J. T. Toniolo1,2, D. Munteanu1, A. Russell1, N. Chiang1, H. Hao1, J. Chuen1,2 1The Austin Hospital,Department Of Vascular Surgery,Melbourne, VICTORIA, Australia 2The University Of Melbourne,Department Of Surgery,Melbourne, VICTORIA, Australia
Introduction:
Ultrasound-guided foam sclerotherapy (UGFS) is a low-cost and minimally invasive treatment option for varicose veins. There is a relative paucity of outcome reports.
Methods:
UGFS at a tertiary hospital between 2010 and 2017 were studied. Treatments were either the greater saphenous vein (GSV) or short saphenous vein (SSV). Pre-treatment, in-treatment, 6-week and 1-year post-treatment ultrasound reports were analysed. Vein diameters were measured at 3cm below the respective junctions. Primary outcome was to determine if vein diameter would predict recanalisation.
Results:
456 treatments were completed in 290 patients. 372 (81%) targeted the GSV. Mean vein diameters of the GSV were smaller than SSV [5.5 +/- 1.9mm (GSV), 6.2 +/- 2.6mm (SSV); p=0.024]. 109 (24%) had CEAP of at least 4.
At six weeks, complete obliteration, partial recanalisation and complete recanalisation rates for GSV were 55%, 29% and 13% respectively. Of the 251 veins with complete obliteration at six-weeks, partial and complete recanalisation at one-year were 21% and 26%, respectively. Regarding the SSV system, complete obliteration, partial recanalisation and complete recanalisation at 6-weeks were 51%, 30% and 13%, respectively. Similarly, partial and complete recanalisation at one-year were 26% and 18%, respectively. Using Student-t test, increasing vein diameter was associated with partial or complete recanalisation at 6 weeks [5.4 +/- 2.0mm (obliteration) cf. 5.9 +/- 2.2mm (recanalisation); p=0.036] and 1 year [4.7 +/- 1.7mm (obliteration) cf. 5.7 +/- 2.0mm (recanalisation); p=0.036). Vein diameter of greater than 6mm was not associated with recanalisation (p=0.07). 15 (3%) new onset DVTs, and 11 (2%) injection-related ulcers reported on follow-up.
Conclusion:
More than 50% achieved complete obliteration at 6 weeks. Significant sonographic recanalisation developed at one-year. Increased vein diameter was associated with recanalisation. Their impact on clinical recurrence is unknown.