Sclerotherapy with a ligation of incompetent veins for a stasis ulcer due to varix cruris: minimal invasive therapy for varix cruris.
A retrospective analysis was performed on 11 patients (mean age 50 years), consisting of 8 men and 3 women, with a stasis ulcer due to varix cruris who underwent sclerotherapy with a ligation of incompetent veins on an outpatient basis. The follow-up ranged from 26 to 76 months (mean 53 months). The ulcers healed in 14 to 128 days (mean 41 days) after this procedure except in 1 patient. Three patients healed within 1 month and 7 others within 2 months. Only 1 patient needed over 2 months to heal. A recurrence of the ulcer was observed in 1 case 59 days after healing, and incompetent perforating veins were newly identified. This patient required an additional endoscopic subfascial division of the perforating veins and is now in the process of healing. No deterioration of the ulcer was observed. Thrombophlebitis and faintness were observed in 1 patient each. Neither pulmonary embolism nor deep venous thrombosis was observed. In conclusion, sclerotherapy with a ligation of any incompetent veins was found to be a safe and effective treatment for a stasis ulcer due to varix cruris; however, long-term observation will be required to confirm the effectiveness of this procedure. To successfully use combination therapy with less or minimally invasive procedures, a precise diagnosis of vein incompetency is crucial.
Takeda
Y
Y
Department of General and Gastroenterological Surgery, Osaka Medical College, 2-7 Daigakucho, Takatsuki, Osaka 569-8686, Japan.
Agui
T
T
Tanaka
K
K
Okuzawa
M
M
Tanigawa
N
N
D000328:Adult; D000556:Ambulatory Surgical Procedures; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008026:Ligation / Q000379:methods; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D012189:Retrospective Studies; D015911:Sclerotherapy / Q000379:methods*; D016896:Treatment Outcome; D014647:Varicose Ulcer / Q000175:diagnosis / Q000628:therapy*; D014945:Wound Healing / Q000502:physiology