Evaluation of Foam Sclerotherapy as Minimally Invasive and First Line Treatment of Varicose Veins in Military Setup

Abstract

Objective: This case series was carried out to determine the efficacy of ultrasound guided foam sclerotherapy as first line and minimally invasive treatment of varicose veins. Study Design: Prospective case series. Place and Duration of Study: Department of Vascular Surgery, Combined Military Hospital, Malir from 1st January 2020 to 31 March 2021. Materials and Methods: Total one hundred patients with varicosities mainly of great saphenous vein (GSV) were included after detailed history and examination. Ultrasound Doppler was done to rule out deep venous thrombosis (DVT) and any secondary reason for varicose vein. Patients were followed up after 3 days, 10 days, 1month and 3 months with a Doppler ultrasound. Results: One hundred patients and 130 legs were studied. Age ranges from 30-60 years with mean of 39.75 years, 70 (70%) of the patients were males and 30 (30%) were females. 98 legs (75.38%) had varicosities of GSV, 10 legs (7.692%) with mixed great and small saphenous vein and 22 legs (16.92%) with isolated small saphenous vein. 25 patients (25%) developed pain at cannula site, 3 patients (3%) had bradycardia following procedure and 4 (4%) developed ulceration on skin at the site of cannulation. All patients were followed up for 3 months with a Doppler ultrasound and no recurrence was found post procedure. Average return period to normal function and work was 15 days. In terms of leg pain and physical functioning, patients who underwent intervention achieved health better in short term. Conclusion: Ultrasound guided foam sclerotherapy is safe, least complicated, and efficacious management for varicose veins with minimal chance of technical failure. This being an outpatient procedure saves time and space for arterial casualties of a vascular surgeon.