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Dedicated to improving the treatment of venous disease

Volume 8, Number 02

www.venousdigest.com

February 2001

Copyright 1995 John J. Bergan, MD, Inc.

1 of 7

Venous Digest, 2329 Barley Drive, Vista, CA 92083 USA (760) 599-9725

TREATMENT OF VARICOSE LONG

SAPHENOUS VEINS WITH

SCLEROSANT IN MICROFOAM FORM:

LONG-TERM OUTCOMES

Cabrera J, Cabrera J Jr., Garcia-Olmedo Ma.A.

Phlebology 2000; 15:19-23

ABSTRACT AND COMMENTARY BY:

Attilio Cavezzi, MD

San Benedetto Del Tronto (AP), Italy

Sclerotherapy has always been an effective way to treat

varicose veins but several studies have shown a high percentage

of recanalization on long-term followup. The authors report

their experience with sclerosant microfoam treatment of varicose

veins as well as their long-term outcomes.

From 1993 to 1996, limbs with varicose veins caused by

greater saphenous vein (GSV) incompetence (diameter at the

junction of 9 to 32 mm) were treated with a proprietary, patented

microfoam of 1 to 3% Lauromacrogol 400. Patients were

studied pre- and post-treatment by physical examination and

color-flow duplex scanning. They were treated by duplex-

guided sclerotherapy with compressive bandages and elastic

stockings in the post-treatment period.

The sclerosing foam used in the authors' experience is a

microbubble foam of the detergent drug Lauromacrogol 400

coupled with carbon dioxide. This new form of sclerosant

permits a greater expansion of the active surface area of the

sclerosing drug which is much larger than the active surface of

the normal liquid sclerosant. The microfoam was injected

through a 20G catheter under duplex guidance and with the

patient supine. Generally, 15 to 30 ml of foam was injected into

the GSV. Spasm of the treated vessel was the final endpoint.

Results of treatment in 500 GSVs can be summarized as

follows: 86% of veins required only one session to achieve

immediate sclerosis, 10.5% required a second session, and 3.5%

required three sessions. Further injections were necessary during

followup to sclerose varicose tributaries. Duplex followup at

three or more years revealed fibrosis in 81% of GSVs, a patent

GSV without reflux in 5%, and recurrence of reflux in 14%.

Disappearance of tributary varicose veins was achieved in 96.5%

of limbs. No major complications were reported. Segmental

varicophlebitis occurred but it was uncommon.

The authors consider duplex-guided sclerotherapy of the

GSV by microfoam to be very effective, even at long-term

TABLE OF CONTENTS

Treatment of Varicose Long Saphenous Veins with

Sclerosant in Microfoam Form: Long-Term Outcomes

Cabrera J, Cabrera J Jr., Garcia-Olmedo Ma.M.

Abstracted by: Attilio Cavezzi, Italy

Extensive Tissue Necrosis Following High-

Concentration Sclerotherapy for Varicose Veins

Bergan JJ, Weiss RA, Goldman MP.

Abstracted by: Eberhard Rabe, Germany

Diameter/Reflux Relationship in Perforating Veins of

Patients with Varicose Veins

Sandri JL, Barros FS, Pontes S, et. al.

Abstracted by: Panos Dimakakos, Greece

Articles Abstracted in 2000

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