title: Ultrasound-guided foam sclerotherapy within a rolling treatment programme is an effective low-cost treatment for superficial venous insufficiency.
abstract: OBJECTIVE
  To review the results and cost of a rolling ultrasound-guided foam sclerotherapy (UGFS) treatment programme for patients with chronic superficial venous insufficiency.
  
  
  METHODS
  A prospective study of a rolling treatment programme where patients were offered unlimited follow-up at intervals of 6-8 weeks and further (top up) UGFS when necessary, until occlusion criteria were met.
  
  
  RESULTS
  A total of 213 lower limbs with complete follow-up were included in the study. Median (range) age was 57 (16-94) years, maximum diameter of varicose vein was 10 (3-18) mm, C of CEAP (clinical, aetiological, anatomical and pathological elements) was 4 (2-6), number of treatment sessions was one (1-4) and follow-up was three (1.5-33) months. Satisfactory occlusion could not be achieved in nine (4%) limbs. The ratio of odds (95% CI) for requiring more than one treatment session was 3.58 (1.46-8.77), P = 0.002 for great saphenous varicosity and 2.11 (1.13-3.94), P = 0.015 for age 50 or more. There were 20 (9.3%) immediate and 63 (29.5%) delayed adverse effects. All were minor except for one cutaneous nerve injury, one pulmonary embolism and one infected haematoma. The ratio for odds (95% CI) for post-treatment skin discolouration was 2.59 (1.14-5.87), P = 0.017 for women and 1.32 (1.02-1.71), P = 0.032 for increasing sclerosant volume used. Service line costing per completed treatment episode was £115.22 (€130.07, $188.60).
  
  
  CONCLUSIONS
  UGFS in a rolling treatment programme is safe and can achieve high occlusion rates at a low cost. Patients above the age of 50 with great saphenous varicosity are likely to require more than one treatment session.
authors.affiliation: Department of Vascular Surgery, St Richard's Hospital, Chichester, West Sussex PO19 6SE, UK. nima81@hotmail.com
authors.forename: N
authors.initials: N
authors.lastname: Abbassi-Ghadi
authors.forename: H
authors.initials: H
authors.lastname: Hafez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003365:Costs and Cost Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000000981:diagnostic imaging; D015911:Sclerotherapy / Q000191:economics / Q000379:methods; D018084:Ultrasonography, Interventional / Q000191:economics / Q000379:methods; D014648:Varicose Veins / Q000000981:diagnostic imaging / Q000191:economics / Q000628:therapy