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Use of Polidocanol Endovenous Microfoam to Improve Hemodynamics and Symptomology in Patients with Challenging Clinical Presentations: A Case Series
- Source :
- Annals of Vascular Surgery. 52:176-182
- Publication Year :
- 2018
- Publisher :
- Elsevier BV, 2018.
-
Abstract
- Background Chronic venous insufficiency (CVI) is a widely prevalent condition. Saphenous venous reflux is the most common underlying pathology that leads to CVI. Endovenous thermal ablations (ETA) are the current gold standard. However, some patients present with some unique challenges making ETA less ideal. Nonthermal nontumescent therapies could be considered as alternative therapy in these patients. Methods We performed a retrospective review of treatment effects with United States Food and Drug Administration-approved polidocanol endovenous microfoam (PEM; Varithena® 1%) on venous symptomology in 10 (n = 10) C3-C6 patients with CVI and concomitant complex disease/pathology that limited the use of ETA. The pathology included risk of bruising or bleeding, severe lipodermatosclerosis, hidradenitis suppurativa, chronic fibrosis of the vein from prior superficial thrombosis, risk for nerve injury, and failed prior ETA. Before treatment, all patients underwent a venous incompetence study by duplex ultrasound (DUS). Preprocedure pain, symptoms, and Venous Clinical Severity Scores (VCSSs) were recorded. Clinical assessments and DUS were performed 4 days, 6 weeks, 6 months, and 1 year after treatment. Results DUS demonstrated reflux in the great saphenous vein (GSV), anterior accessory GSV, and/or the small saphenous vein. Pain scores and VCSS were reduced 4 days and 6 weeks after treatment. These lower scores were maintained for up to 1 year after treatment. Conclusions PEM use in C3-C6 patients resulted in successful improvement in VCSS, CVI symptoms, and wound healing among patients in whom ETA was not considered to be the optimal therapy.
- Subjects :
- Male
medicine.medical_specialty
Time Factors
Chronic venous insufficiency
Polidocanol
030204 cardiovascular system & hematology
Severity of Illness Index
Varicose Veins
03 medical and health sciences
Small saphenous vein
0302 clinical medicine
Sclerotherapy
medicine
Humans
Saphenous Vein
Hidradenitis suppurativa
030212 general & internal medicine
Lipodermatosclerosis
Vein
Aged
Retrospective Studies
Aged, 80 and over
Ultrasonography, Doppler, Duplex
Wound Healing
business.industry
Endovascular Procedures
Great saphenous vein
Hemodynamics
General Medicine
Middle Aged
medicine.disease
Sclerosing Solutions
Thrombosis
Surgery
Treatment Outcome
medicine.anatomical_structure
Venous Insufficiency
Chronic Disease
Female
medicine.symptom
Cardiology and Cardiovascular Medicine
business
medicine.drug
Subjects
Details
- ISSN :
- 08905096
- Volume :
- 52
- Database :
- OpenAIRE
- Journal :
- Annals of Vascular Surgery
- Accession number :
- edsair.doi.dedup.....64591dfb2bd0567ab039e73a27e734a4