Real-time color duplex scanning after sclerotherapy of the greater saphenous vein.
A color real-time duplex scanner was used to scan the greater saphenous vein in 89 limbs of 55 patients to study the efficacy of prior greater saphenous vein sclerotherapy. The greater saphenous vein was insonated from the saphenofemoral junction to the knee to evaluate both reflux to a standardized 30 mm Hg Valsalva maneuver and evidence of greater saphenous vein obliteration by sclerotherapy. These data were correlated with the number of sclerosing injections used (mean, 1.8; range, 1 to 6), time from the last injection (mean, 27.5 mo.; range, 3 to 55 mo), and concentration of injectant used (0.5% to 3% sodium tetradecyl sulfate). Fifty-one of 89 injected limbs (57%) demonstrated reflux through the saphenofemoral junction, and reflux down the more distal greater saphenous vein was found in 67 of 89 injected limbs (75%). Greater saphenous vein obliteration was noted in only 18 of 89 injected limbs (20%); two were totally obliterated, and 16 were partially obliterated. The greater saphenous vein was obliterated in 6% below a refluxing saphenofemoral junction and in 40% below a nonrefluxing junction. A greater saphenous vein obliteration rate of 9% was found with a refluxing greater saphenous vein, and 50% in a nonrefluxing greater saphenous vein. Femoral vein reflux was identified in 11 of the 110 limbs (10%) and in every case was associated with both saphenofemoral junction and greater saphenous vein reflux. We noted a trend toward more successful results with more concentrated injectate (3% sodium tetradecyl sulfate). Fifty percent of patients reported improvement in symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)
Bishop
C C
CC
Division of Vascular and Thoracic Surgery, Scripps Clinic and Research Foundation, La Jolla, CA 92037.
Fronek
H S
HS
Fronek
A
A
Dilley
R B
RB
Bernstein
E F
EF
D000328:Adult; D000368:Aged; D005260:Female; D005268:Femoral Vein / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D007717:Knee / Q000098:blood supply; D008297:Male; D008722:Methods; D008875:Middle Aged; D012039:Regional Blood Flow; D012501:Saphenous Vein / Q000000981:diagnostic imaging* / Q000503:physiopathology; D012597:Sclerosing Solutions / Q000008:administration & dosage / Q000627:therapeutic use; D015911:Sclerotherapy; D012981:Sodium Tetradecyl Sulfate / Q000008:administration & dosage / Q000627:therapeutic use; D013997:Time Factors; D014463:Ultrasonography; D014636:Valsalva Maneuver; D014648:Varicose Veins / Q000628:therapy
D012597:Sclerosing Solutions; D012981:Sodium Tetradecyl Sulfate