Lower extri̇mi̇ty venous i̇nsuffi̇ci̇ency treatment wi̇th evla and evla and concomi̇tant sclerotherapy effect of early symptoms and compli̇cati̇ons

Purpose: Our aim in this study is to compare the two methods used, EVLA alone, EVLA with concomittant foam sclerotherapy to treat venous insufficiency in our clinic for their success rate, early symptoms and complications, and patient satisfaction. Materials and Methods: Between October 26-August 15 a total of 105 patients (143 legs; bilateral in 38 patients), 40 male, 65 female, aged between 14-80 diagnosed with truncal venous insufficiency and treated with EVLA alone (group 1) and EVLA with concomittant foam sclerotherapy (group 2) followed up for 3 months were included this study. Seventy three legs were treated with only EVLA, 70 legs were treated with EVLA and concomittant foam sclerotherapy. Patient-related factors (age, sex, BMI), anatomical and clinical assessments (CEAP, VCSS, VAS, patient complaints score (PCS) and Doppler ultrasonography were used as parameters. At 1st week, patients were evaluated clinically and by Doppler ultrasonography. At 1st month, patients were followed clinically. At 3rd month, clinical evaluation and Doppler ultrasound examination was performed, and the CEAP, VCSS, PCS evaluations were repeated. Results: At 3rd month follow-up, recanalization of the laser-ablated refluxing veins occurred in 2 legs, one in each group. In 141 legs (98,6%) total occlusion was detected. At 1st month in group 1, 15%, in group 2, 19%, legs with persistent varicosities were treated with repeat sclerotherapy. There was no significant difference between groups in pain scores regardless of age, BMI, tumescent, and number of treated veins. At 1st week, there was no difference between the development ecchymosis (in gruop 1 63%, in group 2 67%). At 3rd month, 2 legs (2,7%) in group 1 had paresthesia, in group 2 there was no paresthesia. In group 2 hyperpigmentation occured in 7 legs (4,9%). Major complication occurred in 1 leg (1,4%) in group 2 and included calf vein thrombosis. VCSS, PCS and CEAP evaluations repeated at 3rd month follow-up of patients were compared with respective preprocedural values and significant decrease was observed. Conclusion: In both groups post-procedure pain score and persistent varicosities were same. Concomittant sclerotherapy increases the risk of DVT and hyperpigmentation. Therefore, sclerotherapy should be done at a later stage but not simultaneously.