ABSTRACT
Anil Hingorani, MD
Vascular Surgeon
NYU Lutheran Medical Center
Brooklyn, New York, United States
Duplex-guided foam sclerotherapy is a known therapy for varicose veins. Yet, there is a paucity of data regarding follow-up results. To help clarify this question we queried our database that included treated veins with 3.5mm-5.0mm in diameter.
We retrospectively retrieved data from prospectively maintained patient records. All patients underwent duplex-guided foam sclerotherapy by a single physician from 2012 to 2021. Primary analyzed outcomes were procedure successful obliteration of the treated vein(s), the incidence of superficial / deep venous thrombosis (SVT/DVT) detected by venous duplex within 30 days post- procedure, and symptomatic sclerothrombi requiring aspiration.
There were 3743 consecutive duplex-guided foam sclerotherapy procedures. The mean age for the group was 55.7 ± 13.6 years with 83% women. The median follow-up time was 413 days (IQR: 85 - 1091 d). Procedures were in patients with CEAP class 3(51%), CEAP 4(32%), CEAP 5-6(10%), CEAP 2(7%). Clinical presentation included: edema(79%), pain(67%), active ulcers(4.3%). The ipsilateral great saphenous vein was ablated in 79% of cases prior to the sclerotherapy procedure. All but 3 cases showed obliteration of the target vessel(s) (99.9%). Symptomatic sclerothrombi retention prompted aspiration following 357 procedures (9.5%). Superficial and focal deep vein thrombosis were found following 36 (0.96%) and 5 (0.13%) procedures, respectively, with development of both in only one patient. Patients with DVT were older (mean age 68.8 ± 8.5, p< 0.03). No pulmonary embolism was noted.
This large US based series of consecutive duplex-guided foam sclerotherapy procedures performed by a single physician had proved to be safe and effective with low rates of post procedure symptomatic sclerothrombi retention, superficial and/or deep vein thrombosis.