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Ultrasound guided foam sclerotherapy of varicose veins

Ultrasound guided foam sclerotherapy of varicose veins. Anton Krnić, MD, PhD Poliklinika Sinteza, Zagreb KB Sveti Duh, Zagreb. E-medicine / Medscape. It is most effective for veins less than 6-7 mm in diameter but can be effective for veins of almost any diameter

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Ultrasound guided foam sclerotherapy of varicose veins

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  1. Ultrasoundguidedfoamsclerotherapyofvaricoseveins Anton Krnić, MD, PhD Poliklinika Sinteza, Zagreb KB Sveti Duh, Zagreb

  2. E-medicine / Medscape • It is most effective for veins less than 6-7 mm in diameter but can be effective for veins of almost any diameter • …if excellent technique is employed

  3. E-medicine / Medscape • Sclerotherapy produces minimal procedural and postprocedural pain • It is easier to perform than most alternative strategies.

  4. Clinical practice guidelines • Wesuggest foam sclerotherapy as an option for the treatment of the incompetent saphenousveins • We recommendsclerotherapy to treat varicose tributaries • The care of patients with varicose veins and associated chronic venous diseases: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum.J Vasc Surg. 2011 May;53(5 Suppl):2S-48S.

  5. Authorities’ opinion • JohnBergan: “A TrulyMinimallyInvasiveTechinque” • PhillpColleridge Smith: “Canbeused to treattruncalsaphenousincompetenceandrecurrentvaricoseveins”

  6. Technique • Patient: woman, 44 years • Clinicalpresentation: varicoseveins, CEAP 2 • Duplexultrasound: great saphenousveininsuffitiency, withinsufficientvaricosetributaries

  7. Technique

  8. Technique

  9. Technique

  10. Technique

  11. Technique

  12. Technique

  13. Technique • Compression stockings ccl 2 are applied • The patient is asked to ambulate for ½ hour after leaving the clinic

  14. Before

  15. 2 weeks after

  16. Before - after

  17. Our Results 315 treated limbs with insuffitient GSV/ SSV/ AASV/ Giacomini Vein or recurrent varicose veins in 2,5 years in Zagreb and Sarajevo • Duplex scanning within a month – short term follow up • Primary success rate: 100%

  18. E-medicine/Medscape Success rate after 3 years / meta-analysisof 118 studies • EVLA - 94% • RFA - 84% • UGFS - 77% • Stripping - 78% • van den Bos R, et al. Endovenoustherapiesoflowerextremityvaricosities: a meta-analysis. J VascSurg. Jan 2009;49(1):230-9.

  19. Side Effects – Our Results • Skinstaining – common, fadeswith time • Hard, tender lumps – common, withdrawwith time • DVT – none • Pulmoaryembolism – none • Allergy to sclerosing agent - none

  20. Conclusion • Ultrasoundgudiededfoamsclerotherapy is anoutstandingtechnique for varicoseveinstreatment • It is leastinvasive • It is highlyefficent • Easy to performtreatmentandretreatment

  21. Thank you for your attention.

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