Safety and effectiveness of ultrasound-guided foam sclerotherapy for varicose veins

Abstract

The aim of this study is to compare NICE guidance recommendations to the outcome of a series of patients with varicose veins managed by ultrasound-guided foam sclerotherapy (UGFS), thereby assessing UGFS’s safety and effectiveness. Methods: Between April 2008 and December 2009, 16 outpatients (9 males and 7 females), mean age 48.1 years, with varicose veins were treated with UGFS at the Queen Elizabeth Hospital. An audit support tool provided by NICE was used to collect data relating to three criteria: consent, safety and effectiveness. Results: Consent was sought in 100% of cases. Colour-flow Doppler ultrasound testing showed that 92% of limbs were completely occluded with no reflux at the saphenofemoral junction, whereas only 1 patient showed occlusion with reflux at the saphenopopliteal junction. None of the patients reported recurrence of varicose veins. No serious side-effects were reported. 31% had pigmentation post-procedure, 25% suffered from bruising, but only 6% reported a skin ulcer post-treatment. 75% of patients were happy and satisfied with the results, while the rest (25%) were unhappy due to persistent skin pigmentation (12.5%), pain (6%), or lack of symptom improvement (6%). The A W Q scores show that 86% of patients have an improved quality of life post-treatment. Our results are in accordance with the NICE guidance. The outcome of the 16 patients suggests that UGFS is an efficacious and safe procedure short term. Nonetheless, a study with a larger sample size and a longer follow-up is needed to confirm our findings, yield more statistically significant results and establish long term efficacy.