title: The incidence and characterization of deep vein thrombosis following ultrasound-guided foam sclerotherapy in 1000 legs with superficial venous reflux.
abstract: OBJECTIVE
  The incidence of deep vein thrombosis (DVT) following ultrasound-guided foam sclerotherapy (UGFS) ranges from 0% to 5.7%. The aim of this study was to assess the incidence of DVT following UGFS in a single vascular center.
  
  
  METHODS
  Patients undergoing UGFS between December 2005 and September 2011 underwent quality control duplex imaging within 2 weeks of treatment. This was performed by an independent senior vascular technologist, and data were entered on a prospectively maintained database. Deep venous segments assessed included common femoral vein, femoral vein, above- and below-knee popliteal veins, gastrocnemius, and tibial veins. DVT when present was labeled as endovenous foam-induced thrombosis (EFIT) type 1 when thrombus was lining <25% of the lumen of the deep vein; type 2 when thrombus extension was 25% to 50%; type 3 when thrombus extension was 50% to 99%; and type 4 when the deep vein was occluded.
  
  
  RESULTS
  A total of 1166 UGFS treatments were performed in 1000 legs (776 patients). Complete occlusion of the treated veins was seen in 84.5% of the legs after one session of treatment. Overall, 17 DVTs were detected (1.5%) with no DVTs detected in legs undergoing multiple treatments. Of the 17 episodes of DVT, 16 legs had DVT following treatment for truncal reflux (658 legs; 2.43%). Seven DVTs were EFIT type 1, two were type 2, two were type 3, and five were type 4. One DVT was seen in the gastrocnemius vein alone. Two of 1166 treatments (0.2%) resulted in a symptomatic DVT, both of which were EFIT type 4. On regression analysis, there was an increase in the risk of DVT when ≥10 mL of foam was injected (odds ratio, 4.63; 95% confidence interval, 1.44-14.9; P = .01).
  
  
  CONCLUSIONS
  The incidence of duplex-detected DVT following foam sclerotherapy is low and may be associated with the injection of ≥10 mL of foam.
authors.affiliation: Department of Vascular Surgery, Cheltenham General Hospital, Cheltenham, United Kingdom.
authors.forename: Sachin R
authors.initials: SR
authors.lastname: Kulkarni
authors.affiliation: Department of Vascular Surgery, Cheltenham General Hospital, Cheltenham, United Kingdom.
authors.forename: David E
authors.initials: DE
authors.lastname: Messenger
authors.affiliation: Department of Vascular Surgery, Cheltenham General Hospital, Cheltenham, United Kingdom.
authors.forename: Fiona J A
authors.initials: FJ
authors.lastname: Slim
authors.affiliation: Department of Vascular Surgery, Cheltenham General Hospital, Cheltenham, United Kingdom.
authors.forename: Lorraine G
authors.initials: LG
authors.lastname: Emerson
authors.affiliation: Department of Vascular Surgery, Cheltenham General Hospital, Cheltenham, United Kingdom.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Bulbulia
authors.affiliation: Department of Vascular Surgery, Cheltenham General Hospital, Cheltenham, United Kingdom.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Whyman
authors.affiliation: Department of Vascular Surgery, Cheltenham General Hospital, Cheltenham, United Kingdom. Electronic address: keith.poskitt@glos.nhs.uk.
authors.forename: Keith R
authors.initials: KR
authors.lastname: Poskitt