Ultrasound-guided perisaphenous tumescence infiltration improves the outcomes of long catheter foam sclerotherapy combined with phlebectomy of the varicose tributaries
A prospective comparative observational study was performed to assess the short--term efficacy and safety of the peri-saphenous infiltration of tumescence solution (PST) in great saphenous vein (GSV) long catheter foam sclerotherapy (LCFS) combined with phlebectomy of the varicose tributaries. Since...
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| Format: | Article |
| Language: | English |
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PAGEPress Publications
2015-04-01
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| Series: | Veins and Lymphatics |
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| Online Access: | http://www.pagepressjournals.org/index.php/vl/article/view/4676 |
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| author | Attilio Cavezzi Giovanni Mosti Sonia Di Paolo Lorenzo Tessari Fausto Campana Simone Ugo Urso |
| author_facet | Attilio Cavezzi Giovanni Mosti Sonia Di Paolo Lorenzo Tessari Fausto Campana Simone Ugo Urso |
| author_sort | Attilio Cavezzi |
| collection | DOAJ |
| description | A prospective comparative observational study was performed to assess the short--term efficacy and safety of the peri-saphenous infiltration of tumescence solution (PST) in great saphenous vein (GSV) long catheter foam sclerotherapy (LCFS) combined with phlebectomy of the varicose tributaries. Since November 2006 through November 2010 fifty-one consecutive patients (16 males and 35 females, mean age 51.5 years) who underwent LCFS of GSV + multiple phlebectomies were prospectively enrolled, without any pre-selection criteria, in three different groups (17 patients per group) and reviewed as to their outcomes: i) patients without additional PST; ii) with PST under visual control; iii) with ultrasound-guided PST. All procedures were performed in local anesthesia and an average of 7 mL [interquartile range (IQR) 6.5-7.5] of 3% sodiumtetradecylsulfate CO2+O2-based sclerosant foam was injected in the diseased segment of GSV (median caliber 7) (IQR 6-8) by means of a 4F long catheter. Clinical and color-duplex ultrasound (CDU) follow-up was performed at regular intervals, the last of which 14 months after the treatment. At 14 months follow-up no varicose veins were visible in 94%, 94% and 100% of the cases in group I, II and III respectively. The CDUbased outcomes were the following: 71%, 71% and 84% GSV occlusion rate in group I, II and III respectively; reflux was found in 5, 4 and 1 cases in group I, II and III respectively. Clinical and CDU morphologic and hemodynamic results were assembled and scored through an arbitrary system. The relative statistical analysis showed a significant (P<0.0001) improvement of the results for patients who received ultrasound guided PST over the other two groups. No relevant complications were recorded in all 51 cases. GSV treatment by means of LCFS + phlebectomy of varicose tributaries proved to be effective and safe in this prospective observational study. The addition of ultrasound guided PST resulted in a significant improvement of GSV occlusion rate and of varicose vein clinical resolution. |
| first_indexed | 2024-04-13T02:56:45Z |
| format | Article |
| id | doaj.art-5fec998d2dd349a9a0e3ad4f8f644a46 |
| institution | Directory Open Access Journal |
| issn | 2279-7483 |
| language | English |
| last_indexed | 2024-04-13T02:56:45Z |
| publishDate | 2015-04-01 |
| publisher | PAGEPress Publications |
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| series | Veins and Lymphatics |
