Operative and postoperative risks of combined interventions by phlebectomy and foam sclerotherapy

A. L. Recke; A. Frendel; B. Kahle

doi:10.12687/phleb2356-2-2017

Phlebologie, Table of Contents

Phlebologie 2017; 46(02): 75-80
DOI: 10.12687/phleb2356-2-2017

Original article

Schattauer GmbH

Operative and postoperative risks of combined interventions by phlebectomy and foam sclerotherapy

A retrospective analysis of the example of isolated anterior accessory vein incompetence Article in several languages: English | deutsch

A. L. Recke

¹Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum Schleswig-Holstein (UKSH) Campus Lübeck, Lübeck, Germany

,

A. Frendel

¹Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum Schleswig-Holstein (UKSH) Campus Lübeck, Lübeck, Germany

,

B. Kahle

¹Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum Schleswig-Holstein (UKSH) Campus Lübeck, Lübeck, Germany

› Author Affiliations

Abstract

Summary

Background: Insufficiency of anterior accessory great saphenous vein (AASV) with a competent great saphenous vein (GSV) is frequently encountered in patients referred for phlebological evaluation. The classic therapeutic approach to treat AASV insufficiency consists of crossectomy and stripping of GSV and all tributaries. In isolated AASV insufficiency, stripping of the AASV combined with foam sclerotherapy of the proximal AASV section is a useful alternative to preserve the GSV. Historically, the combination of phlebectomy and sclerotherapy in a single session was avoided given the perceived and reported risk of complications

Aim: A retrospective analysis of the side effects and complications following phlebectomy of the AASV combined with foam sclerotherapy in one session.

Patients and method: Case records of all patients with isolated AASV insufficiency, who underwent a combined procedure (phlebectomy of the AASV and foam sclerotherapy) between 01.01.2013 and 30.11.2016, were evaluated.

Results: 28 patients (29 legs) were included. There were no severe side effects or complications in any case. Complete occlusion of the proximal AASV could be demonstrated sono-graphically.

Conclusion: The combination of phlebectomy and foam sclerotherapy in one session is an effective and safe treatment option in cases of isolated AASV insufficiency.

Keywords

Anterior accessory great saphenous vein - foam sclerotherapy - varicose vein surgery

Full Text

References

References
1 Hach W. Varikose der V. saphena accessoria lateralis. In: Hach W. (Hrsg.) VenenChirurgie. Leitfaden für Gefäßchirurgen, Angiologien, Dermatologen und Phlebologen. Stuttgart: Schattauer; 3. Aufl. 2013
2 Editor‘s Choice – Management of Chronic Venous Disease.. Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS). EJVES 2015; 49: 678-737.
3 Caggiati A. The saphenous venous compartments. Surg Radiol Anat 1999; 21: 29e-34e.
4 Yamaki T, Nozaki M, Sasaki K. Acute Massive Pulmonary Embolism Following High Ligation Combined with Compression Sclerotherapy for Varicose Veins. Derm Surg 1999; 25: 321-325.
5 Ikeda M, Kambayashi J, Iwamoto S, Shinoki N, Nakamura T, Okahara K, Fujitani K, Shibuya T, Kawasaki T, Monden M. Hemostasis activation during sclerotherapy of lower extremity varices. Thromb Res 1996; 82: 87-95.
6 Iwamoto S, Ikeda M, Kawasaki T, Monden M. Treatment of Varicose Veins: An Assessment of Intraoperative and Postoperative Compression Sclerotherapy. Ann Vasc Surg 2003; 17: 290-295.
7 Hamel-Desnos CM, Desnos PR, Ferre B, Le Querrec A. In vivo Biological effects of Foam Sclerotherapy. Eur J Vasc Endovasc Surg 2011; 42: 238-245.
8 Bountouroglou DG, Azzam M, Kakkos SK, Path-marajah M, Young P, Geroulakos G. Ultrasound-guided Foam sclerotherapy Combined with Sapheno-femoral Ligation Compared to Surgical Treatment of Varicose Veins: Early Results of a Randomised Controlled Trial. Eur J Vasc Endovasc Surg 2006; Jan 31 (Suppl. 01) 93-100.
9 Liu X, Jia X, Guo W, Xiong J, Zhang H, Liu M, Du X, Zhang M. Ultrasound guides foam sclerotherapy of the great saphenous vein with sapheno-fe-moral ligation compared to standard stripping: a prospective clinical study. Int Angiol 2011; 30: 321-326.
10 Zhao ZY, Zhang XJ, Li JH, Huang M. Comparison of high ligation and stripping of the great saphenous vein combined with foam sclerotherapy versus conventional surgery for the treatment of superficial venous varicosities of the lower extremity. Int J Clin Exp Med 2015; 8 (Suppl. 05) 7843-7848.
11 Li H, Tong X, Qiu X. Clinical Observation of Foam Sclerotherapy Combined with Ligation of Great Saphenous Vein in the Treatment of Great Saphenous Varicose Veins. West Indian Med J. 2015 Nov 4. Pii: wimj.2015.164.
12 Yin H, He H, Wang M, Li Z, Hu Z, Yao C, Wang J, Wang S, Chang G. Prospective Randomised Study of Ultrasound-Guided Foam Sclerotherapy Combined with Great Saphenous Vein High Ligation in the Treatment of Severe Lower Extremity Varicosis. Ann Vasc Surg. 2016 Sep 23. Pii: S0890-5096(16)30842–1.
13 Rabe E, Gerlach H, Breu FX, Guggenbichler S, Stücker M, Pannier F. Sklerosierungsbehandlung der Varikose S1 Leitlinie AWMF Registernummer 037–015.
14 Rabe E, Breu FX, Cavezzi A, Coleridge Smith P, Frullini A, Gillt JL, Guex JJ, Hamel-Desnos C, Kern P, Partsch B, Ramelet AA, Tessari L, Pannier F. European guidelines for sclerotherapy in chronic venous disorders. Phlebology 2014; 29: 338-354.