Healing and recurrence rates following ultrasound-guided foam sclerotherapy of superficial venous reflux in patients with chronic venous ulceration.
OBJECTIVE
To determine healing and recurrence rates following ultrasound-guided foam sclerotherapy (UGFS) of superficial venous reflux (SVR) in patients with healed (clinical, etiologic, anatomic and pathophysiologic (CEAP) classification, C5) and open (C6) chronic venous ulceration (CVU).


METHODS
Between 1 March 2005 and 31 December 2009, 130 consecutive patients (132 limbs, 49 CEAP C5, 83 C6) of median age 70 (interquartile range (IQR) 56-76) years underwent UGFS as part of their treatment for CVU.


RESULTS
The median (IQR) follow-up time was 16 (12-32) months. One C6 patient moved abroad 1 week after UGFS and was lost to follow-up. Healing was observed in 67/82 (82%) remaining C6 patients at a median (IQR) of 1 (1-2) month following their first UGFS treatment. In 49 limbs originally treated for C5 disease, and in 67 limbs treated for C6 that healed following UGFS, there were five recurrent ulcers during the follow-up period, giving a 4.9% Kaplan-Meier estimate of recurrence at 2 years. In legs treated for C6 and C5 disease, the median (IQR) ulcer-free periods were 22 (IQR 9-32) and 14 (IQR 8-36) months, respectively.


CONCLUSIONS
Healing rates following UGFS for CVU are comparable to those reported after surgery but recurrence may be lower. UGFS is a safe, clinically effective and, thus, highly attractive minimally invasive alternative to surgery in patients with C5 and C6 disease.
Pang
K H
KH
Birmingham University, Department of Vascular Surgery, Heart of England Foundation Trust, Birmingham, UK. karlpang@doctors.org.uk
Bate
G R
GR
Darvall
K A L
KA
Adam
D J
DJ
Bradbury
A W
AW
D000368:Aged; D002908:Chronic Disease; D019992:Databases as Topic; D004739:England; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D012597:Sclerosing Solutions / Q000627:therapeutic use*; D015911:Sclerotherapy; D013997:Time Factors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D014647:Varicose Ulcer / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D014689:Venous Insufficiency / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D014945:Wound Healing
D012597:Sclerosing Solutions