FOAM SCLEROTHERAPY: AN EMERGING, MINIMALLY INVASIVE AND SAFE MODALITY OF TREATMENT FOR VARICOSE VEINS
AbstractBackground: Ultrasound guided foam sclerotherapy is an outdoor, office based and minimally invasive procedure for the treatment of varicose veins. This study was carried out to highlight the potential of foam sclerotherapy as a first line treatment for varicose vein. Methods: This prospective observational study was conducted at CMH Rawalpindi, form 1 Aug 2017 to 30 Aug 2018The demographic and outcome data of the patients, who underwent ultrasound guided foam sclerotherapy, were collected and analysed. Results: A total of 662 patients and 752 legs were treated with foam sclerotherapy. Four hundred and ten (61.93%) were males and 252 (38.06%) were females. Their ages ranged from 17 to 68 years with the mean age of 43.21 years. Six hundred and sixty-eight (88.82%) legs were having Great Saphenous Vein while 84 (11.17%) legs were having short saphenous vein disease. Maximum legs 256 (34.04%) had C3 disease. single session of Foam sclerotherapy was enough in 511 (67.95%) legs, while 197 (26.19%) legs were treated with two and 44 (5.85%) legs were treated with three sessions of foam sclerotherapy. Percentages of main trunk occlusion were 98.01% at 1 month while 97.39% at 3 months follow up. Only 2 (0.30%) patients had Deep Venous Thrombosis while 3 (0.45%) patients had thrombophlebitis which required surgery. Conclusion: Ultrasound Guided Foam sclerotherapy is an OPD based, innovative, minimally invasive and safe method of treatment for varicose veins. In the context of prevalence of varicose vein disease in our community, it relieves the Burdon of operation theatre list and creates the theatre space for vascular surgeon for arterial Surgery.Keywords: Ultrasound Guided Foam Sclerotherapy; UGFS; Varicose veins
Van den Bremer J, Moll FL. Historical overview of varicose vein surgery. Ann Vasc Surg 2010;24(3):426–32.
Attaran RR. Latest Innovations in the Treatment of Venous Disease. J Clin Med 2018;7(4):pii:E77.
Mendes CA, Martins AA, Fukuda JM, Parente JB, Munia MA, Fioranelli A, et al. Randomized trial of radiofrequency ablation versus conventional surgery for superficial venous insufficiency: if you don't tell, they won't know. Clinics (Sao Paulo) 2016;71(11):650–6.
Balint R, Farics A, Parti K, Vizsy L, Batorfi J, Menyhei G, et al. Which endovenous ablation method does offer a better long-term technical success in the treatment of the incompetent great saphenous vein? Review. Vascular 2016;24(6):649–57.
Lasheen AE, Hefny MR, El Askry SM, Al Bakly E. Closed subfascial ligation of incompetent perforating veins of the lower extremities. Surg Today 2004;34(12):1057–60.
Brittenden J, Cotton SC, Elders A, Tassie E, Scotland G, Ramsay CR, et al. Clinical effectiveness and cost-effectiveness of foam sclerotherapy, endovenous laser ablation and surgery for varicose veins: results from the Comparison of LAser, Surgery and foam Sclerotherapy (CLASS) randomised controlled trial. Health Technol Assess 2015;19(27):1–342.
Myers K. A history of injection treatments - II sclerotherapy. Phlebology 2018;18:0268355518798283.
Xu J, Wang YF, Chen AW, Wang T, Liu SH. A modified Tessari method for producing more foam. Springerplus 2016;5:129.
Alder G, Lees T. Foam Sclerotherapy. Phlebology 2015;30(2 Suppl):18–23.
Khan AF, Chaudhri R, Ashraf MA, Mazaffar MS, Zawar-ul-Imam S, Tanveer M. Prevalence and presentation of chronic venous disease in Pakistan: a multicentre study. Phlebology 2013;28(2):74–9.
Shadid N, Ceulen R, Nelemans P, Dirksen C, Veraart J, Schurink GW, et al. Randomized clinical trial of ultrasound-guided foam sclerotherapy versus surgery for the incompetent great saphenous vein. Br J Surg 2012;99(8):1062–70.
Darvall KA, Bate GR, Bradbury AW. Patient-reported outcomes 5-8 years after ultrasound-guided foam sclerotherapy for varicose veins. Br J Surg 2014;101(9):1098–104.
Darvall KA, Bate GR, Silverman SH, Adam DJ, Bradbury AW. Medium-term results of ultrasound-guided foam sclerotherapy for small saphenous varicose veins. Br J Surg 2009;96(11):1268–73.
Darvall KA, Bate GR, Adam DJ, Bradbury AW. Recovery after ultrasound-guided foam sclerotherapy compared with conventional surgery for varicose veins. Br J Surg 2009;96(11):1262–7.