All that is swollen and red is not infection!

An unusual cause of venous hypertension

The gold standard vascular access for hemodialysis is the arteriovenous fistula (AVF). Venous hypertension (VH) is an unusual complication of AVF, which can be misdiagnosed as cellulitis due to the similarities in clinical presentation. Here we present a case of venous hypertension in a 40-years-old gentleman, who presented with progressive pain and swelling of three lateral fingers of his left hand without other inflammatory signs after a year of AVF creation. Further evaluation with a duplex scan supported the clinical diagnosis of VH. He had undergone a surgical ligation of AVF and completely recovered from the symptoms.

Foam sclerotherapy for reticular veins of the dorsal hands: a retrospective review

BACKGROUND

Despite being the gold standard for lower extremity reticular vein treatment, few studies have yet evaluated foam sclerotherapy for hand veins.

OBJECTIVE

This retrospective study evaluates the safety and efficacy of foam sclerotherapy for reticular veins of the dorsal hands.

METHODS

A telephone-based questionnaire was used for patient self-assessment of overall improvement, satisfaction, prevalence of adverse events, and willingness for repeat treatment after foam sclerotherapy with sodium tetradecyl sulfate (STS). All patients had been treated with foam STS of 0.25% to 1.0% concentration using room air.

RESULTS

Twenty-one of 45 patients were successfully contacted, with a total of 54 treatment sessions performed on 38 hands. Overall, patients reported scores of 2.55 ± 0.56 for overall improvement (0 = none, 1= mild, 2 = moderate, and 3 = complete resolution) and 1.79 ± 0.41 for satisfaction with results (0 = not satisfied at all, 1 = mildly satisfied, and 2 = very satisfied), with few significant treatment-related adverse events. Most patients stated they would undergo another treatment if needed.

CONCLUSION

This single-center experience found that foam sclerotherapy with STS is a safe and effective treatment for reticular veins of the dorsal hands with excellent long-term patient satisfaction.