Deak Vein NJ Clinic, Somerset, NJ.
J Vasc Surg Venous Lymphat Disord. 2018 Jul;6(4):477-484. doi: 10.1016/j.jvsv.2018.03.015.
This study measured patient outcomes among symptomatic patients with superficial chronic venous insufficiency who were treated with retrograde ultrasound-guided polidocanol microfoam 1% in a community setting.
Between March 2015 and June 2017, 250 symptomatic patients with C2-C6 chronic venous insufficiency received polidocanol microfoam 1% and were followed for 16 ± 7 months. Sixteen of the 250 patients (6.4%) had skin ulcers, and 56 (22.4%) were treated previously with thermal or surgical interventions. All patients underwent a duplex ultrasound venous incompetence study to map perforators and veins to be treated. Incompetent veins were accessed with a micropuncture needle distal to the midthigh perforator, approximately 10 cm above the knee fold. The leg was then elevated 45°. Under ultrasound guidance, the incompetent greater saphenous vein was closed with polidocanol microfoam 1%. A second injection was administered through the same catheter directing the microfoam to flow in a retrograde fashion through the incompetent venous valves to the ankle.
All patients completed the initial treatment; 55 (22.0%) required planned secondary treatment during the follow-up period for residual venous reflux in the below-knee greater saphenous vein. Complete elimination of venous valvular reflux and symptom improvement was documented in 236 patients (94.4%). Minor adverse events included asymptomatic deep vein thrombi (n = 2), common femoral vein thrombus extension (n = 1), and superficial venous thrombi (n = 4). Of the 16 patients with skin ulcers, 10 were C6 patients and 80% experienced wound closure within 4 weeks of treatment.
Retrograde administration of polidocanol microfoam 1% is a safe and effective treatment with important clinical benefit for superficial venous insufficiency in community practice.
本研究测量了在社区环境中接受逆行超声引导 1%聚多卡醇微泡治疗的有症状慢性浅静脉功能不全患者的治疗效果。
2015 年 3 月至 2017 年 6 月，250 例 C2-C6 慢性静脉功能不全有症状患者接受 1%聚多卡醇微泡治疗，并随访 16±7 个月。250 例患者中有 16 例（6.4%）有皮肤溃疡，56 例（22.4%）曾接受过热疗或手术干预。所有患者均行双功能超声静脉不全研究以定位治疗的穿通支和静脉。在大腿中穿通支远侧用微穿刺针进入功能不全的静脉，大约在膝褶上方 10cm 处。然后抬高腿部 45°。在超声引导下，用 1%聚多卡醇微泡闭合功能不全的大隐静脉。通过同一导管将微泡逆行注入功能不全的静脉瓣膜，流向踝关节，以进行第二次注射。
所有患者均完成初始治疗；55 例（22.0%）在随访期间因膝下大隐静脉静脉反流残留而需要计划的二次治疗。236 例（94.4%）患者记录到静脉瓣反流完全消除和症状改善。轻微不良事件包括无症状深静脉血栓形成（n=2）、股总静脉血栓延伸（n=1）和浅静脉血栓形成（n=4）。16 例皮肤溃疡患者中，10 例为 C6 患者，80%的患者在治疗后 4 周内伤口闭合。
逆行给予 1%聚多卡醇微泡是一种安全有效的治疗方法，对社区实践中的浅静脉功能不全具有重要的临床获益。
