NEW YORK (Reuters Health) - Ultrasound-guided injection of polidocanol microfoam (UIPM) into incompetent veins results in healing of venous leg ulcers, according to a report in the June Archives of Dermatology.
“The cause here is venous hypertension,” Dr. Pedro Redondo from University Clinic of Navarra, Pamplona, Spain told Reuters Health. “Hypertension leads to edema, and that is what compression tries to improve. We resolve edema from inside; a sclerosed vein leads neither to a progressive dilatation throughout the day nor to the consequent edema.”
Dr. Redondo and colleagues evaluated the effectiveness and safety of sclerosant in microfoam in treating venous leg ulceration in 116 consecutive patients ranging in age from 25 to 85 years.
The number of treatment sessions ranged from 1 to 17, the authors report, but only 19 patients required more than five sessions.
Treatment with UIPM brought complete healing in 86% of patients at 6 months, the report indicates, with a median time to complete healing of 8 weeks. Seven patients were never cured.
Success rates were significantly lower in ulcers of longer duration and in patients with incompetent deep venous systems, the researchers note.
Ten patients experienced recurrences. “We re-treated all of these patients, with results consistent with the first recurrence,” Dr. Redondo said. Patients with larger and older ulcers, and those with deep vein incompetence tended to heal later and to have a recurrence.
There were no major complications, the investigators report.
“Sclerotherapy may be the gold standard treatment for venous leg ulcers,” Dr. Redondo concluded. “We are planning a double-arm, prospective, randomized study comparing sclerotherapy to compression.”
Source: Arch Dermatol 2004;140:667-673. [ Google search on this article ]
MeSH Headings:Investigative Techniques: Varicose Ulcer: Analytical, Diagnostic and Therapeutic Techniques and EquipmentCopyright © 2002 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.
