Sclerotherapy for Residual Incompetent Tributaries after Varicose Vein Surgery

Abstract

To achieve less-invasive for varicose vein surgery, we performed foam sclerotherapy alone for residual incompetent tributaries after truncal vein surgery without phlebectomy. This study investigated 239 consecutive patients (140 women; mean age, 66.2±0.7 years) with varicose veins between April 2018 and December 2020. We performed endovenous therapy for truncal veins without phlebectomy, then sclerotherapy for incompetent tributary varicosities and the below-knee great saphenous vein (BKGSV) after 2–3 weeks. Among the 239 cases, 229 were treated with radiofrequency ablation and 10 with cyanoacrylate closure. No adverse events of nerve injury or thromboembolism were encounterd. Reflux in the BKGSV after endovenous therapy persisted in 67.0% (150/224). Sclerotherapy was performed once in 174 cases, two or more in 35, and not at all in 30. Mean follow-up period was 13.2±0.6 months (range, 0–32 months). Varicose veins recurred in only one case, due to development of anterior accessory saphenous vein incompetence, but no recurrence of BKGSV or tributaries was seen. Therapy with foam sclerotherapy alone for incompetent tributaries appears less invasive than phlebectomy, safe, and effective.