Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/1677-5449.200178
Jornal Vascular Brasileiro
Original Article

Escleroterapia com espuma de polidocanol em veias safenas magnas e suas tributárias bilateralmente em tempo único

Bilateral foam polidocanol sclerotherapy of great saphenous veins and their tributaries in synchronous procedure

Luiz Antonio Miranda; Rachel Cristina do Carmo; Cláudia Carvalho Sathler-Melo; Guilherme de Castro-Santos

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Resumo

Resumo: Contexto: A insuficiência venosa crônica é uma entidade com alta prevalência. Os casos avançados apresentam morbidade elevada.

Objetivos: Avaliar os riscos e benefícios da escleroterapia com espuma de polidocanol em pacientes que foram submetidos ao tratamento das veias safenas magnas bilateralmente em tempo único.

Métodos: Foram revistos retrospectivamente 55 pacientes (110 membros) portadores de incompetência bilateral das veias safenas magnas submetidas a tratamento escleroterápico com espuma bilateralmente, em tempo único, usando uma dose máxima de 20 mL de espuma de polidocanol por paciente.

Resultados: Das 110 safenas analisadas, obteve-se a oclusão de 81 (73,6%) com uma sessão, de 106 (96,3%) com duas sessões e de 110 (100%) com três sessões. Houve oclusão bilateral das safenas magnas em 27 pacientes (50%) em uma sessão, em 34 (62%) em duas sessões e em 55 (100%) em três sessões. De 11 pacientes portadores de úlceras, houve cicatrização total de sete (63%) e parcial de três (27%) 42 dias após a escleroterapia. Houve lipotimia autolimitada e escotomas visuais em um paciente (1,8%) e manchas em três (5,45%); 19 pacientes (34,5%) foram submetidos a punção para drenagem de coágulo retido.

Conclusões: A escleroterapia com espuma de polidocanol em veias safenas magnas em tempo único mostrou-se uma técnica segura e eficaz em pacientes selecionados.

Palavras-chave

escleroterapia com espuma, varizes bilaterais, complicações

Abstract

Background: Chronic venous insufficiency is a highly prevalent disease. Advanced cases have high morbidity. Objectives: To evaluate the risks and benefits of foam sclerotherapy in patients who underwent bilateral treatment of the great saphenous veins in a single procedure, in selected cases of advanced venous insufficiency. Methods: We retrospectively reviewed 55 patients (110 limbs) with bilateral incompetence of the great saphenous veins who had undergone foam sclerotherapy treatment bilaterally, using a maximum dose of 20 ml of foam per patient and inelastic compression. Results: In 81 (73.6%) of the 110 saphenous veins analyzed, occlusion was obtained in the first session. After a second session this figure rose to 106 (96.3%) and all 110 (100%) veins were occluded after three sessions. Bilateral occlusion of the great saphenous veins was achieved in 27 patients (50%) in one session, in 34 (62%) patients in two sessions, and in 55 (100%) patients in three sessions. At 42 days after sclerotherapy, there was complete ulcer healing in seven (63%) of the 11 patients with ulcers and partial healing in 3 (27%) of these patients. One patient (1.8%) had self-limited lipothymia and visual scotomas, 3 patients (5.45%) had skin spots, and 19 patients (34.5%) developed retained intravascular coagulum. Conclusions: Bilateral foam sclerotherapy in a synchronous procedure is an option to be considered for treatment of varicose veins of the lower limbs.

Keywords

foam sclerotherapy; bilateral varicose veins; complications.

References

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Submitted date:
09/30/2020

Accepted date:
01/18/2021

60c9ea76a953953568045023 jvb Articles

J Vasc Bras

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