X ray-guided foam sclerotherapy with polidocanol in the treatment of lower extremity varicose ulcer

doi:10.3877/cma.j.issn.2095-5782.2016.04.007

Abstract

Abstract:

Objective:

To explore the therapeutic effect of the X ray-guided percutaneous intravenous injection of polidocanol hardening foam to treat the lower extremity varicose ulcers (C₅ period, C₆ period).

Methods:

A retrospective follow-up analysis of 51 varicose ulcer patients, whose 64 legs received the X ray-guided IV of polidocanol hardening foam in different concentrations, was performed.

Results:

The injection went well into the 64 legs with an average dose of (16.35±1.36)ml. From the follow-up analysis after 2 weeks, 3 months and 6 months, C₆ veins (28 cases) ulcers healed eventually, and the tension of skin ulcer around the legs decreased in C₅ veins (36). The symptoms in all these patients have improved in different degrees, and pigmentations significantly degraded.

Conclusions:

The X ray-guided foam sclerotherapy of polidocanol is a safe, effective and reliable strategy for lower extremity varicose, with no serious complications.

Key words: Lower extremity varicose vein, Venous ulceration, Polidocanol, Sclerotherapy

Qiwei Liang, Huigang Feng, Weizhao Zhuang, Huizhuang Guo, Chen Huang, Guanyuan Chen, Yukuan Tang, Hanwei Chen, Yi Huang. X ray-guided foam sclerotherapy with polidocanol in the treatment of lower extremity varicose ulcer[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2016, 04(04): 216-220.

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References 13

1	Schwartz L, Maxwell H. Sclerotherapy for lower limb telangiectasias［J］. Cochrane Database Syst Rev, 2011, 7(12):CD008826. doi: 10.1002/14651858.CD008826.pub2.
2	Zhang J, Jing Z, Schliephake DE, et al. Efficacy and safety of Aethoxysklerolw (polidocanol) 0.5%,1% and 3% in comparison with placebo solution for the treatment of varicose veins of the lower extremities in Chinese patients(ESA-China Study)［J］. Phlebology, 2012, 27(4):184-190. doi: 10.1258/phleb.2011.010094.
3	Kundu S, Lurie F, Millward SF, et al. Recommended reporting standards for endovenous ablation for the treatment of venous insufficiency: joint statement of the American Venous Forum and the Society of Interventional Radiology［J］. J Vasc Interv Radiol, 2009, 20(7 Suppl.):S417-424. doi: 10.1016/j.jvir.2009.04.019.
4	Pereira SM, Frade MA, Rangayyan RM, et al. Classification of color images of dermatological ulcers［J］. IEEE J Biomed Health inform, 2013, 17(1):136-42. doi: 10.1109/TITB.2012.2227493.
5	Breu FX, Guggenbichler S, Wollmann JC. 2nd European Consensus Meeting on Foam Sclerotherapy 2006, Tegernsee, Germany[J]. Vasa, 2008, 37(Suppl 71):1-29.
6	Rabe E, Pannier F. Sclerotherapy of varicose veins with polidocanol based on the guidelines of the German Society of Phlebology[J]. Dermatol Surg, 2010, 36(Suppl 2):968-975. doi: 10.1111/j.1524-4725.2010.01495.x.
7	张柏根.下肢慢性静脉功能不全诊治进展[C]. 中国中西医结合学会周围血管疾病专业委员会第六届换届暨学术交流会论文集,2004: 150-158.
8	Howard JK, Slim FJA, Wakely MC, et al. Recanalisation and ulcer recurrence rates following ultrasound-guided foam sclerotherapy[J]. Phlebology, 2016, 31(7): 506-513. doi: 10.1177/0268355515598450.
9	Brake M, Lim CS, Shepherd AC, et a1. Pathogenesis and etiology of recurrent varicose veins[J]. Vasc Surg, 2013,57(3): 860-868．doi: 10.1016/j.jvs.2012.10.102.
10	Rabe E, Schliephake D, Otto J, et al. Sclerotherapy of telangiectases and reticular veins: a double-blind, randomized, comparative clinical trial of polidocanol, sodium tetradecyl sulphate and isotonic saline (EASI study)[J]. Phlebology, 2010,25(3):124-131. doi: 10.1258/phleb.2009.009043.
11	Nicolaides AN, Allegra C, Bergan J, et al. Management of chronic venous disorders of the lower limbs: guidelines according to scientific evidence[J]. Int Angiol,2008,27(1):1-59.
12	Couzan S, Leizorovicz A, Laporte S, et al. A randomized double-blind trial of upward progressive versus degressive compressive stockings in patients with moderate to severe chronic venous insufficiency[J]. J Vasc Surg, 2012, 56(5): 1344-1350. doi: 10.1016/j.jvs.2012.02.060.
13	刘昌伟, 陈跃鑫.应重视下肢静脉性溃疡的综合治疗[J]. 中华医学杂志, 2012,92(32):2017-2019.doi:10.3760/cma.j.issn.0376-2491.2012.29.001.

