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Varicose veins are common disorders that affect the quality of life of sufferers due to the symptoms they cause. The efficacy of different varicose vein treatments has been studied extensively, with varying success rates. Less invasive treatments, such as sclerotherapy, can be mentioned among the proposed therapies. This study investigates the efficacy of ultrasound-guided foam sclerotherapy (UGFS) for treating varicose veins. In this study, the results were reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines of the Meta-analysis of Observational Studies in Epidemiology (MOOSE) protocol. By searching in 11 databases as well as the Google Scholar search engine using the keywords "varicose vein," "foam sclerotherapy," "occlusion," "success," "Duplex-guided foam sclerotherapy," "efficacy," and "Ultrasound-Guided Foam Sclerotherapy," randomized clinical trial (RCT) and cohort articles published until July 2022 were collected. The required information was extracted and analyzed using Comprehensive Meta-analysis (CMA) software version 2. Data analysis of 35 randomized clinical trial articles showed that the success rate of ultrasound-guided foam sclerotherapy in the treatment of varicose veins is 78% (95% CI: 73–83; P value < 0.001) (I2 = 89.11, P value < 0.001). The subgroup analysis showed that the success of this method is more in the form of sodium tetradecyl sulfate and polidocanol 2% foam and in a period of fewer than 3 months from the start of treatment and in the Asian race. Also, the analysis of 8 cohort studies showed that the success rate of ultrasound-guided foam sclerotherapy in the treatment of varicose veins is 81% (95% CI: 65–91; P value < 0.001). The most prevalent complications of this method in the treatment of varicose veins were induration, thrombophlebitis, bruising, dyspigmentation, hematoma, pain, and phlebitis. Present study illustrated that the effectiveness of ultrasound-guided foam sclerotherapy in the treatment of varicose veins is high. However, it was significantly less successful than published meta-analyses on other less invasive methods such as radiofrequency ablation (RFA) and endovenous laser ablation (EVLA). Also, this method showed more major complications than our previous study on the effect of endovenous laser ablation in the treatment of varicose veins. Factors such as foam type, follow-up duration, and racial differences can affect the study's results. [ABSTRACT FROM AUTHOR]

Varicose veins are common problems and there are many ways of treatment starting from life style modification, medications, compression therapy, surgical treatment, endovenous treatment etc. One of the endovenous treatments is sclerotherapy, a method which can be applied to the telengiectasia, reticular veins, and varicose veins. In the past, it was used only for smaller veins but now with the help of ultrasound guidance, it can be used for main truncal veins as well. It destroys the vein endothelium leading to occlusion and subsequent fibrosis of the target vessel. Injection sclerotherapy has assumed a major role in the treatment of venous insufficiency, particularly in the treatment of smaller veins such as telengiectasias and spider veins and smaller diameter tributaries. This is a very important treatment for recurrent veins and it can be combined with various other treatments. In the procedure of sclerotherapy, sclerosant agent is injected in veins. It may be injected direct undiluted, diluted, or in a form of foam. Depending on the type of vein and diameter of vein, different dilutions are used. Though the recurrence with sclerotherapy is high but being a minimal invasive technique with low cost, it is a favorable technique for varicose veins. [ABSTRACT FROM AUTHOR]

Varicose veins are a common presentation, and its treatment has been a challenge for surgeons. Many studies have evaluated the efficacy of foam sclerotherapy with a high failure rate. One of the postulated reasons is inadequate obliteration of saphenofemoral junction with foam sclerotherapy. To test this hypothesis we compared whether there is a decrease in reflux with saphenofemoral junction ligation, along with foam sclerotherapy. Forty-eight patients (50 legs) with primary varicosities of the Great saphenous vein system were randomized into two groups: saphenofemoral junction ligation with foam sclerotherapy (SFJL + FS) and foam sclerotherapy alone (FS), and followed up at 2 months. There was complete disappearance of varicose veins in great saphenous vein territory in 96% of patients in SFJL + FS group, and 88% of patients in FS group. Veins ≥ 8 mm in diameter were incompletely occluded with sclerotherapy. Patient satisfaction score was comparable in both the groups. The addition of saphenofemoral junction ligation to foam sclerotherapy offers no additional patient benefit, particularly with regard to disappearance of varicose veins, relief of symptoms, recurrence, and morbidity. However, in large diameter veins (≥ 8 mm), saphenofemoral junction ligation with foam sclerotherapy gives better results. [ABSTRACT FROM AUTHOR]

