[Injection sclerotherapy for varicosities of the lower limb: 25 years of experience with 115000 injections].
BACKGROUND
The author began to deal with injection sclerotherapy 25 years ago, which is still being practised by him to this day.


METHODS
Experience is drawn from 115 000 injections given to 4025 limbs of 3107 patients. The mean age is 41.7 years, 80.3% of patients were women.


METHODS
For decades, medicines necessary for sclerotherapy (polidocanol, tetradecylsulphate) have been available in Hungary. At the same time diagnosis and method have developed both abroad and in Hungary. Instead of the previously used standard standing position, the patient is either sitting or lying during the puncture. The diameter of the needle used is smaller than earlier. Previously at the injection the patient was lying and her leg was raised, but now usually she is in the same position as during the puncture. The amount of given medicine at one session was 1 x 0.2 ml, later 4 and 6 x 0.5 ml, but now the allowed maximal dosage is 28 ml 0.5%.


RESULTS
Treatments were successful in every case and there were not any serious complications. This method has an outstanding importance in the treatment of intracutaneous venectases and reticular varicosis but side branches and perforators can be cured as well. As is well known, varicosity is a progressive disease and the sclerotherapy can be repeated unrestricted. It is therefore suitable for its treatment in the long run. Strong reactions and complications: The most common strong reactions are fainting, suffusion, phlebitis and pigmentation at the site of the injection.


RESULTS
Very rarely blistering, allergic reaction and deep venous thrombosis. The latter is highly focused, therefore the patient's thrombophilic history is revealed. The authors' results and the survey in Hungary showed 1.5% complication in treated patients including one non serious deep venous thrombosis. The recently introduced ultrasound-guided foam sclerotherapy of the leg is suitable for the injection of stem varicosities. Successful treatments were carried out not only in the lower leg but also in upper limb varicosities, vascular malformations, venous lake of the lip and hemorrhoidal nodes. The sclerotherapy and operation rather supplement each other than compete.


CONCLUSIONS
Sclerotherapy has proved to be suitable for the therapy of lower limb varicosity and some other venous dilatations.
Bihari
Imre
I
Semmelweis Egyetem, Egészségügyi Fôiskolai Kar, Klinikai Tanszék, Budapest, Népszínház u. 42-44, 1081. biharimi@freemail.hu
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000075202:Contraindications; D018450:Disease Progression; D005260:Female; D006801:Humans; D007275:Injections, Intravenous / Q000379:methods; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D000077423:Polidocanol; D011092:Polyethylene Glycols / Q000008:administration & dosage; D019233:Retreatment; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000473:pathology; D012597:Sclerosing Solutions / Q000008:administration & dosage* / Q000009:adverse effects; D015911:Sclerotherapy / Q000009:adverse effects / Q000379:methods; D012981:Sodium Tetradecyl Sulfate / Q000008:administration & dosage; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography; D014648:Varicose Veins / Q000000981:diagnostic imaging / Q000628:therapy*
D012597:Sclerosing Solutions; D000077423:Polidocanol; D011092:Polyethylene Glycols; D012981:Sodium Tetradecyl Sulfate