:All patients are evaluated by colour Doppler and DVT is excluded 1. Among the 34 patients treated with FS 2. 7(20.5%) patients are treated for varicosities alone. a. 21(61.7%) patients are treated for venous ulcer. b. 6 (17.8%) patients - reticular veins and ankle flare with pigmentation and ulceration. 2. In all cases, sodium tetradecyl sulphate is used ( to avoid drug bias ) as sclerosant. 3. Foam is created with 2ml of STDS, and 8ml of air making 10 ml of foam by TESSARI s method and is injected into veins after cannulating with scalp vein needle/ 26 G needle to a maximum of 15ml foam. Post operatively crepe bandage applied. All injections are given under MAC( monitored anaesthesia care) 4.In case of venous ulcers treated with sclerotherapy alone all veins in the vicinity of ulcer are injected.In cases where FS is used as an adjunct it is done on a second visit after 20 days post operatively into the residual blow outs. Results: a. In all cases the veins occluded completely, confirmed clinically and sonologically. b. In ulcer patients 16 ulcers healed completely and in 5 patients there is regression of ulcer size from 40-60% of pre FS stage. c. In cases where there is pigmentation there is improvement in pigmentation. In all patients there is subjective improvement in dragging pain of the legs and tiredness of calf muscles. Complications included pain in the course of veins extravasation of drug with pigmentation at injection site and temporary dizziness during the procedure. Conclusion: Though further evaluation is needed Foam sclerotherapy appears to be cheap and reliable adjunct treatment for varicose veins particularly in patients having reticular vein, ankle flare with pigmentation and ulceration. Moreover , it appears to be an adjunctive treatment for post operative residual veins.
Authors and Affiliations
V. Praveen Kumar, Vijay Kumar, Adilakshmi .
Keywords
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- EP ID EP554252
- DOI 10.9790/0853-1803035761.
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