2023 Volume 34 Issue 3 Pages 401-405
As a less-invasive alternative to varicose vein surgery, we performed foam sclerotherapy for residual incompetent tributaries after truncal vein radio frequency ablation (RFA) without concomitant phlebectomy. This study investigated 298 consecutive patients (191 women; mean age, 67.3±0.7 years) with saphenous-type varicose veins between April 2018 and December 2021. We performed RFA alone in all patients for truncal veins without concomitant phlebectomy, afterwards sclerotherapy for incompetent tributary varicosities and the below-knee great saphenous vein (BK-GSV) between two and four weeks after RFA. No adverse events of nerve injury or severe thromboembolism occured after RFA. Reflux in the BK-GSV after RFA persisted in 186 (62.4%) cases. Foam sclerotherapy was performed once in 212 (71.1%) cases, two or more in 44 cases (14.8%). On the other hand, 42 cases (14.1%) did not require foam sclerotherapy. The mean follow-up period was 20.9±0.7 months (range, 0–44 months). Varicose veins recurred in four cases, due to development of anterior accessory saphenous vein incompetence and perforating vein incompetence in two cases, respectively, but no recurrence in the BK-GSV was observed. Post-EVTA treatment with foam sclerotherapy for incompetent tributaries varicosities and the BK-GSV appears as a safe, effective and less- invasive alternative to phlebectomy.
