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Innovative Ultrasound-Guided Foam Sclerotherapy for Varicose Veins Treatment

Learn about the effective, minimally invasive technique of foam sclerotherapy for varicose veins, its benefits, success rates, and minimal side effects based on clinical practice guidelines and expert opinions.

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Innovative Ultrasound-Guided Foam Sclerotherapy for Varicose Veins Treatment

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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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