Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Fluoroscopy-Guided Endovenous Sclerotherapy Using a Microcatheter Prior to Endovenous Laser Ablation: Comparison between Liquid and Foam Sclerotherapy for Varicose Tributaries

  • Park, Sang Woo (Department of Radiology, Konkuk University Hospital, Konkuk University School of Medicine) ;
  • Yun, Ik Jin (Department of Surgery, Konkuk University Hospital, Konkuk University School of Medicine) ;
  • Hwang, Jae Joon (Department of Thoracic and Cardiovascular Surgery, Konkuk University Hospital, Konkuk University School of Medicine) ;
  • Lee, Song Am (Department of Thoracic and Cardiovascular Surgery, Konkuk University Hospital, Konkuk University School of Medicine) ;
  • Kim, Jun Seok (Department of Thoracic and Cardiovascular Surgery, Konkuk University Hospital, Konkuk University School of Medicine) ;
  • Chee, Hyun Keun (Department of Thoracic and Cardiovascular Surgery, Konkuk University Hospital, Konkuk University School of Medicine) ;
  • Chang, Il Soo (Department of Radiology, Konkuk University Hospital, Konkuk University School of Medicine)
  • Received : 2014.01.12
  • Accepted : 2014.04.15
  • Published : 2014.07.01
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Abstract

Objective: To compare the efficacy and adverse effects of endovenous foam sclerotherapy (EFS) and liquid sclerotherapy (ELS) using a microcatheter for the treatment of varicose tributaries. Materials and Methods: From December 2007 to January 2009, patients with venous reflux in the saphenous vein were enrolled. The foam or liquid sclerosant was injected through a microcatheter just before endovenous laser ablation (EVLA). Patients were evaluated for the technical success, clinical success, and procedure-related complications during the procedure and follow-up visits. Results: A total of 94 limbs were included: 48 limbs (great saphenous vein [GSV], 35; small saphenous vein [SSV], 13) were managed using EFS and EVLA (foam group; FG), and 46 limbs (GSV, 37; SSV, 9) were treated by ELS and EVLA (liquid group; LG). Varicose tributaries demonstrated complete sclerosis in 92.7% with FG and in 71.8% with LG (p = 0.014). Bruising (78.7% in FG vs. 73.2% in LG, p > 0.05), pain or tenderness (75.6% in FG vs. 51.2% in LG, p = 0.0237) were noted. Hyperpigmentation (51.2% in FG vs. 46.2% in LG, p > 0.05) was found. Conclusion: Endovenous foam sclerotherapy using a microcatheter is more effective than ELS for eliminating remnant varicose tributaries prior to EVLA. However, EFS is more commonly associated with local complications such as pain or tenderness than ELS. Furthermore, both techniques seem to prolong the duration of hyperpigmentation along with higher costs.

Keywords

Acknowledgement

Supported by : Konkuk University

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