Periulcer Foam Sclerotherapy Injection in Chronic Venous Leg Ulcers Using Near-Infrared Laser for Vein Visualization
High recurrence and high costs of treatment are the main problems with venous ulcer management. Therefore, it is of utmost importance to target the exact pathological cause. The role of cutaneous microvalves reflux in the pathogenesis of these ulcers has been confirmed. In this study, 20 chronic ven...
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| Veröffentlicht in: | International journal of lower extremity wounds 2020-03, Vol.19 (1), p.63-69 |
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| container_title | International journal of lower extremity wounds |
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| creator | Kamhawy, Adel Hussieny Elbarbary, Ahmed Husseiny Elhenidy, Mohamed Ahmed Elwagih, Ahmed Mohamed Morsy |
| description | High recurrence and high costs of treatment are the main problems with venous ulcer management. Therefore, it is of utmost importance to target the exact pathological cause. The role of cutaneous microvalves reflux in the pathogenesis of these ulcers has been confirmed. In this study, 20 chronic venous leg ulcers were prospectively subjected to foam sclerotherapy injection into periulcer veins using direct visualization by AccuVein AV400. Patients having infected ulcers, acute deep vein thrombosis, hypercoagulability, Ankle-Brachial Index |
| doi_str_mv | 10.1177/1534734619870680 |
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Therefore, it is of utmost importance to target the exact pathological cause. The role of cutaneous microvalves reflux in the pathogenesis of these ulcers has been confirmed. In this study, 20 chronic venous leg ulcers were prospectively subjected to foam sclerotherapy injection into periulcer veins using direct visualization by AccuVein AV400. Patients having infected ulcers, acute deep vein thrombosis, hypercoagulability, Ankle-Brachial Index <0.9, pregnancy, and/or allergy to the sclerosant were excluded. Endpoints included rates of ulcer size reduction, complete healing, ulcer recurrence, and procedure-related complications. Aethoxysklerol 1% was used in all cases to produce foam employing the double-syringe system. The mean reduction in ulcer surface area, postinjection, was 75% after 8 weeks and 91% after 12 weeks. Nineteen ulcers (95%) healed in a median time of 8 weeks, range 3 to 17 weeks. At 1 year of follow-up, 18 patients (90%) were still ulcer-free, while 1 patient’s ulcer (5%) recurred 19 weeks postinjection. No major complications were encountered. Periulcer foam sclerotherapy injection, guided by vein visualization technology, should be one of the main lines of treatment of venous leg ulcers. It offers good results with regard to rapid ulcer healing and low recurrence rate without major risk. Randomized controlled trials are needed to establish these conclusions.</description><identifier>ISSN: 1534-7346</identifier><identifier>EISSN: 1552-6941</identifier><identifier>DOI: 10.1177/1534734619870680</identifier><identifier>PMID: 31496316</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Chronic Disease ; Female ; Humans ; Lasers ; Leg Ulcer - physiopathology ; Leg Ulcer - therapy ; Male ; Middle Aged ; Outcome and Process Assessment, Health Care ; Polidocanol - administration & dosage ; Regional Blood Flow ; Sclerosing Solutions - administration & dosage ; Sclerotherapy - adverse effects ; Sclerotherapy - methods ; Secondary Prevention - methods ; Secondary Prevention - statistics & numerical data ; Varicose Ulcer - physiopathology ; Varicose Ulcer - therapy ; Veins - diagnostic imaging ; Wound Healing</subject><ispartof>International journal of lower extremity wounds, 2020-03, Vol.19 (1), p.63-69</ispartof><rights>The Author(s) 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c445t-baefb1f39be60945f002a77ec805d44166f8cfc284c4b906ff8609745f9358363</citedby><cites>FETCH-LOGICAL-c445t-baefb1f39be60945f002a77ec805d44166f8cfc284c4b906ff8609745f9358363</cites><orcidid>0000-0001-5328-018X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/1534734619870680$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/1534734619870680$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,777,781,21800,27905,27906,43602,43603</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31496316$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kamhawy, Adel Hussieny</creatorcontrib><creatorcontrib>Elbarbary, Ahmed Husseiny</creatorcontrib><creatorcontrib>Elhenidy, Mohamed Ahmed</creatorcontrib><creatorcontrib>Elwagih, Ahmed Mohamed Morsy</creatorcontrib><title>Periulcer Foam Sclerotherapy Injection in Chronic Venous Leg Ulcers Using Near-Infrared Laser for Vein Visualization</title><title>International journal of lower extremity wounds</title><addtitle>Int J Low Extrem Wounds</addtitle><description>High recurrence and high costs of treatment are the main problems with venous ulcer management. Therefore, it is of utmost importance to target the exact pathological cause. The role of cutaneous microvalves reflux in the pathogenesis of these ulcers has been confirmed. In this study, 20 chronic venous leg ulcers were prospectively subjected to foam sclerotherapy injection into periulcer veins using direct visualization by AccuVein AV400. Patients having infected ulcers, acute deep vein thrombosis, hypercoagulability, Ankle-Brachial Index <0.9, pregnancy, and/or allergy to the sclerosant were excluded. Endpoints included rates of ulcer size reduction, complete healing, ulcer recurrence, and procedure-related complications. Aethoxysklerol 1% was used in all cases to produce foam employing the double-syringe system. The mean reduction in ulcer surface area, postinjection, was 75% after 8 weeks and 91% after 12 weeks. Nineteen ulcers (95%) healed in a median time of 8 weeks, range 3 to 17 weeks. At 1 year of follow-up, 18 patients (90%) were still ulcer-free, while 1 patient’s ulcer (5%) recurred 19 weeks postinjection. No major complications were encountered. Periulcer foam sclerotherapy injection, guided by vein visualization technology, should be one of the main lines of treatment of venous leg ulcers. It offers good results with regard to rapid ulcer healing and low recurrence rate without major risk. Randomized controlled trials are needed to establish these conclusions.