Introduction: This study aims to investigate the efficacy of incision-free endovenous laser treatment (EVLT) combined with sclerosing foam in treating varicose veins of the lower extremities.Methods: A total of 140 patients (186 limbs) who underwent laser closure of the great saphenous vein + injection sclerotherapy were included in the present study. Preoperative information, intraoperative conditions, duration of the operation, and length of hospital stay were recorded in detail. During the 6-month follow-up, the closure of the trunk and branches of the great saphenous vein, postoperative pain, the recovery of ulcer and dermatitis, and postoperative complications were traced.Results: All patients were treated with laser closure of the great saphenous vein and lauromacrogol injection. Twenty-six stage C6 limbs (lower extremity with ulcer) healed within 6 months, and the postoperative subjective pain disappeared after 1 month. In six patients, pigmentation in the surgical site did not completely disappear at 6 months after the operation. Saphenous nerve injury was found in five patients within 3 months after the operation, and all healed at 6 months after the operation.Conclusion: EVLT combined with sclerosing foam is effective for treating varicose great saphenous veins.Trial Registration: This study was registered at http://www.chictr.org.cn (registration number: ChiCTR1900021409). [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of air, CO2 and contrast medium-air on the dwell time (DT) stability of sodium tetradecyl sulfate (STS) foam.Materials and Methods: Three types of foam sclerosants (air-foam, CO2-foam, contrast-air-foam) were injected eight times into an inclined straight plastic tube (internal diameters 4 mm and 10 mm) filled with a blood substitute. Injections were captured by CCD camera, and images were transferred for digital analysis and calculation of DT.Results: Contrast-air-foam and air-foam in a 4-mm tube showed 5.6-/3.3-fold greater DT compared to CO2-foam, respectively (P = 0.001). Contrast-air-foam in a 10-mm tube showed 2.1-fold greater DT compared to CO2-foam (P = 0.0167).Conclusion: A mixture of air and iodinated contrast improves the stability of STS foam compared to mixtures using only air or CO2. Further, animal and clinical studies are needed to validate this in vitro result. [ABSTRACT FROM AUTHOR]

Day surgery is being more and more adopted by clinicians. Higher wavelength lasers give patients better experience than lower wavelength lasers, which makes it more suitable for day surgery. This study compares the short- and mid-term efficacy, postoperative morbidity, and patient satisfaction of "1470-nm endovenous laser ablation (EVLA) combining foam sclerotherapy in day surgery" with "810-nm EVLA with high ligation combining foam sclerotherapy in hospital surgery" on great saphenous vein (GSV) insufficiency postoperatively. A single-institution historical cohort study of 194 patients was performed in Shanghai Ninth People's Hospital, China. Ninety-seven patients received 1470-nm EVLA combining foam sclerotherapy in day surgery ("1470-nm group"), and 97 patients received 810-nm EVLA with high ligation combining foam sclerotherapy in hospital surgery recommended by guidelines ("810-nm group"). No significant difference was found between the 1470-nm group and the 810-nm group in terms of GSV occlusion rate (both 100%), complication rate, and recurrence rate (8.2 vs. 11.3%) during the period of 1-12 months after surgery. Serious complications in the 1470-nm group and 810-nm group were 0 and 1.0%. Minor complications in the 1470-nm group and 810-nm group were ecchymosis at 20.6 and 18.6%, edema at 69.1 and 63.9%, and paresthesia around ankle at 0 and 3.1%, respectively. Advantage of the 1470-nm group over the 810-nm group was statistically significant considering the patient perioperative comfort and economic cost. Treatment of 1470-nm EVLA combining foam sclerotherapy in day surgery has similar efficacy as the 810-nm EVLA with high ligation combining foam sclerotherapy in hospital surgery in GSV insufficiency and is more comfortable with less incision, hospitalization procedure, and medical costs. It may be a new option for patients who are afraid or unable to be hospitalized. [ABSTRACT FROM AUTHOR]

