Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/S1677-54492006000100010
Jornal Vascular Brasileiro
Original Article

Tratamento combinado da cirurgia de varizes com a escleroterapia de telangiectasias dos membros inferiores no mesmo ato

Combined treatment including varicose vein surgery with sclerotherapy for lower extremity telangiectasias at the same procedure

Ricardo José Gaspar; Charles Angotti Furtado de Medeiros

http://dx.doi.org/10.1590/S1677-54492006000100010 J Vasc Bras, vol.5, n1, p.53-57, 2006
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Resumo

OBJETIVOS: A escleroterapia por método químico é o tratamento mais tradicional para eliminar as telangiectasias. Há varias décadas, é realizada em consultório, mas com alto índice de abandono devido ao seu caráter prolongado, doloroso e, por isso, pouco eficaz. Uma grande proporção destes pacientes apresenta também insuficiência de tributárias, ou seja, veias varicosas com indicação de fleboextração e que serão submetidas à cirurgia. O objetivo deste trabalho é descrever a opção de tratamento combinado da cirurgia de varizes com a escleroterapia das telangiectasias no mesmo ato. MÉTODOS: De janeiro de 1998 a março de 2002, 213 pacientes (426 membros inferiores) foram submetidos ao tratamento das telangiectasias por meio de injeção de glicose hipertônica durante a cirurgia de varizes. RESULTADOS: Mais de 90% dos pacientes relataram altos índices de satisfação estética. A escleroterapia complementar foi necessária em 165 pacientes, para atingir plena satisfação estética durante o seguimento. Não foram constatados casos de tromboflebites superficiais, nem de trombose venosa profunda. Também não houve relatos de complicações graves. Em 10% dos casos, foram necessárias pequenas drenagens de microtrombos residuais. O índice de manchas hipercrômicas não ultrapassou 3%. Apenas um paciente desenvolveu uma pequena úlcera no dorso do pé (0,2%), que cicatrizou espontaneamente. CONCLUSÕES: O tratamento combinado da cirurgia de varizes com a escleroterapia das telangiectasias dos membros inferiores é uma alternativa para os pacientes que desejam um resultado mais rápido e indolor. As sessões múltiplas com injeção de glicose hipertônica são uma opção segura e eficaz.

Palavras-chave

Cirurgia ambulatorial, escleroterapia, insuficiência venosa, varizes

Abstract

OBJECTIVES: Chemical sclerotherapy is the most traditional treatment to eliminate telangiectasias. For several decades, it has been carried out in the office, although it has a high index of treatment dropout for being a painful, long and, therefore, little efficient treatment. Most of these patients also present insufficient varicose veins, which require phlebectomy and are candidates for surgery. The aim of this paper is to describe the combined treatment including varicose vein surgery and sclerotherapy for telangiectasias at the same procedure. METHODS: From January 1998 to March 2002, 213 patients (426 lower limbs) with telangiectasias were treated by means of hypertonic glucose infusion during the varicose vein surgery. RESULTS: More than 90% of the patients reported high indices of aesthetic satisfaction. The complementary sclerotherapy was necessary in 165 patients to have full aesthetic satisfaction during follow-up. Any cases of superficial thrombophlebitis or of deep venous thrombosis were reported. There were no serious complications either. In 10% of cases, small drainage of residual microthrombus was necessary. The index of hyperchromic spots did not exceed 3%. Only one patient developed a small ulcer in the back of the foot (0.2%), which spontaneously healed. CONCLUSIONS: Combined treatment including surgery with sclerotherapy for varicose veins and lower extremity telangiectasias is an alternative for patients who desire faster and painless results. Multiple session sclerotherapy with hypertonic glucose is a safe and efficient procedure.

Keywords

Ambulatory surgical procedures, sclerotherapy, venous insufficiency, varicose veins

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