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Microfoam ultrasound-guided sclerotherapy in primary trunk varicose veins

OBJECTIVE: To evaluate the treatment of primary trunk varicose veins by microfoam ultrasound-guided sclerotherapy. METHODS: The sample was composed of 25 members of six male and 19 female patients, with incompetence of great saphenous vein (21) and short saphenous vein (4). Patients were assessed according to the clinical, etiologic, anatomical and pathophysiological (CEAP) classification and divided into degrees C³ (10), C4 (6), C5 (5) and C6 (4). With the patients in the Trendelenburg position, microfoam (5 ml), prepared by mixture of 1 ml polidocanol at 3% and 5 ml of air, was injected in their vein and monitored by color-flow Doppler ultrasonography. The members were then swaddled with inelastic bandage for 3 days; afterward, the patients used 30-40 mmHg, 3/4 or 7/8, elastic socks, during 3 months. Treatment efficiency was evaluated based on the CEAP classification for pain, edema and claudication, and on color-flow Doppler ultrasonographic changes 12 months later. Clinical scores, before and after treatment, were compared using the Wilcoxon test. RESULTS: There was a significant decrease in the clinical scores (p < 0.05). Therapeutic success was achieved, with total occlusion and partial recanalization without reflux in 84% of the cases. The remaining 16% of the cases presented partial recanalization with reflux or complete recanalization. CONCLUSION: Ultrasound-guided sclerotherapy, which is an easy and low-cost method that does not require hospitalization and anesthesia, proved to be promising for the treatment of primary trunk varicose veins.

Sclerotherapy; varicose veins; polidocanol; color-flow Doppler ultrasonography


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