尽管采取了推荐的治疗调整措施，在大隐静脉泡沫硬化治疗过程中仍发生了静脉气体栓塞。

Venous gas embolism during foam sclerotherapy of saphenous veins despite recommended treatment modifications.

作者信息

Parsi K

机构信息

Sydney Skin and Vein Clinic, Sydney, Australia.

出版信息

Phlebology. 2011 Jun;26(4):140-7. doi: 10.1258/phleb.2010.010030. Epub 2010 Nov 18.

DOI:10.1258/phleb.2010.010030

PMID:21087951

Abstract

OBJECTIVE

To investigate the effectiveness of methods proposed to prevent venous gas embolism during foam sclerotherapy.

METHODS

Transthoracic echocardiography was performed concurrent with ultrasound-guided sclerotherapy (UGS) of great or small saphenous veins. A volume of 2.5 mL of 3% sodium tetradecyl sulphate foam was prepared following the Tessari method and injected slowly 5-10 cm away from saphenous junctions. The procedure was repeated with modifications including using a 5 µm filter to generate microfoam, carbon dioxide as the foaming gas, leg elevation before or after the injection and immobility post-treatment.

RESULTS

Bubbles entered the right heart in less than 60 seconds and continued for up to 50 minutes despite all treatment modifications. None of the patients had a patent foramen ovale and none developed any neurological or cardiac symptoms.

CONCLUSION

Bubble emboli entered the heart during foam UGS of saphenous veins despite all treatment modifications and low volumes of foam used.

摘要

目的

探讨在泡沫硬化疗法中预防静脉气体栓塞所采用方法的有效性。

方法

在超声引导下对大隐静脉或小隐静脉进行硬化治疗（UGS）的同时，进行经胸超声心动图检查。按照泰萨里方法制备2.5毫升3%的十四烷基硫酸钠泡沫，并在距隐静脉汇合处5 - 10厘米处缓慢注射。对该操作进行了改进后重复进行，改进措施包括使用5微米过滤器产生微泡沫、使用二氧化碳作为发泡气体、注射前或注射后抬高腿部以及治疗后保持不动。