Outcome four years after transcatheter foam sclerotherapy of the greater saphenous vein

Efficacy and safety of endovenous foam sclerotherapy: meta-analysis for treatment of venous disorders

Aim

Endovenous foam sclerotherapy (EFS) is used widely throughout the USA for the treatment of venous disorders. The purpose of the quantitative meta-analysis was to systematically and comprehensively evaluate the literature to provide accurate estimates of safety and efficacy outcomes for this procedure.

Methods

A comprehensive electronic search of published literature in several databases was performed using a wide variety of MESH headings. In addition, meeting abstracts and bibliographies of selected references were reviewed for eligible papers. Two reviewers abstracted selected treatment-related data.

Results

Of 684 identified manuscripts and abstracts reviewed, 104 papers were abstracted and analysed. More than 50% were published between 2004 and 2008. EFS was found to be effective with similar vein occlusion rates to laser therapy, but less effective than surgery. In addition, major adverse effects were rare.

Conclusions

EFS is a safe and effective therapy for the treatment of venous disorders.

Triple-lumen double-balloon catheter for foam sclerotherapy of the great saphenous vein: critical review on preliminary results

BACKGROUND

Different catheters (angiography, single-balloon) have been used for foam sclerotherapy of the great saphenous vein (GSV).

OBJECTIVE

Is there greater efficacy and safety in the use of a double-balloon catheter?

METHODS

Twenty patients were treated with a double-balloon catheter and 3% polidocanol foam. Follow-up after one day, one and six weeks, six and 12 months.

RESULTS

Up to week six complete success was seen in 95% (19/20) patients. Only eight patients attended the checks after six and 12 months. The occlusion rates were 75% (6/8, 6 months) resp. 50% (4/8, 12 months). A further 10 patients refused these checks as they were free of symptoms but could be questioned. Side-effects were haematoma (100%), limited phlebitis (15%) and one extended thrombophlebitis followed by hyperpigmentation.

CONCLUSION

A double-balloon catheter is a safe treatment option for foam sclerotherapy of the GSV. However, in this case series efficacy is not superior to the use of an angiography-catheter, a single-balloon catheter or just the direct puncture of the vein.

Foam sclerotherapy techniques: different gases and methods of preparation, catheter versus direct injection

INTRODUCTION

Foam sclerotherapy has gained a great popularity among phlebologists worldwide, although a major lack of homogeneity in the material used to produce sclerosant foam (SF) and to inject SF has been reported.

AIMS

To highlight the literature data and a few personal clinical and experimental outcomes concerning the main variables in SF production and injection.

METHODS

A review of the published literature and of our own 12 year clinical and experimental experience has been undertaken in order to focus on a few variables of the material and methods used to produce SF with Tessari method and to inject SF.

RESULTS

In SF production, differences in gas components, liquid to gas ratio, as well in disposable material can variably influence the resulting SF. Similarly SF injection through ultrasound guidance, with needle, or with short/long catheter may exhibit different foam behaviours according to the variable material and techniques which are employed. More recently the introduction of long catheters, possibly together with hook phlebectomy, seems to potentiate the short-mid term outcomes of foam sclerotherapy.

CONCLUSION

SF formation is greatly influenced by the choice of the gas component, the liquid-to-gas ratio, the type of syringes; also larger needles are to be preferred for injection of SF, while long catheters seem to represent a valid alternative especially when combined with tumescence to minimise saphenous diameter.