Use of Polidocanol Endovenous Microfoam to Improve Hemodynamics and Symptomology in Patients with Challenging Clinical Presentations: A Case Series
| Autor: | John Phillips, Raghu Kolluri, Paul E. Davis |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Chronic venous insufficiency Polidocanol 030204 cardiovascular system & hematology Severity of Illness Index Varicose Veins 03 medical and health sciences Small saphenous vein 0302 clinical medicine Sclerotherapy medicine Humans Saphenous Vein Hidradenitis suppurativa 030212 general & internal medicine Lipodermatosclerosis Vein Aged Retrospective Studies Aged 80 and over Ultrasonography Doppler Duplex Wound Healing business.industry Endovascular Procedures Great saphenous vein Hemodynamics General Medicine Middle Aged medicine.disease Sclerosing Solutions Thrombosis Surgery Treatment Outcome medicine.anatomical_structure Venous Insufficiency Chronic Disease Female medicine.symptom Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | Annals of Vascular Surgery. 52:176-182 |
| ISSN: | 0890-5096 |
| DOI: | 10.1016/j.avsg.2018.02.034 |
| Popis: | Background Chronic venous insufficiency (CVI) is a widely prevalent condition. Saphenous venous reflux is the most common underlying pathology that leads to CVI. Endovenous thermal ablations (ETA) are the current gold standard. However, some patients present with some unique challenges making ETA less ideal. Nonthermal nontumescent therapies could be considered as alternative therapy in these patients. Methods We performed a retrospective review of treatment effects with United States Food and Drug Administration-approved polidocanol endovenous microfoam (PEM; Varithena® 1%) on venous symptomology in 10 (n = 10) C3-C6 patients with CVI and concomitant complex disease/pathology that limited the use of ETA. The pathology included risk of bruising or bleeding, severe lipodermatosclerosis, hidradenitis suppurativa, chronic fibrosis of the vein from prior superficial thrombosis, risk for nerve injury, and failed prior ETA. Before treatment, all patients underwent a venous incompetence study by duplex ultrasound (DUS). Preprocedure pain, symptoms, and Venous Clinical Severity Scores (VCSSs) were recorded. Clinical assessments and DUS were performed 4 days, 6 weeks, 6 months, and 1 year after treatment. Results DUS demonstrated reflux in the great saphenous vein (GSV), anterior accessory GSV, and/or the small saphenous vein. Pain scores and VCSS were reduced 4 days and 6 weeks after treatment. These lower scores were maintained for up to 1 year after treatment. Conclusions PEM use in C3-C6 patients resulted in successful improvement in VCSS, CVI symptoms, and wound healing among patients in whom ETA was not considered to be the optimal therapy. |
| Databáze: | OpenAIRE |
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