Search

Aim: To assess the safety and efficacy of sclerotherapy of the great saphenous vein (GSV) comparing standardised polidocanol foam to liquid polidocanol in a randomised controlled trial (RCT)., Methods: A multicentre randomised controlled clinical trial was carried out in which saphenous trunks were treated by sclerotherapy. 106 patients with primary varicose veins due to an incompetent GSV were treated with either standardised 3% polidocanol foam or 3% liquid polidocanol. The primary efficacy criterion was elimination of reflux (<0.5 sec) measured 3 cm below the sapheno-femoral junction (SFJ) by duplex ultrasonography 3 months after the last injection., Results: A significantly greater number of patients were successfully treated by foam sclerotherapy resulting in 69% elimination of reflux compared to 27% patients treated with liquid sclerosant. The secondary endpoints of vein occlusion, reflux time, refilling time and patient satisfaction also improved significantly more in the foam group. The mean number of treatment sessions was 1.3 in the foam group compared to 1.6 in the liquid group. Differences between study centres occurred with a mean of 96% reflux elimination in 6 centres versus 39% in 4 other centres. Centres with a high response rate injected a higher mean volume (4.3 vs. 3.6 ml) in the first session in a vein with a smaller diameter (7.5 mm vs. 8.4 mm). No difference in adverse drug reactions was observed between treatment groups., Conclusions: Standardised 3% polidocanol foam is more efficient and equally safe compared to 3% liquid polidocanol for treatment of GSV. In comparison to other studies a relatively small volume was injected into relatively large veins.

The article presents an overview of the socioeconomic costs of chronic venous insufficiency, which is due to the large number of patients with the condition, the cost of investigations and management of the condition and the deterioration of the quality of life and loss of working days in patients with the condition. A discussion of the costs that are associated with advanced stages of the condition, and of the prevalence of venous treatment in the general population, is presented.

The article presents a study that assessed the effect of immediately performing embolization in the treatment of leg varices associated with pelvic venous insufficiency (PVI). The results indicate show that embolization is not essential in treating leg varicose veins of pelvic origin. Foam sclerotherapy or phlebectomy is effective for patients with vulvar or pudendal varicose veins.