[MO-44] Ultrasound-guided foam sclerotherapy using 1% polidocanol endovenous microfoam experience in China Medical University Hospital
Objective: Ultrasound-guided foam sclerotherapy (UGFS) is an effective and recommended alternative treatment for trunk varicose vein in patients unsuitable for endovenous thermal therapy. A new commercially available 1% polidocanol endovenous microfoam (PEM), Varithena(BTG International Ltd, UK) had been used in China Medical University Hospital on patient name basis since May 2017.
Method: 41 patients with symptomatic or complicated greater saphenous vein (GSV) incompetence received PEM sclerotherapy since May 2017. Preoperative CEAP, AVVQ, VCSS, sonography and photographs were recorded. A maximum of 20-40mL of PEM was injected in 2-8mL/dose each site from proximal to distal with the leg raised to a 45-degrees angle and groin compression. Treated veins were compressed with eccentric compression pads, cohesive bandages, and Class II compression hosiery for 48 hours followed by 2 weeks of day-time compression stockings.
Results: There were minimal amount of gas detected in heart chambers after release of the groin compression. No allergies, visual disturbance, nor migraine was complained. Sonography with Duplex showed 100% closure of sapheno-femoral junction rate 3-10 days after treatment in 42 limbs. One failed on post-operative day 7. We assumed relatively low dosage of PEM, high abdominal pressure during injection and unexperienced assistance of groin compression were main causes of failure. Crossectomy and reverse catheter-directed foam sclerotherapy were performed by their choice. The intraoperative pain score was 2.49 in average. The ecchymosis is mostly trivial and mild（<2cm）. Twenty-one patients needed the 2nd sclerotherapy, 7 patients needed the 3rd and 1 patient needed the 4th. Total 16 patients needed phlebectomy or removal of coagula. The 3-month and 1-year sonography showed remarkable and excellent remission of saphenous vein. The 12-16month post-op appearance was satisfactory to all follow-up patients.
Conclusions: PEM might be an safe and effective treatment for GSV incompetence patient.
Method: 41 patients with symptomatic or complicated greater saphenous vein (GSV) incompetence received PEM sclerotherapy since May 2017. Preoperative CEAP, AVVQ, VCSS, sonography and photographs were recorded. A maximum of 20-40mL of PEM was injected in 2-8mL/dose each site from proximal to distal with the leg raised to a 45-degrees angle and groin compression. Treated veins were compressed with eccentric compression pads, cohesive bandages, and Class II compression hosiery for 48 hours followed by 2 weeks of day-time compression stockings.
Results: There were minimal amount of gas detected in heart chambers after release of the groin compression. No allergies, visual disturbance, nor migraine was complained. Sonography with Duplex showed 100% closure of sapheno-femoral junction rate 3-10 days after treatment in 42 limbs. One failed on post-operative day 7. We assumed relatively low dosage of PEM, high abdominal pressure during injection and unexperienced assistance of groin compression were main causes of failure. Crossectomy and reverse catheter-directed foam sclerotherapy were performed by their choice. The intraoperative pain score was 2.49 in average. The ecchymosis is mostly trivial and mild（<2cm）. Twenty-one patients needed the 2nd sclerotherapy, 7 patients needed the 3rd and 1 patient needed the 4th. Total 16 patients needed phlebectomy or removal of coagula. The 3-month and 1-year sonography showed remarkable and excellent remission of saphenous vein. The 12-16month post-op appearance was satisfactory to all follow-up patients.
Conclusions: PEM might be an safe and effective treatment for GSV incompetence patient.