Short-Term Outcomes of Surgery Combined with Form Sclerotherapy for Treatment of Varicose Veins

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  • Mizumoto Kazuo
    Department of Dermatology, Shimane University Faculty of Medicine
  • Niihara Hiroyuki
    Department of Dermatology, Shimane University Faculty of Medicine
  • Morita Eishin
    Department of Dermatology, Shimane University Faculty of Medicine

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  • 下肢静脈瘤に対するフォーム硬化療法を併用した手術の短期治療成績
  • カシ ジョウミャクリュウ ニ タイスル フォーム コウカ リョウホウ オ ヘイヨウ シタ シュジュツ ノ タンキ チリョウ セイセキ

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Abstract

We measured 3-month outcomes of surgical therapy for varicose veins in 38 legs between October 2008 and September 2009. We used the venous clinical severity score (VCSS), the visual analog scale (VAS), and duplex ultrasound (DU) scanning to evaluate outcomes. For flow reversal via the sapheno-femoral junction, partial stripping or high ligation was performed. For the flow reversal via the sapheno-popliteal junction, high ligation was performed. Insufficient perforating veins were interrupted under direct or endoscopic visualization. Saphenous varicose veins in all legs were treated with foam sclerotherapy. Thirty-two legs (84%) showed satisfactory progress, but 6 did not (16%). Their VCSS and VAS after surgery did not improve, and DU scanning revealed that reverse flow remained from the deep vein to the saphenous varicose vein via insufficient perforating veins. All cases were classified as C4 in the CEAP classification and had severe stasis dermatitis. The cause of failure was determined to be incomplete treatment of reverse flows via insufficient perforating veins. Insufficient perforating veins and deactivation of the sclerosing agent caused by reverse flow led to the survival of varicose veins. In cases with severe stasis dermatitis, complete treatment of reverse flows in combination with form sclerotherapy is important.

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