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双侧泡沫聚多卡醇同步硬化治疗大隐静脉及其属支。

Bilateral foam polidocanol sclerotherapy of great saphenous veins and their tributaries in synchronous procedure.

作者信息

Miranda Luiz Antonio, do Carmo Rachel Cristina, Sathler-Melo Cláudia Carvalho, de Castro-Santos Guilherme

机构信息

Hospital Infantil Padre Anchieta, Belo Horizonte, MG, Brasil.

Hospital Militar de Área de Manaus - HMAM, Manaus, AM, Brasil.

出版信息

J Vasc Bras. 2021 Jun 16;20:e20200178. doi: 10.1590/1677-5449.200178.

Abstract

BACKGROUND

Chronic venous insufficiency is a highly prevalent disease. Advanced cases have high morbidity.

OBJECTIVES

To evaluate the risks and benefits of foam sclerotherapy in patients who underwent bilateral treatment of the great saphenous veins in a single procedure, in selected cases of advanced venous insufficiency.

METHODS

We retrospectively reviewed 55 patients (110 limbs) with bilateral incompetence of the great saphenous veins who had undergone foam sclerotherapy treatment bilaterally, using a maximum dose of 20 ml of foam per patient and inelastic compression.

RESULTS

In 81 (73.6%) of the 110 saphenous veins analyzed, occlusion was obtained in the first session. After a second session this figure rose to 106 (96.3%) and all 110 (100%) veins were occluded after three sessions. Bilateral occlusion of the great saphenous veins was achieved in 27 patients (50%) in one session, in 34 (62%) patients in two sessions, and in 55 (100%) patients in three sessions. At 42 days after sclerotherapy, there was complete ulcer healing in seven (63%) of the 11 patients with ulcers and partial healing in 3 (27%) of these patients. One patient (1.8%) had self-limited lipothymia and visual scotomas, 3 patients (5.45%) had skin spots, and 19 patients (34.5%) developed retained intravascular coagulum.

CONCLUSIONS

Bilateral foam sclerotherapy in a synchronous procedure is an option to be considered for treatment of varicose veins of the lower limbs.

摘要

背景

慢性静脉功能不全是一种高度流行的疾病。晚期病例发病率高。

目的

在选定的晚期静脉功能不全病例中,评估在单次手术中对双侧大隐静脉进行治疗的患者采用泡沫硬化疗法的风险和益处。

方法

我们回顾性分析了55例(110条肢体)双侧大隐静脉功能不全且接受双侧泡沫硬化疗法治疗的患者,每位患者使用的泡沫最大剂量为20 ml,并采用非弹性压迫。

结果

在分析的110条大隐静脉中,81条(73.6%)在首次治疗后实现闭塞。第二次治疗后,这一数字升至106条(96.3%),三次治疗后所有110条(100%)静脉均闭塞。27例(50%)患者在一次治疗后实现双侧大隐静脉闭塞,34例(62%)患者在两次治疗后实现,55例(100%)患者在三次治疗后实现。硬化疗法后42天,11例溃疡患者中有7例(63%)溃疡完全愈合,3例(27%)部分愈合。1例患者(1.8%)出现自限性晕厥和视觉暗点,3例患者(5.45%)出现皮肤斑点,19例患者(34.5%)形成血管内血栓残留。

结论

同步进行双侧泡沫硬化疗法是治疗下肢静脉曲张时可考虑的一种选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/00c1/8218854/25fc0c48c039/jvb-20-e20200178-g01-en.jpg

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