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Phlebologie 2008; 37(04): 211-220
DOI: 10.1055/s-0037-1622233
Original Article
Schattauer GmbH

Foam sclerotherapy

How to improve results and reduce side effects?SchaumsklerotherapieWie können Therapieergebnisse verbessert und Nebenwirkungen reduziert werden?Sclérothérapie à la moussePeut-on améliorer les résultats et diminuer les effets secondaires ?
N. Morrison
1   Morrison Vein Institute Scottsdale, Az., USA
› Institutsangaben
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Publikationsverlauf

Received: 28. Juli 2008

accepted: 29. Juli 2008

Publikationsdatum:
04. Januar 2018 (online)

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Summary

Methods to improve the efficacy of foam sclerotherapy might include: more vigorous agitation methods to produce more stable foam with smaller bubble size, increasing the volume and/or concentration of the sclerosing agent, use of an intravenous catheter, and leg elevation to evacuate as much blood as possible. Methods to improve the safety of foam sclerotherapy might include: use of an intravenous indwelling catheter; saphenofemoral junction occlusion; low foam volume; use of low silicon syringes; use of non airbased foam; avoidance of high concentration sclerosing agents in patients with duplicated femoral vein segments; leg elevation before or after injection of foam; and maintaining patient immobility after injection.

A series of studies and exercises are described which call into question many methods proposed to limit the dispersal of injected foam. The use of non air-based foam may reduce the incidence of side effects.

Zusammenfassung

Verfahren zur Verbesserung der Wirksamkeit der Schaumsklerotherapie sind: turbulente Mischverfahren, um stabilen Schaum mit kleinen Blasen zu erzeugen, Erhöhung des Volumens und/oder der Konzentration des Sklerosierungsmittels, Einsatz eines Venenkatheters, Hochlagern der Beine, um Blutleere zu erzeugen. Verfahren zur Verbesserung der Sicherheit der Schaumsklerotherapie sind: Einsatz von Venenverweilkathetern, saphenofemorale Ligatur, geringes Schaumvolumen, Einsatz von Spritzen mit niedrigem Silikonanteil, Verwendung von Schaum, der als Gaskomponente keine Luft enthält, Vermeidung hoher Sklerosierungsmittel-Konzentrationen bei Patienten mit doppelt angelegten Segmenten der Oberschenkelvene, Hochlagern der Beine vor und nach Schauminjektion und Einhaltung der Liegezeit nach Injektion.

Mehrere Studien und Tests werden beschrieben, die viele Verfahren in Frage stellen, die zur Begrenzung der Ausbreitung des injizierten Schaums empfohlen wurden. Mit Schaum ohne Luft als Gaskomponente kann die Inzidenz von Nebenwirkungen verringert werden.

Résumé

Les méthodes pour améliorer l’efficacité de la sclérothérapie à la mousse sont nombreuses : il faut mélanger avec vigueur le liquide pour obtenir les bulles les plus petites possibles, augmenter le volume et/ou la concentration de l’agent sclérosant, utiliser un cathéter intraveineux et surélever la jambe pour en vider le maximum de sang possible. Pour augmenter la sécurité du traitement il faut : placer correctement le cathéter intraveineux, obtenir l’occlusion de la jonction saphéno-fémorale, utiliser un faible volume de mousse, avoir des seringues faiblement siliconées. La mousse ne doit pas être mélangée à de l’air; il faut éviter les fortes concentrations d’agent sclérosant chez des patients avec des segments veineux fémoraux dupliqués; la surélévation de la jambe doit être faite avant ou après l’injection de mousse; le patient doit rester immobile après l’injection. Il existe une série d’études et de méthodes dont le but est de limiter la dispersion de la mousse injectée. L’usage d’une mousse produite sans air doit réduire le nombre des effets secondaires.

Keywords

Foam sclerotherapy - transthoracic echocardiography - transcranial Doppler

Schlüsselwörter

Schaumsklerotherapie - transthorakale Echokardiographie - transkranieller Doppler

Mots clés

Sclérothérapie à la mousse - échocardiographie trans-thoracique - doppler trans-crânien
 

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