scholarly journals LEV 3. Outcomes of Ultrasound-Guided Catheter-Directed Foam Sclerotherapy With or Without Perivenous Tumescent Enhancement in the Treatment of Great Saphenous Vein Reflux

2018 ◽  
Vol 68 (5) ◽  
pp. e127
Author(s):  
Pharawee Prayoonhong ◽  
Suthas Horsirimanont ◽  
Wiwat Tirapanich ◽  
Sopon Jirasiritum ◽  
Surasak Leela-Udomlipi ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Ultrasound Guided ◽  
Foam Sclerotherapy ◽  
Vein Reflux

Prospective five-year study of ultrasound-guided foam sclerotherapy in the treatment of great saphenous vein reflux

2009 ◽  
Vol 24 (4) ◽  
pp. 183-188 ◽  
Author(s):  
P Chapman-Smith ◽  
A Browne
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Duplex Ultrasound ◽  
Adverse Outcomes ◽  
Patient Acceptance ◽  
Ultrasound Guided ◽  
Foam Sclerotherapy ◽  
Clinical Recurrence ◽  
Over Time

Objectives The purpose of this study was to determine the long-term efficacy, safety and rate of recurrence for varicose veins associated with great saphenous vein (GSV) reflux treated with ultrasound-guided foam sclerotherapy (UGFS). Methods A five-year prospective study was performed, recording the effect on the GSV and saphenofemoral junction (SFJ) diameters, and reflux in the superficial venous system over time. UGFS was the sole treatment modality used in all cases, and repeat UGFS was performed where indicated following serial annual ultrasound. Results No serious adverse outcomes were observed – specifically no thromboembolism, arterial injection, anaphylaxis or nerve damage. There was a 4% clinical recurrence rate after five years, with 100% patient acceptance of success. Serial annual duplex ultrasound demonstrated a significant reduction in GSV and SFJ diameters, maintained over time. There was ultrasound recurrence in 27% at 12 months, and in 64% at five years, including any incompetent trunkal or tributary reflux even 1 mm in diameter being recorded. Thirty percent had pure ultrasound recurrence, 17% new vessel reflux and 17% combined new and recurrent vessels on ultrasound. Of all, 16.5% required repeat UGFS treatment between 12 and 24 months, but less than 10% in subsequent years. The safety and clinical efficacy of UGFS for all clinical, aetiological, anatomical and pathological elements classes of GSV reflux was excellent. Conclusion The popularity of this outpatient technique with patients reflects ease of treatment, lower cost, lack of downtime and elimination of venous signs and symptoms. Patients accept that UGFS can be repeated readily if required for recurrence in this common chronic condition. The subclinical ultrasound evidence of recanalization or new vein incompetence needs to be considered in this light.

Efficacy of Ultrasound-Guided Foam Sclerotherapy for Great Saphenous Vein

2012 ◽  
Vol 23 (1) ◽  
pp. 1-5
Author(s):  
Hiroko Kume ◽  
Shoji Sato ◽  
Satoko Fujita ◽  
Tomoko Kagayama ◽  
Takehisa Iwai
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Ultrasound Guided ◽  
Foam Sclerotherapy

Predictors of recurrence of great saphenous vein reflux following treatment with ultrasound-guided foamsclerotherapy

2014 ◽  
Vol 30 (3) ◽  
pp. 194-199 ◽  
Author(s):  
N Shadid ◽  
P Nelemans ◽  
J Lawson ◽  
A Sommer
Keyword(s):  
Saphenous Vein ◽  
Cox Regression ◽  
Great Saphenous Vein ◽  
Controlled Trial ◽  
Clinical Severity ◽  
Ultrasound Guided ◽  
Cox Regression Analysis ◽  
Venous Clinical Severity Score ◽  
Vein Reflux

Objective To investigate which clinical characteristics at baseline are predictive for great saphenous vein recurrence following ultrasound-guided foamsclerotherapy. Material and methods Data of patients treated for great saphenous vein incompetence with ultrasound-guided foamsclerotherapy were derived from a multicentre prospective randomized controlled trial comparing surgery versus ultrasound-guided foamsclerotherapy with a follow-up of two years. Recurrence of reflux was determined on colour duplex scans at three months, one year and two years. Univariate and multivariate Cox regression analysis was used to evaluate the effect of gender, age, C of CEAP classification, diameter of great saphenous vein, injected foam volume, presence of distal great saphenous vein reflux, presence of reflux in the anterior accessory saphenous vein and Venous Clinical Severity Score on risk of recurrent reflux. Results Two hundred twenty-five patients were available for analysis. Treatment after one single session was successful in 120 patients and recurrence of saphenous reflux was observed in 105 patients within two years during follow-up. Significant associations with risk of recurrence were observed for mid thigh great saphenous vein diameter (HR = 1.012 with 95% CI: 1.002–1.022, p = 0.022) and presence of distal great saphenous vein reflux (HR = 1.882 with 95% CI: 1.029–3.443, p = 0.040). Conclusion In conclusion, this prospective study suggests that ultrasound-guided foamsclerotherapy treatment for the proximal great saphenous vein is less effective for patients with a large vein and a refluxing distal great saphenous vein at baseline.

Cost-utility analysis of great saphenous vein ablation with radiofrequency, foam and surgery in the emerging health-care setting of Thailand

2016 ◽  
Vol 31 (8) ◽  
pp. 573-581 ◽  
Author(s):  
Boonying Siribumrungwong ◽  
Pinit Noorit ◽  
Chumpon Wilasrusmee ◽  
Pattara Leelahavarong ◽  
Ammarin Thakkinstian ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Cost Effective ◽  
Quality Adjusted Life Year ◽  
Cost Utility ◽  
Ultrasound Guided ◽  
Foam Sclerotherapy ◽  
One Year ◽  
Quality Adjusted Life

Objectives To conduct economic evaluations of radiofrequency ablation, ultrasound-guided foam sclerotherapy and surgery for great saphenous vein ablation. Method A cost-utility and cohort analysis from societal perspective was performed to estimate incremental cost-effectiveness ratio. Transitional probabilities were from meta-analysis. Direct medical, direct non-medical, indirect costs, and utility were from standard Thai costings and cohort. Probabilistic sensitivity analysis was performed to assess parameter uncertainties. Results Seventy-seven patients (31 radiofrequency ablation, 19 ultrasound-guided foam sclerotherapy, and 27 surgeries) were enrolled from October 2011 to February 2013. Compared with surgery, radiofrequency ablation costed 12,935 and 20,872 Baht higher, whereas ultrasound-guided foam sclerotherapy costed 6159 lower and 1558 Bath higher for outpatient and inpatient, respectively. At one year, radiofrequency ablation had slightly lower quality-adjusted life-year, whereas ultrasound-guided foam sclerotherapy yielded additional 0.025 quality-adjusted life-year gained. Because of costing lower and greater quality-adjusted life-year than other compared alternatives, outpatient ultrasound-guided foam sclerotherapy was an option being dominant. Probabilistic sensitivity analysis resulted that at the Thai ceiling threshold of 160,000 Baht/quality-adjusted life-year gained, ultrasound-guided foam sclerotherapy had chances of 0.71 to be cost-effective. Conclusions Ultrasound-guided foam sclerotherapy seems to be cost-effective for treating great saphenous vein reflux compared to surgery in Thailand at one-year results.

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