title: Fluoroscopy-guided endovenous sclerotherapy using a microcatheter prior to endovenous laser ablation: comparison between liquid and foam sclerotherapy for varicose tributaries.
abstract: OBJECTIVE
  To compare the efficacy and adverse effects of endovenous foam sclerotherapy (EFS) and liquid sclerotherapy (ELS) using a microcatheter for the treatment of varicose tributaries.
  
  
  METHODS
  From December 2007 to January 2009, patients with venous reflux in the saphenous vein were enrolled. The foam or liquid sclerosant was injected through a microcatheter just before endovenous laser ablation (EVLA). Patients were evaluated for the technical success, clinical success, and procedure-related complications during the procedure and follow-up visits.
  
  
  RESULTS
  A total of 94 limbs were included: 48 limbs (great saphenous vein [GSV], 35; small saphenous vein [SSV], 13) were managed using EFS and EVLA (foam group; FG), and 46 limbs (GSV, 37; SSV, 9) were treated by ELS and EVLA (liquid group; LG). Varicose tributaries demonstrated complete sclerosis in 92.7% with FG and in 71.8% with LG (p = 0.014). Bruising (78.7% in FG vs. 73.2% in LG, p > 0.05), pain or tenderness (75.6% in FG vs. 51.2% in LG, p = 0.0237) were noted. Hyperpigmentation (51.2% in FG vs. 46.2% in LG, p > 0.05) was found.
  
  
  CONCLUSIONS
  Endovenous foam sclerotherapy using a microcatheter is more effective than ELS for eliminating remnant varicose tributaries prior to EVLA. However, EFS is more commonly associated with local complications such as pain or tenderness than ELS. Furthermore, both techniques seem to prolong the duration of hyperpigmentation along with higher costs.
authors: Department of Radiology, Konkuk University Hospital, Konkuk University School of Medicine, Seoul 143-729, Korea.
authors: Sang Woo
authors: SW
authors: Park
authors: Department of Surgery, Konkuk University Hospital, Konkuk University School of Medicine, Seoul 143-729, Korea.
authors: Ik Jin
authors: IJ
authors: Yun
authors: Department of Thoracic and Cardiovascular Surgery, Konkuk University Hospital, Konkuk University School of Medicine, Seoul 143-729, Korea.
authors: Jae Joon
authors: JJ
authors: Hwang
authors: Department of Thoracic and Cardiovascular Surgery, Konkuk University Hospital, Konkuk University School of Medicine, Seoul 143-729, Korea.
authors: Song Am
authors: SA
authors: Lee
authors: Department of Thoracic and Cardiovascular Surgery, Konkuk University Hospital, Konkuk University School of Medicine, Seoul 143-729, Korea.
authors: Jun Seok
authors: JS
authors: Kim
authors: Department of Thoracic and Cardiovascular Surgery, Konkuk University Hospital, Konkuk University School of Medicine, Seoul 143-729, Korea.
authors: Hyun Keun
authors: HK
authors: Chee
authors: Department of Radiology, Konkuk University Hospital, Konkuk University School of Medicine, Seoul 143-729, Korea.
authors: Il Soo
authors: IS
authors: Chang
mesh_terms: D057785:Catheters / Q000009:adverse effects; D005268:Femoral Vein; D005471:Fluoroscopy / Q000379:methods; D006801:Humans; D053685:Laser Therapy / Q000379:methods; D015641:Radiography, Interventional / Q000379:methods; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000601:surgery; D012597:Sclerosing Solutions / Q000008:administration & dosage* / Q000737:chemistry; D015911:Sclerotherapy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome; D014648:Varicose Veins / Q000000981:diagnostic imaging / Q000628:therapy*; D014689:Venous Insufficiency / Q000601:surgery
chemical_list: D012597:Sclerosing Solutions
keywords: Laser; Sclerotherapy; Varicose vein