指标		C₅期（36条）			C₆期（28条）
指标		术后2周	术后3个月	术后6个月	术后2周	术后3个月	术后6个月
皮肤症状		?	?	?	?	?	?
?	张力下降	34(94)	36(100)	36(100)	26(93)	28(100)	28(100)
?	色素沉着变淡	21(58)	29(80)	30(83)	12(43)	17(60)	18(64)
?	瘙痒感改善	23(64)	34(94)	34(94)	16(57)	25(89)	28(100)
?	无变化	2 (6)	0(0)	0(0)	2(7)	0(0)	0(0)
下肢酸胀感		?	?	?	?	?	?
?	消失或改善	30(83)	35(97)	36(100)	24(86)	25(89)	28(100)
?	无变化	6(17)	1(3)	0(0)	4(14)	3(11)	0(0)
溃疡面积		?	?	?	?	?	?
?	缩小或愈合	-	-	-	16(57)	24(86)	28(100)
?	无扩大伴渗液减少	-	-	-	11(39)	4(14)	0(0)
?	无变化	-	-	-	1(4)	0(0)	0(0)
闭塞（隐静脉主干）		-	28(78)	30(83)	-	21(75)	24(86)
疗效（成功或部分成功）		34(94)	36(100)	36(100)	24(86)	25(89)	28(100)
不良反应		2(6)	5(14)	1(3)	1(4)	4(14)	2(7)

指标		C₅期（36条）			C₆期（28条）
指标		术后2周	术后3个月	术后6个月	术后2周	术后3个月	术后6个月
皮肤症状		?	?	?	?	?	?
?	张力下降	34(94)	36(100)	36(100)	26(93)	28(100)	28(100)
?	色素沉着变淡	21(58)	29(80)	30(83)	12(43)	17(60)	18(64)
?	瘙痒感改善	23(64)	34(94)	34(94)	16(57)	25(89)	28(100)
?	无变化	2 (6)	0(0)	0(0)	2(7)	0(0)	0(0)
下肢酸胀感		?	?	?	?	?	?
?	消失或改善	30(83)	35(97)	36(100)	24(86)	25(89)	28(100)
?	无变化	6(17)	1(3)	0(0)	4(14)	3(11)	0(0)
溃疡面积		?	?	?	?	?	?
?	缩小或愈合	-	-	-	16(57)	24(86)	28(100)
?	无扩大伴渗液减少	-	-	-	11(39)	4(14)	0(0)
?	无变化	-	-	-	1(4)	0(0)	0(0)
闭塞（隐静脉主干）		-	28(78)	30(83)	-	21(75)	24(86)
疗效（成功或部分成功）		34(94)	36(100)	36(100)	24(86)	25(89)	28(100)
不良反应		2(6)	5(14)	1(3)	1(4)	4(14)	2(7)

时间	未成功	部分成功	成功
术后2周	6	4	54
术后3个月	3	0	61
术后6个月	0	0	64

时间	未成功	部分成功	成功
术后2周	6	4	54
术后3个月	3	0	61
术后6个月	0	0	64

时间	C₆期溃疡面积（28条）	C₅期色素沉着面积（36条）
治疗前	4.27±1.51	6.23±3.69
术后2周	3.41±1.45	5.11±3.83
t值	2.063	1.254
P值	0.044	0.214

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