Visualized sclerotherapy of varicose veins.
BACKGROUND
The spread and movement of sclerosant after injection during sclerotherapy is difficult to monitor.


OBJECTIVE
To develop a new visualization method that allows monitoring of sclerosant dosage and flow during sclerotherapy.


METHODS
We used a photodynamic eye (PDE) to perform indocyanine green (ICG) imaging. ICG produces strong fluorescence detectable using PDE and allows monitoring of sclerosant spread through blood vessels in real time. We performed visualized sclerotherapy on 50 limbs, comprising high ligation and sclerotherapy (35 limbs), stripping and sclerotherapy (10 limbs), and sclerotherapy alone (5 limbs).


RESULTS
In all cases, fluorescence imaging of the injected sclerosant was possible. No complications resulted from combining ICG and polidocanol in any of the patients, all of whom received follow-up evaluations at 1 week, 1 month, and 3 months after treatment.


CONCLUSIONS
Our new method not only avoids the risk of radiation exposure, but also allows for simple observation of sclerosant range of access, determination of the dosage for each lesion, and accurate administration of therapy to target lesions. This method will contribute to further advances in sclerotherapy, given that it allows administration of sclerosant and visual confirmation of optimal injection dosage, speed, and movement of sclerosant after injection. The authors have indicated no significant interest with commercial supporters.
Kikuchi
Mamoru
M
Department of Plastic Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan. mamoru-osk@umin.ac.jp
Hosokawa
Ko
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004396:Coloring Agents; D005260:Female; D005456:Fluorescent Dyes; D006801:Humans; D007208:Indocyanine Green; D007834:Lasers; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D012597:Sclerosing Solutions / Q000008:administration & dosage / Q000493:pharmacokinetics*; D015911:Sclerotherapy / Q000379:methods*; D014648:Varicose Veins / Q000628:therapy*
D004396:Coloring Agents; D005456:Fluorescent Dyes; D012597:Sclerosing Solutions; D007208:Indocyanine Green