| spelling | doaj.art-5fec998d2dd349a9a0e3ad4f8f644a462022-12-22T03:05:37ZengPAGEPress PublicationsVeins and Lymphatics2279-74832015-04-014110.4081/vl.2015.46764283Ultrasound-guided perisaphenous tumescence infiltration improves the outcomes of long catheter foam sclerotherapy combined with phlebectomy of the varicose tributariesAttilio Cavezzi0Giovanni Mosti1Sonia Di Paolo2Lorenzo Tessari3Fausto Campana4Simone Ugo Urso5Eurocenter Venalinfa, S. Benedetto del Tronto (AP)Clinica Barbantini, LuccaClinica Stella Maris, S. Benedetto del Tronto (AP)Fondazione Glauco Bassi, TriesteVascular Medicine Unit, Cesena Hospital, Cesena (FC)Eurocenter Venalinfa, S. Benedetto del Tronto (AP)A prospective comparative observational study was performed to assess the short--term efficacy and safety of the peri-saphenous infiltration of tumescence solution (PST) in great saphenous vein (GSV) long catheter foam sclerotherapy (LCFS) combined with phlebectomy of the varicose tributaries. Since November 2006 through November 2010 fifty-one consecutive patients (16 males and 35 females, mean age 51.5 years) who underwent LCFS of GSV + multiple phlebectomies were prospectively enrolled, without any pre-selection criteria, in three different groups (17 patients per group) and reviewed as to their outcomes: i) patients without additional PST; ii) with PST under visual control; iii) with ultrasound-guided PST. All procedures were performed in local anesthesia and an average of 7 mL [interquartile range (IQR) 6.5-7.5] of 3% sodiumtetradecylsulfate CO2+O2-based sclerosant foam was injected in the diseased segment of GSV (median caliber 7) (IQR 6-8) by means of a 4F long catheter. Clinical and color-duplex ultrasound (CDU) follow-up was performed at regular intervals, the last of which 14 months after the treatment. At 14 months follow-up no varicose veins were visible in 94%, 94% and 100% of the cases in group I, II and III respectively. The CDUbased outcomes were the following: 71%, 71% and 84% GSV occlusion rate in group I, II and III respectively; reflux was found in 5, 4 and 1 cases in group I, II and III respectively. Clinical and CDU morphologic and hemodynamic results were assembled and scored through an arbitrary system. The relative statistical analysis showed a significant (P<0.0001) improvement of the results for patients who received ultrasound guided PST over the other two groups. No relevant complications were recorded in all 51 cases. GSV treatment by means of LCFS + phlebectomy of varicose tributaries proved to be effective and safe in this prospective observational study. The addition of ultrasound guided PST resulted in a significant improvement of GSV occlusion rate and of varicose vein clinical resolution.http://www.pagepressjournals.org/index.php/vl/article/view/4676sclerotherapy, ultrasound-guided sclerotherapy, long-catheter-foam-sclerotherapy, perisaphenous tumescence infiltration. |
| spellingShingle | Attilio Cavezzi Giovanni Mosti Sonia Di Paolo Lorenzo Tessari Fausto Campana Simone Ugo Urso Ultrasound-guided perisaphenous tumescence infiltration improves the outcomes of long catheter foam sclerotherapy combined with phlebectomy of the varicose tributaries Veins and Lymphatics sclerotherapy, ultrasound-guided sclerotherapy, long-catheter-foam-sclerotherapy, perisaphenous tumescence infiltration. |
| title | Ultrasound-guided perisaphenous tumescence infiltration improves the outcomes of long catheter foam sclerotherapy combined with phlebectomy of the varicose tributaries |
| title_full | Ultrasound-guided perisaphenous tumescence infiltration improves the outcomes of long catheter foam sclerotherapy combined with phlebectomy of the varicose tributaries |
| title_fullStr | Ultrasound-guided perisaphenous tumescence infiltration improves the outcomes of long catheter foam sclerotherapy combined with phlebectomy of the varicose tributaries |
| title_full_unstemmed | Ultrasound-guided perisaphenous tumescence infiltration improves the outcomes of long catheter foam sclerotherapy combined with phlebectomy of the varicose tributaries |
| title_short | Ultrasound-guided perisaphenous tumescence infiltration improves the outcomes of long catheter foam sclerotherapy combined with phlebectomy of the varicose tributaries |
| title_sort | ultrasound guided perisaphenous tumescence infiltration improves the outcomes of long catheter foam sclerotherapy combined with phlebectomy of the varicose tributaries |
| topic | sclerotherapy, ultrasound-guided sclerotherapy, long-catheter-foam-sclerotherapy, perisaphenous tumescence infiltration. |
| url | http://www.pagepressjournals.org/index.php/vl/article/view/4676 |
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