Perforators are those which connect the superficial and deep venous system either directly to main veins or indirectly through the muscular and soleal venous plexus. The emergence of minimally invasive techniques like ambulatory phlebectomy (AP) and foam sclerotherapy (FS) has led to increasing interest about the appropriate therapy for the treatment of isolated perforator incompetence. There have been no studies which have compared the effectiveness of these in-office procedures in isolated perforator incompetence due to the low prevalence of cases. The primary goal of this study is to compare the clinical parameters (return to normal activity, primary symptom relief), functional parameters (procedure time, change in disease severity, course of venous ulcer), and duplex parameters (recurrence in treated veins, complete occlusion of treated veins) in the management of leg varicosities having isolated primary perforator incompetence by ambulatory phlebectomy and duplex guided foam sclerotherapy. Though the procedure time was shorter with FS than AP, the other parameters of primary symptom relief such as change in disease severity, faster healing of venous ulcer, complete occlusion of treated veins in follow-up duplex examination, and lower recurrence of treated veins are better with AP than FS. In conclusion, the interruption of perforators is effective in decreasing the symptoms of chronic venous insufficiency and for the rapid healing of ulcers. The interruption of the incompetent perforating veins appears to be essential to decrease ambulatory venous hypertension. It is apparent from this study that ambulatory phlebectomy stands distinct with enormous benefits and serves as a superior alternative to foam sclerotherapy in treating patients with isolated perforator incompetence. [ABSTRACT FROM AUTHOR]

Chronic venous insufficiency of lower limbs is a common problem in adults. We compared the two modalities, namely duplex ultrasound-guided, catheter-directed foam sclerotherapy (UGFS) and radio-frequency ablation (RFA), in the management of great saphenous varicose veins using clinical assessment (Venous Clinical Severity Score, Venous Disability Score) and duplex imaging. Patients presenting with great saphenous vein (GSV) varicosity due to incompetent saphenofemoral junction (SFJ) were selected and randomly assigned in each arm, i.e., duplex UGFS group and RFA group. Patients were assessed on days 7, 30, and 90 both clinically and sonologically. Clinical assessment was based on the Venous Clinical Severity Score (VCSS) and Venous Disability Score (VDS). Obliteration of the treated GSV segment was noted in all the limbs of the RFA group (31/31) on duplex sonography on days 7, 30, and 90, while in the UGFS group, out of 30 limbs, obliteration was successful in 28 (28/30) and 2 had treatment failure. However, outcome of both the groups were statistically comparable ( P value > 0.05). After the procedure, improvement in the VCSS was noted in both the study arms in every follow-up and both the modalities were found to be equally effective. Improvement in the Venous Disability Score was there on every follow-up, but maximum improvement was seen on the second visit, i.e., post-treatment day 30. Improvement was statistically significant and equal in both arms after the initial 1 week. Foam sclerotherapy, especially catheter-directed, is as effective as radio-frequency ablation in achieving anatomical obliteration and yielding relief in clinical signs and symptoms in patients with GSV varicosity with SFJ incompetence. [ABSTRACT FROM AUTHOR]

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Copyright of Der Hautarzt is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Hautarzt is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Varicose veins are one of the most common vascular problems encountered. Ultrasound guided foam sclerotherapy is one such option it was introduced in 2001. We present our two needle technique of ultrasound guided foam sclerotherapy along with our short term results. Materials and methods: Patients presenting us between January 2009 to October 2009 with symptomatic primary varicose veins were selected for this procedure. Ultrasound guided foam sclerotherapy was done using the two needle technique using sodium tetra decyl sulphate. Results: Fifteen patients and 19 legs were treated. Complete closure of veins was achieved with a single injection at 1 month follow up in 17 legs. One leg required one additional injection and one leg required two injections. No recurrence has been noted at the end of a follow up of 1-6 months. Conclusion: Foam sclerotherapy is an effective, less expensive day care procedure with minimal complication rates. [ABSTRACT FROM AUTHOR]