Treatment of superficial venous insufficiency class C 6 with ultrasound-guided foam sclerotherapy

BACKGROUND: Venous insufficiency of the lower limbs has a prevalence of 30 to 40% in the general population, venous hypertension would be the etiological cause of venous ulcers. Superficial venous insufficiency C 6 manifests as venous ulcer in 75% of cases and have shown a poor response to healing practiced through containment measures, which were presented as one of the most cited methods. In recent decades, the introduction of surgical procedures with stripping accelerated healing and prevented recurrences, just as thermal and non-thermal procedures have proven effective in treating category C6 superficial venous insufficiency. In this article we will try to demonstrate the advantages of using the ultrasound-guided foam sclerotherapy (UGFS), as an effective, safe, simple and low-cost method that does not need the use of an operating room and with healing times comparable to thermal and non-thermal methods. The aim of this study was to treat all patients who are within category C6, with ultrasound-guided foam sclerotherapy (UGFS). Taking as maximum healing time 24 weeks.METHODS: All patients with superficial insufficiency were be studied, and those in category C 6 underwent treatments. Inclusion criteria: all patients who are in category C 6 and agreed to participate, or have an ABI>I. Exclusion criteria: patients who refused to participate, had an ABI<0.9, or had ulcer of another etiology. The treatment was performed using the Tessari method with a 1:4 ratio 1% Polidocanol and 4 cc of air, in three injections. A control was carried out after 7 days, and in the same session the second foam injection was carried out if the ulcer has not been completely closed.RESULTS: Seven hundred thirty-six patients were studied, 78% were female, with an average age of 67 years, 11 patients had ulcers. There were no patients with deep vein thrombosis. Nine patients had total ulcer closure, 8 patients had total obstruction of their ulcers after 24 weeks.CONCLUSIONS: UGFS is a simple, safe, low-cost procedure and does not require the use of an operating room. The healing of ulcers in terms of time is comparable to the other thermal and non-thermal procedures.