The effects of foam sclerotherapy on ulcer healing: A single-centre prospective study

Abstract

Introduction: This prospective study of foam sclerotherapy for varicose veins aimed to determine the outcomes of treatment including ulcer healing and complication rates in our unit. Data were collected prospectively over a 10-year period and maintained on a database by our vascular sciences unit, which performed the planning and post-treatment venous duplex scans. Patients undergoing treatment due to venous ulceration were identified from this database. An initial cohort of patients underwent a follow-up scan and assessment at one year. MATERIALS AND METHODS Patients were treated with foam sclerotherapy, in multiple sessions if required, to occlude all incompetent superficial veins greater than 3 mm in size. We used 3% sodium tetradecyl sulphate as our sclerosing agent, according to our departmental protocol, followed by a period of compression therapy. Patients underwent pre-and post-treatment scans to assess venous competence, the effects of treatment and any complications that arose. Results: We identified 336 patients treated for clinical, aetiological, anatomical and pathophysiological stage 5/6 venous ulceration. At six weeks post-treatment, 21% had fully healed ulcers and a further 46.1% were clinically improving with no further venous incompetence. The remainder continued treatment. An initial cohort of 162 patients was assessed at one year and 77.1% ulcers remained healed. The remainder demonstrated some venous incompetence and ultimately 12.5% required further treatment. Our complication rates were similar to those quoted in published meta-analyses including a deep vein thrombosis rate of 1.16%. CONCLUSIONS Foam sclerotherapy remains a useful treatment option for venous ulceration with a low morbidity rate.