Outcome assessment of foam sclerotherapy for the treatment of reticular varicose veins as an alternative to surgical intervention for deformed and large varicose veins

BACKGROUND: This study aimed to evaluate the efficacy of foam sclerotherapy in treating reticular varicose veins as an alternative to surgery for deformed and large varicose veins. We present our findings based on patient outcomes.METHODS: This single-center, observational, retrospective study included 40 patients (62 extremities) with a mean age of 41±10 years. The majority (85%, N.=34) were female. All patients underwent foam sclerotherapy using lauromacrogol. Prior to the procedure, patients underwent CEAP (clinical, etiologic, anatomic, and pathophysiologic) evaluations, and a Venous Clinical Severity Score (VCSS) was calculated. Data on healing of large venous swellings and reticular varices, adverse events (such as hyperpigmentation and pain duration due to thrombosis), recurrence rates, and cosmetic and quality of life improvements were documented. Following foam sclerotherapy, patients reported an average satisfaction score of 8, ranging from 3 to 10. Specifically, there was a moderate positive correlation (correlation coefficient: 0.681) between the duration of venous stiffness and the duration of brown pigmentation postoperatively (P<0.05). Additionally, a moderate positive correlation (correlation coefficient: 0.446) was observed between the duration of venous stiffness and the duration of pain following sclerotherapy (P<0.05). No statistically significant correlations were found between the degree of patient satisfaction, age, preoperative great saphenous vein diameter, and other numerical variables (P>0.05). Patients wore compression stockings for 2 weeks following each session. Follow-ups were conducted at 10 days, 1 month, and 3 months after sclerotherapy.RESULTS: There was a moderate positive correlation (correlation coefficient: 0.681, P<0.05) between the duration of venous stiffness and brown pigmentation. Additionally, a moderate positive correlation (correlation coefficient: 0.446, P<0.05) was found between venous stiffness duration and pain duration postsclerotherapy. The median satisfaction score postsclerotherapy was 8 (range: 3-10). 86% of patients rated the results of foam sclerotherapy for large venous swellings as satisfactory, while 9% were uncertain and 5% dissatisfied.CONCLUSIONS: Overall, the satisfaction rate among patients was high. Nevertheless, there remains a lack of standardized techniques for the preparation and application of foam sclerosants in this modality. Long-term studies are necessary to ascertain the outcomes of various techniques in the treatment of varicose veins.