title: Incidence of side effects using carbon dioxide-oxygen foam for chemical ablation of superficial veins of the lower extremity.
abstract: OBJECTIVE
  To determine the incidence of side effects following treatment of varicose veins with carbon dioxide-oxygen (CO(2)/O(2)) foam sclerotherapy, and to compare results with historical controls using CO(2)- or air-based foams.
  
  
  METHODS
  Cohort study with prospective data collection, private clinic setting.
  
  
  METHODS
  The patient population consisted of one hundred patients, 95% women, age 52 SD 13 years-old, CEAP class C(2)EpAsPr.
  
  
  METHODS
  Patients underwent ultrasound-guided foam sclerotherapy following thermal ablation of saphenous trunks; 1-3% polidocanol and 70%CO(2)-30%O(2) gas were mixed in a 1:4 proportion. Volume injected averaged 22 SD 11 (range: 2-46) mL. Vital signs were monitored for 1 h; side effects were recorded up to 24 h post treatment. Incidence of side effects was compared to CO(2)- and air-based foam data.
  
  
  RESULTS
  Heart rate decreased from 73 SD 11 at the start to 68 SD 9 bpm (p < 0.001, paired t-test) following the procedure. Systolic and diastolic pressures, 127/75 SD 18/14 mmHg, respiratory rate, 15 SD 4 rpm and pO(2), 98 SD 2%, did not change significantly. Itching (7) or leg pain (24) reporting was similar to that for air-based foam (p = NS). Lack of reported chest tightness and/or dry cough was superior to our previous data with CO(2) or air foam (p < 0.05). Reporting of dizziness (1) was less than that for air-based foam (p = 0.002). The incidence of visual disturbance (2%), was comparable with that for CO(2) (3%) or air (8%) foam, but too few cases were available for meaningful statistical analysis.
  
  
  CONCLUSIONS
  Foam sclerotherapy using CO(2)/O(2) foam was well tolerated by patients and resulted in fewer side effects than similar treatment using air foams.
authors.affiliation: Morrison Vein Institute, Scottsdale, AZ, USA. nickmorrison@morrisonveininstitute.com
authors.forename: N
authors.initials: N
authors.lastname: Morrison
authors.forename: D L
authors.initials: DL
authors.lastname: Neuhardt
authors.forename: C R
authors.initials: CR
authors.lastname: Rogers
authors.forename: J
authors.initials: J
authors.lastname: McEown
authors.forename: T
authors.initials: T
authors.lastname: Morrison
authors.forename: E
authors.initials: E
authors.lastname: Johnson
authors.forename: S X
authors.initials: SX
authors.lastname: Salles-Cunha
mesh_terms: D000328:Adult; D000368:Aged; D002245:Carbon Dioxide / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000009:adverse effects / Q000627:therapeutic use*; D000077423:Polidocanol; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011446:Prospective Studies; D012597:Sclerosing Solutions / Q000009:adverse effects / Q000627:therapeutic use*; D015911:Sclerotherapy / Q000009:adverse effects / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D014648:Varicose Veins / Q000000981:diagnostic imaging / Q000628:therapy*
chemical_list: D012597:Sclerosing Solutions; D000077423:Polidocanol; D002245:Carbon Dioxide; D011092:Polyethylene Glycols; D010100:Oxygen