</description><subject>Chronic Disease</subject><subject>Female</subject><subject>Humans</subject><subject>Lasers</subject><subject>Leg Ulcer - physiopathology</subject><subject>Leg Ulcer - therapy</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Outcome and Process Assessment, Health Care</subject><subject>Polidocanol - administration & dosage</subject><subject>Regional Blood Flow</subject><subject>Sclerosing Solutions - administration & dosage</subject><subject>Sclerotherapy - adverse effects</subject><subject>Sclerotherapy - methods</subject><subject>Secondary Prevention - methods</subject><subject>Secondary Prevention - statistics & numerical data</subject><subject>Varicose Ulcer - physiopathology</subject><subject>Varicose Ulcer - therapy</subject><subject>Veins - diagnostic imaging</subject><subject>Wound Healing</subject><issn>1534-7346</issn><issn>1552-6941</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kMFKAzEQhoMoVqt3T5IXWE2abLI5SrFaWFTQ9rpk00mbst2UZPdQn94sVQ-CpxmY7_thfoRuKLmjVMp7mjMuGRdUFZKIgpygC5rnk0woTk-HnfFsuI_QZYxbQiaUKHmORoxyJRgVF6h7g-D6xkDAM693-N00EHy3gaD3Bzxvt2A651vsWjzdBN86g5fQ-j7iEtZ4MYgRL6Jr1_gFdMjmrQ06wAqXOqZM60Pik7x0sdeN-9RD2hU6s7qJcP09x2gxe_yYPmfl69N8-lBmhvO8y2oNtqaWqRoEUTy36QEtJZiC5CvOqRC2MNZMCm54rYiwtkicTKBiecEEGyNyzDXBxxjAVvvgdjocKkqqocDqb4FJuT0q-77ewepX-GksAdkRiHoN1db3oU0v_B_4BaLieP8</recordid><startdate>20200301</startdate><enddate>20200301</enddate><creator>Kamhawy, Adel Hussieny</creator><creator>Elbarbary, Ahmed Husseiny</creator><creator>Elhenidy, Mohamed Ahmed</creator><creator>Elwagih, Ahmed Mohamed Morsy</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><orcidid>https://orcid.org/0000-0001-5328-018X</orcidid></search><sort><creationdate>20200301</creationdate><title>Periulcer Foam Sclerotherapy Injection in Chronic Venous Leg Ulcers Using Near-Infrared Laser for Vein Visualization</title><author>Kamhawy, Adel Hussieny ; Elbarbary, Ahmed Husseiny ; Elhenidy, Mohamed Ahmed ; Elwagih, Ahmed Mohamed Morsy</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c445t-baefb1f39be60945f002a77ec805d44166f8cfc284c4b906ff8609745f9358363</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Chronic Disease</topic><topic>Female</topic><topic>Humans</topic><topic>Lasers</topic><topic>Leg Ulcer - physiopathology</topic><topic>Leg Ulcer - therapy</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Outcome and Process Assessment, Health Care</topic><topic>Polidocanol - administration & dosage</topic><topic>Regional Blood Flow</topic><topic>Sclerosing Solutions - administration & dosage</topic><topic>Sclerotherapy - adverse effects</topic><topic>Sclerotherapy - methods</topic><topic>Secondary Prevention - methods</topic><topic>Secondary Prevention - statistics & numerical data</topic><topic>Varicose Ulcer - physiopathology</topic><topic>Varicose Ulcer - therapy</topic><topic>Veins - diagnostic imaging</topic><topic>Wound Healing</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kamhawy, Adel Hussieny</creatorcontrib><creatorcontrib>Elbarbary, Ahmed Husseiny</creatorcontrib><creatorcontrib>Elhenidy, Mohamed Ahmed</creatorcontrib><creatorcontrib>Elwagih, Ahmed Mohamed Morsy</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>International journal of lower extremity wounds</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kamhawy, Adel Hussieny</au><au>Elbarbary, Ahmed Husseiny</au><au>Elhenidy, Mohamed Ahmed</au><au>Elwagih, Ahmed Mohamed Morsy</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Periulcer Foam Sclerotherapy Injection in Chronic Venous Leg Ulcers Using Near-Infrared Laser for Vein Visualization</atitle><jtitle>International journal of lower extremity wounds</jtitle><addtitle>Int J Low Extrem Wounds</addtitle><date>2020-03-01</date><risdate>2020</risdate><volume>19</volume><issue>1</issue><spage>63</spage><epage>69</epage><pages>63-69</pages><issn>1534-7346</issn><eissn>1552-6941</eissn><abstract>High recurrence and high costs of treatment are the main problems with venous ulcer management. 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| subjects | Chronic Disease Female Humans Lasers Leg Ulcer - physiopathology Leg Ulcer - therapy Male Middle Aged Outcome and Process Assessment, Health Care Polidocanol - administration & dosage Regional Blood Flow Sclerosing Solutions - administration & dosage Sclerotherapy - adverse effects Sclerotherapy - methods Secondary Prevention - methods Secondary Prevention - statistics & numerical data Varicose Ulcer - physiopathology Varicose Ulcer - therapy Veins - diagnostic imaging Wound Healing |
| title | Periulcer Foam Sclerotherapy Injection in Chronic Venous Leg Ulcers Using Near-Infrared Laser for Vein Visualization |
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