alexa Outcome of ultrasound-guided sclerotherapy for varicose veins: medium-term results assessed by ultrasound surveillance.
Surgery

Surgery

Journal of Vascular Medicine & Surgery

Author(s): Myers KA, Jolley D, Clough A, Kirwan J

Abstract Share this page

Abstract OBJECTIVE: To estimate medium-term success after a technique for ultrasound-guided sclerotherapy for superficial chronic venous disease. DESIGN: A prospective study in a single unit with ultrasound surveillance after treatment. MATERIALS: Results after 1189 treatment sessions for 807 venous saphenous veins and related tributaries or non-saphenous tributaries in 489 patients. METHODS: Univariate life table analysis determined primary and secondary success rates. Multivariate Cox regression analysis detected covariates that affected outcome. RESULTS: Primary and secondary success rates at 36 months for all veins were 52.4\% (95\%CI 46-58\%) and 76.8\% (95\%CI 71-82\%). Cox regression analysis for primary success for all veins showed significantly worse results for saphenous veins compared to tributaries (HR 3.72 - 95\%CI 1.9 to 7.3). Cox regression for all saphenous veins showed independently worse results for patients less than 40 years age (HR 2.16 - 95\%CI 1.27-3.66), small compared to great saphenous veins (HR 1.58 - 95\%CI 1.11-2.24), veins greater than 6mm diameter compared to smaller veins (HR 2.22 - 95\%CI 1.40-3.50), liquid compared to foam sclerotherapy (HR 2.20 - 95\%CI 1.28-3.78), lower volumes of sclerosant compared to volumes greater than 12 ml (HR 0.51 - 95\%CI 0.33-0.81) and highly diluted compared to concentrated sclerosant (HR 2.05 - 95\%CI 1.21-3.46) with worse results using highly diluted or undiluted 3\% sclerosant compared to a 1.5\% concentration. There were no significant differences for primary success for saphenous veins for date of procedure, sex, side, primary or recurrent varicose veins, or commercial type of sclerosant. CONCLUSIONS: Ultrasound-guided sclerotherapy gives satisfactory results if it is accepted that treatment may need to be repeated to achieve secondary success. Results provide a basis for further research to explore factors that might affect outcome. Younger patients with larger diameter saphenous veins may warrant alternative forms of treatment, particularly for small saphenous reflux. This article was published in Eur J Vasc Endovasc Surg and referenced in Journal of Vascular Medicine & Surgery

Relevant Expert PPTs

Relevant Speaker PPTs

  • Donald silverberg
    Is correction of iron deficiency a new addition to the treatment of heart failure?
    PPT Version | PDF Version
  • Ahmed Zeidan
    Effects of intravenous iron in chronic kidney disease and heart failure
    PPT Version | PDF Version
  • Yosef Yarden
    Classically, the 3’untranslated region (3’UTR) is that region in eukaryotic protein-coding genes from the translation termination codon to the polyA signal. It is transcribed as an integral part of the mRNA encoded by the gene. However, there exists another kind of RNA, which consists of the 3’UTR alone, without all other elements in mRNA such as 5’UTR and coding region. The importance of independent 3’UTR RNA (referred as I3’UTR) was prompted by results of artificially introducing such RNA species into malignant mammalian cells. Since 1991, we found that the middle part of the 3’UTR of the human nuclear factor for interleukin-6 (NF-IL6) or C/EBP gene exerted tumor suppression effect in vivo. Our subsequent studies showed that transfection of C/EBP 3’UTR led to down-regulation of several genes favorable for malignancy and to up-regulation of some genes favorable for phenotypic reversion. Also, it was shown that the sequences near the termini of the C/EBP 3’UTR were important for its tumor suppression activity. Then, the C/EBP 3’UTR was found to directly inhibit the phosphorylation activity of protein kinase CPKC in SMMC-7721, a hepatocarcinoma cell line. Recently, an AU-rich region in the C/EBP 3’UTR was found also to be responsible for its tumor suppression. Recently we have also found evidence that the independent C/EBP 3’UTR RNA is actually exists in human tissues, such as fetal liver and heart, pregnant uterus, senescent fibroblasts etc. Through 1990’s to 2000’s, world scientists found several 3’UTR RNAs that functioned as artificial independent RNAs in cancer cells and resulted in tumor suppression. Interestingly, majority of genes for these RNAs have promoter-like structures in their 3’UTR regions, although the existence of their transcribed products as independent 3’UTR RNAs is still to be confirmed. Our studies indicate that the independent 3’UTR RNA is a novel non-coding RNA species whose function should be the regulation not of the expression of their original mRNA, but of some essential life activities of the cell as a whole.
    PPT Version | PDF Version
  • Ishfaq A Bukhari
    Protective Effect of Diltiazem and Fenofibrate Against Ischemia-reperfusion Induced Cardiac Arrhythmias in the Isolated Rat Heart.
    PPT Version | PDF Version
  • A Martin Gerdes
    Wrong about β-blockers! Wrong about positive inotropes! Wrong about Thyroid Hormone treatment of Heart Failure?
    PDF Version
  • Fatih Yalcin
    EARLY IMAGING BIOMARKER IN REMODELING DUE TO HEART FAILURE
    PDF Version
  • Samuel C Dudley
    Novel biomarkers for diastolic heart failure
    PDF Version
  • Abdulaziz U Joury
    Acute Myocardial Infarction as First Presentation among patients with Coronary Heart Disease
    PPT Version | PDF Version
  • Helena Dominguez
    Can we protect the brain against thromboembolism during open heart surgery? LAACS project
    PDF Version
  • Saverio Gentile
    Ion channels phosphorylopathy: 3rd International Conference on Clinical & Experimental Cardiology April 15-17, 2013 A link between genomic variations and heart arrhythmia
    PDF Version

Recommended Conferences

  • 19th Annual Cardiology Conference (10 Plenary Forums - 1 Event)
    August 31-September 01, 2017 Philadelphia, USA

Relevant Topics

Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

 
© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version
adwords