Phlebologie 2019; 48(02): 95-101
DOI: 10.1055/a-0843-4324
Original Article
© Georg Thieme Verlag KG Stuttgart · New York

Evidence of Foam Sclerotherapy in the Treatment of Recurrent Varicose Veins

Evidenz der Schaumsklerosierung in der Behandlung von Rezidivvarizen
Jochen Peter
1   Phlebicum® Venenzentrum an der Rue, Wiesbaden
,
Siamak Pourhassan
2   Gemeinschaftspraxis für Gefäßchirurgie/Gefäßmedizin, Oberhausen-Sterkrade
› Author Affiliations
Further Information

Publication History

18 September 2018

18 January 2019

Publication Date:
10 April 2019 (online)

Abstract

Purpose Efficacy and safety of ultrasound-guided foam sclerotherapy (UGFS) for the treatment of primary venous disease is proven, but the main application field of UGFS remains the treatment of recurrent varicose veins (RVV). The aim of this study is to determine the extent to which this treatment indication is evidence-based.

Methods In PubMed and other publicly accessible databases, literature was reviewed until June 2018 and checked for relevance. The focus was on results with regard to anatomical success as well as clinical success and perception by patients.

Results Several observational studies comprised a subgroup of RVV patients, but systematic stratification for RVV patients were only rarely performed. In most of these studies including the few reports specifically investigating RVV patients anatomical success as the primary outcome measure revealed similar results compared to primary interventions and favourable results in patients with neovascularization. Data on clinical outcome and patient perception were inconclusive due to low study numbers and insufficient stratification. Complications in RVV patients were rare.

Conclusion Although the advantages inherent to the UGFS principle provide a strong rationale that this method best meets the requirements of the specific RVV characteristics, concept and previous observations should be supported by more evidence. Systematic studies in RVV patients with sufficient sample size are required.

Zusammenfassung

Ziel der Studie Die Wirksamkeit und Sicherheit der ultraschallassistierten Schaumverödung (UGFS) zur Behandlung der primären Varikose ist nachgewiesen, aber das Hauptanwendungsgebiet von UGFS bleibt die Behandlung der Rezidivvarikose (RVV). Diese Studie soll nachweisen, in welchem Umfang diese Behandlungsindikation evidenzbasiert ist.

Methodik In PubMed und weiteren öffentlich zugänglichen Datenbanken wurde Literatur bis Juni 2018 gesichtet und auf Relevanz für die Fragestellung geprüft. Im Fokus standen dabei Ergebnisse sowohl im Hinblick auf anatomischen Erfolg als aber auch klinischer Erfolg und Wahrnehmung durch Patienten.

Ergebnisse Mehrere Beobachtungsstudien umfassten zwar Untergruppen von RVV-Patienten, aber eine systematische Stratifizierung für RVV-Patienten wurde nur selten durchgeführt. In den meisten Studien, einschließlich der wenigen Berichte, die spezifisch RVV-Patienten untersuchten, zeigte anatomischer Erfolg als primäre Outcome-Messung ähnliche Ergebnisse im Vergleich zu primären Interventionen und günstige Ergebnisse bei Patienten mit Neovaskularisation. Die Daten über klinische Ergebnisse und Patientenwahrnehmung waren jedoch aufgrund der geringen Anzahl von Studien und der unzureichenden Stratifizierung nicht schlüssig. Komplikationen bei RVV-Patienten waren selten.

Schlussfolgerungen Obwohl die Vorteile der UGFS stark dafür sprechen, die spezifischen Anforderungen der RVV am besten zu erfüllen, sollten das UGFS-Konzept und bisherige Beobachtungen mit mehr Evidenz untermauert werden. Systematische Studien bei RVV-Patienten mit ausreichendem Stichprobenumfang sind erforderlich.

 
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