Curative Effect Analysis Of Ultrasound-Guided Intralesional Injectionoflauromacrogol Foam Sclerotherapyforearly Primary Varicose Veins Of Lower Limb And Klippel-Trenaunay Syndrome

Objective:Currently, foam sclerotherapy for varicose veins and venous malformations is advocated by oversea doctors and patients for the treatment of lower extremity varicose veins and venous malformations. This study aims to investigate the safety and efficacy of ultrasound-guided percutaneous administration of foam sclerotherapy for the treatment of early primary varicose veins of lower limb and Klippel-Trenaunay Syndrome (K-TS).Methods:Objects:(1)A total of 25 patients with great saphenous varicose veins (30 affected extremities, in which5 cases were with double varicose veins of lower extremityand were treated respectively) were included, and their clinical stage were C2. (2) A total of 19 K-TS patients with venous malformation legs (unilateral lower limbs) were included. The limbs of these patients were thicker and longer(2-4cm) and had different degree of varicose veins laterally, and 7 patients also had single hemangioma. All the patients were treated with ultrasound-guided foam sclerotherapy.The foam was produced by Tessari method:2ml gas added 0.5ml scleroant (liquid gas ratio was 1:4) into 2.5ml foam sclerotherapy, and was immediate applied. Before the treatment, Duplex Ultrasonography was under taken in the standing position.Needle insertion of target vessel was guidedby ultrasound for accurate placement, and venous blood was withdrawn before the injection. Ultrasound was applied in monitoring the diffusing area of the foam duringtreatment. The injecting area was compressed with gauze sponge and wrapped with elastic bandages. The patients were asked to release the bandages 1 week after the treatment and then wear thecompression stockings. Follow-ups were undergone for 6-12months after the latest treatment.Results:(1) Efficacy rate was 100% for 25 varicose veins, and they were cured basically. The 6-months recurrence rate was 31.2% (5/16), and no more relapse limbs were seen after 1 year. (2) A total of 19 K-TS patients underwent 3-6 session of treatments, the efficacy rate was 84.2%(16/19) and theinefficiency rate was 15.8%(3/19). For the 6 hemangiomas, the size reduced for more than 80%. The 2 patients with venous ulcers, one is cured and the size of the other had shrunk. Among the 16 efficient patients, the 6-months recurrence rate was 31.2% (5/16), and one-year recurrence rate was 43.8% (7/16). (3) Among the 19 K-TS patients,7 patients had^5 efficient thick malformed veins; the effective rate,6-months recurrence rate and one-year recurrence rate were 57.1%,50.0% and 75.0%, respectively. And 12 patients had<5 efficient thick malformed veins,the effective rate,6-months recurrence rate and one-year recurrence rate were 100%,25.0% and 33.3%,respectively. The difference of effective rate between the two groups was statistically significant. (4) Among all the patients of varicose group and K-TS group, for the diameter of varicose veins between ≥3mm to <10mm and diameter ≥10mm, the effective rate, 6-months recurrence rate and one-year recurrence rate were 76.9%,27.5%, 32.5% and 46.34%,47.4%,63.2%, respectively. The difference of effective ratebetween the two groups was statistically significant.Conclusion:The treatment of ultrasonic-guided percutaneous intralesional injection of foam sclerotherapy is safe and effective to cure varicose veins and to alleviate the symptoms of K-TS, especially for early stage of varicose veins. The treatment has important clinical application value.