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Vascular Surgery 2019
March 28-29, 2019
Rome, Italy
Vascular Surgery
4
th
Edition of World Congress & Exhibition on
Journal of Vascular and Endovascular Therapy
ISSN: 2573-4482
Page 24
Ligation of GSV in sclerotherapy with foam:
Technical notes – personal experience
Paolo Valle
1
, Domenico Spoletini
1
, Domenico Monetti
1
and
Giampaolo Valle
2
1
S. Eugenio Hospital, Italy
2
University “La Sapienza” of Rome, Italy
Statement of the Problem:
The specific complications
after treatment of the incompetent GSV with foam
are early recanalization (13%) and superficial
thrombophlebitis (7.4%).
Methodology & Theoretical Orientation:
From 1
January 2016 to today, in 79 patients (CEAP C2-C3),
85 sclerofoam treatments of GSV were performed for
varicose veins of the lower limbs with: saphenofemoral
reflux >3 sec, saphenous diameter >8 mm and at
least 2 varicose thigh/leg collateral. To obtain the
GSV, local surgical anesthesia was performed with a
surgical access localized to the thigh, always above
the end of the Hunter perforator and of the varicose
collateral. The GSV is bound and sectioned and finally
cannulated with an Arteriofix 8 mm catheter, through
which, after washing with physiological solution, the
sclerofoam with TDS 3% (ratio 1:4) for a maximum
of 4 cc of foam according to Tessari’s technique. The
remaining saphenous veins are removedwith theMuller
technique. Controls with ecocolordoppler are expected
at 1, 3, 6 months and 1 year.
Findings:
Only in 4 patients (4.7%), however very thin,
was found, in the first month, a superficial phlebitis
of the thigh, between the surgical incision and the
inguinal fold. Recanalization occurred after 1 year
in only 8 patients (9.4%). In any case the diameter of
saphenous veins was reduced by more than 50%, the
saphenous walls were thickened, there was no reflux at
the saphenofemoral junction and clinically the patients
reported no disturbances. In all other patients, GSV
presented with obliterated and reduced caliber.
Conclusion & Significance:
From these first results we
can state that this technique that includes the ligation
of the GSVmakes the foammore stable than that which
occurs with the direct injection of the GSV. Furthermore,
a smaller amount of foam is sufficient, with no local and
general phenomena and complications
Recent Publications:
1. Bountouroglou D G et al. (2006) Ultrasound-
guided foam sclerotherapy combined with
saphenofemoral ligation compared to surgical
treatment of varicose veins: early results
of a randomized controlled trial. Eur J Vasc
Endovasc Surg 31(1):93-100.
2. Cavezzi A and Tessari L (2009) Foam
sclerotherapy techniques: different gases
and methods of preparation, catheter versus
Paolo Valle et al., J Vasc Endovasc Therapy 2019, Volume 4
DOI: 10.21767/2573-4482-C1-004