Treatment of recurrent varicose veins with sclerotherapy foam

Varicose veins often appear after primary surgery. The recognized recurrence rate is at least 25%, simply because mechanical means of treatment of varicose veins does not modify the heredity or the tendency of varicose veins to follow the laws of inheritance of Mendel.

Recurrent varicose veins are more common after strong saphenous ligation (35%) than after stripping (18%). Publication of publications from 1954 to 1988 and from 14% to 80%, the majority from 30% to 70% of cases.

In patients who have had surgery, the most common cause is wrong surgery. Erik L. It is unclear whether this is a question related to whether it is an appropriate clinical treatment or not. “With the widespread use of diagnostic ultrasound, this conclusion on etography. Allegra, for example one Declared:” Varicose veins have reappeared despite operations technically corrects confirmations by postoperative duplex ultrasound. “

On Think that 20% of recurrent varicose veins are fees for neovascularization, and a few are fees for abnormal anatomy. Fischer reported three main patterns of neovascularization in patients with late recurrent saphenofemoral reflux after ligation and stripping. Diagram them as single-channel (29%), multi-channel (41%) and Circum-Functional (29%).

Personal experience

Patients were referred to a single Büro in a private Anhänger Kabinett for more than 48 months. A history of complicated treatments and anterior has been recorded. A targeted physical examination was supplemented by a standardized duplex ultrasound examination. A venous card was established for each lower limb considered for treatment.

Patients with recurrent varicose veins, whether primary or post-thrombotic, in the distribution of the large or small saphenous vein were included in this study. Members of limbs have protruding saccular varicose veins and a history of surgery, laser or radio frequency occlusion. The excluded were members treated by sclerotherapy without surgery, isolated telangiectasias, members who were part of the Klippel-Trenaunay Syndrom, members with congenital or acquired arteriovenous malformations and members with malformation veins. Legs with a history of venous ulceration, ulceration and / or lipodermatosclerosis were not excluded (CEAP classification C4, C5 and C6).

Patients and methods

A total of 75 lower membranes from 62 patients presented with recurrent varicose veins after long saphenous stripping (35 lower membranes), ligation and phlebectomy (38 lower membranes) or VNUS occlusion (2 lower membranes). There are 49 women (average age: 52.7 years) and 13 men (average age: 59.6 years) with 68 membranes that were symptomatic according to the CEAP C2 classification, five were C4, 1 was C3 and 1 was C6.

The sclerosing foam was manufactured by Tessari technik with two syringes with a mixture of 1/4 sclerosing agent-air. The sclerosing agent was polidocanol, which was administered by one or more varicose veins guided by Massage in varicose veins previously marked using ultrasound guidance. For the most part, the main saphenous vein was missing or obliterated, so it was not a regular target for treatment.

After instilling the foam, the treated limb was held in an elevated position at 45 °, followed by 10 minutes to fix the foam distally and allow the foam to drop out in its liquid state. This was done to avoid adverse events and was successful. The positivity of sclerotherapy foam varied from 5 to 17 ml per membrane (1% of polidocanol in 2 membranes, 3% in 18 membranes and 2% in 55 other membranes). The number of treatments varied from 1 to 4 (mean: 2.1). The basis for performing class II or III with pressure that relates to the question of whether it is a miscarriage that lasts 48 to 72 hours. After that, the stockings were only worn for 2 weeks during the day or for reasons of comfort at the request of the patient. Follow you

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