Fluoroscopy-Guided Endovenous Sclerotherapy Using a Microcatheter Prior to Endovenous Laser Ablation: Comparison between Liquid and Foam Sclerotherapy for Varicose Tributaries.
10.3348/kjr.2014.15.4.481
- Author:
Sang Woo PARK
1
;
Ik Jin YUN
;
Jae Joon HWANG
;
Song Am LEE
;
Jun Seok KIM
;
Hyun Keun CHEE
;
Il Soo CHANG
Author Information
1. Department of Radiology, Konkuk University Hospital, Konkuk University School of Medicine, Seoul 143-729, Korea.
- Publication Type:Original Article ; Comparative Study ; Research Support, Non-U.S. Gov't
- Keywords:
Varicose vein;
Sclerotherapy;
Laser
- MeSH:
Catheters/adverse effects;
Femoral Vein;
Fluoroscopy/methods;
Humans;
Laser Therapy/methods;
Radiography, Interventional/methods;
*Saphenous Vein/radiography/surgery;
Sclerosing Solutions/*administration & dosage/chemistry;
Sclerotherapy/adverse effects/instrumentation/*methods;
Treatment Outcome;
Varicose Veins/radiography/*therapy;
Venous Insufficiency/surgery
- From:Korean Journal of Radiology
2014;15(4):481-487
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To compare the efficacy and adverse effects of endovenous foam sclerotherapy (EFS) and liquid sclerotherapy (ELS) using a microcatheter for the treatment of varicose tributaries. MATERIALS AND METHODS: From December 2007 to January 2009, patients with venous reflux in the saphenous vein were enrolled. The foam or liquid sclerosant was injected through a microcatheter just before endovenous laser ablation (EVLA). Patients were evaluated for the technical success, clinical success, and procedure-related complications during the procedure and follow-up visits. RESULTS: A total of 94 limbs were included: 48 limbs (great saphenous vein [GSV], 35; small saphenous vein [SSV], 13) were managed using EFS and EVLA (foam group; FG), and 46 limbs (GSV, 37; SSV, 9) were treated by ELS and EVLA (liquid group; LG). Varicose tributaries demonstrated complete sclerosis in 92.7% with FG and in 71.8% with LG (p = 0.014). Bruising (78.7% in FG vs. 73.2% in LG, p > 0.05), pain or tenderness (75.6% in FG vs. 51.2% in LG, p = 0.0237) were noted. Hyperpigmentation (51.2% in FG vs. 46.2% in LG, p > 0.05) was found. CONCLUSION: Endovenous foam sclerotherapy using a microcatheter is more effective than ELS for eliminating remnant varicose tributaries prior to EVLA. However, EFS is more commonly associated with local complications such as pain or tenderness than ELS. Furthermore, both techniques seem to prolong the duration of hyperpigmentation along with higher costs.
