Saint Martin Private Hospital, Department of Vascular Medicine, 18 rue des Roquemonts, 14050 Caen, France.
Eur J Vasc Endovasc Surg. 2011 Aug;42(2):238-45. doi: 10.1016/j.ejvs.2011.03.034. Epub 2011 Apr 30.
This study aims to assess by biological markers the in vivo consequences of foam sclerotherapy (FS) of saphenous veins. The secondary objective of this randomised controlled trial (RCT) is to compare results of two randomised groups: with or without post-treatment compression.
Forty patients with incompetent great or small saphenous veins underwent ultrasound-guided FS. Randomisation was conducted immediately after sclerotherapy to two parallel groups, one (CG) with compression stockings and the other (WCG) without compression. A laboratory work-up was done on days 0 (before sclerotherapy), 1, 7, 14 and 28. The studied markers were: fibrinogen, factor VIII, thrombomodulin, thrombin-antithrombin complex, D-dimers, platelet factor 4 and troponin.
General data repartition was homogenous for CG and WCG. Twenty patients were included in each group (females 90%; mean age 58 years). On day 28 (D28), the occlusion rate of the veins was 100% in both groups. In all the samples (D0-D28), apart from a moderate D-dimers' increase at D1-D14, no significant biological change was observed in either the WCG or the CG groups.
In terms of inflammation and coagulation, FS seems to have a minimal effect on peripheral blood, either with or without post-treatment compression and does not appear to have an effect on the myocardial risk.
本研究旨在通过生物标志物评估泡沫硬化疗法(FS)治疗隐静脉的体内后果。这项随机对照试验(RCT)的次要目的是比较两组随机分组的结果:有或没有治疗后压迫。
40 例大隐或小隐静脉功能不全的患者接受了超声引导下的 FS。硬化治疗后立即进行随机分组,一组(CG)穿压迫弹力袜,另一组(WCG)不穿。在第 0 天(硬化治疗前)、第 1 天、第 7 天、第 14 天和第 28 天进行实验室检查。研究的标志物包括纤维蛋白原、VIII 因子、血栓调节蛋白、凝血酶-抗凝血酶复合物、D-二聚体、血小板因子 4 和肌钙蛋白。
CG 和 WCG 的一般数据分布均匀。每组纳入 20 例患者(女性 90%;平均年龄 58 岁)。在第 28 天(D28),两组静脉闭塞率均为 100%。在所有样本(D0-D28)中,除了 D1-D14 期间 D-二聚体中度增加外,WCG 或 CG 组均未观察到明显的生物学变化。
就炎症和凝血而言,FS 对周围血液的影响似乎很小,无论是否进行治疗后压迫,并且似乎不会对心肌风险产生影响。