title: Catheter-directed foam sclerotherapy of great saphenous veins in combination with pre-treatment reduction of the diameter employing the principals of perivenous tumescent local anesthesia.
abstract: OBJECTIVE
  The aim of this study was to evaluate occlusion rates of great saphenous veins (GSV) with a diameter between 5-10 mm that received a pre-treatment size reduction via perivenous tumescent application (TA) followed by catheter-directed foam sclerotherapy (CDFS).
  
  
  METHODS
  A prospective blinded randomized clinical trial comparing the occlusion rates of GSV at 1-, 6-, and 12-month follow-up. Fifty patients were included and randomized into two groups. CDFS was performed accessing the GSV at knee level and applying 8 mL of 2% polidocanol-foam (EasyFoam) while the catheter was withdrawn. Strictly perivenous TA was performed in group 1 before applying the sclerosant agent. Occlusion rates and clinical scores were assessed by blinded examiners.
  
  
  RESULTS
  After 12 months in group 1 full occlusion was achieved in 73.9%, partial occlusion in 8.7%, and 17.4% were classified as treatment failure. In group 2, 75% of the targeted GSV were fully occluded, 20% were partially occluded, and 5% were diagnosed as treatment failure. Both groups showed a significant reduction of the vein diameter. Patient's tolerance and satisfaction with the treatment was high in both groups.
  
  
  CONCLUSIONS
  No benefit could be found using additional TA to reduce the vein diameter before the treatment.
authors.affiliation: Department of Dermatology, University of Schleswig-Holstein, Campus Luebeck, Germany.
authors.forename: N
authors.initials: N
authors.lastname: Devereux
authors.affiliation: Department of Dermatology, University of Schleswig-Holstein, Campus Luebeck, Germany.
authors.forename: A L
authors.initials: AL
authors.lastname: Recke
authors.affiliation: Dermatological Practise, Hamburg, Germany.
authors.forename: L
authors.initials: L
authors.lastname: Westermann
authors.affiliation: Department of Dermatology, University of Schleswig-Holstein, Campus Luebeck, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Recke
authors.affiliation: Department of Dermatology, University of Schleswig-Holstein, Campus Luebeck, Germany. Electronic address: birgit.kahle@uksh.de.
authors.forename: B
authors.initials: B
authors.lastname: Kahle
mesh_terms: D061605:Administration, Intravenous; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local / Q000009:adverse effects; D002406:Catheterization, Peripheral / Q000009:adverse effects; D057510:Endovascular Procedures / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010865:Pilot Projects; D000077423:Polidocanol; D011092:Polyethylene Glycols / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies; D012501:Saphenous Vein / Q000000981:diagnostic imaging; D012597:Sclerosing Solutions / Q000008:administration & dosage* / Q000009:adverse effects; D015911:Sclerotherapy / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography; D014689:Venous Insufficiency / Q000175:diagnosis / Q000628:therapy*; D055815:Young Adult
chemical_list: D012597:Sclerosing Solutions; D000077423:Polidocanol; D011092:Polyethylene Glycols
keywords: Catheter-directed sclerotherapy; Foam sclerotherapy; Tumescence; Varicose veins; Venous insufficiency