X线透视引导下下肢静脉曲张泡沫硬化疗法的可行性和短期效果 李龙VIP免费

TechnicalFeasibilityandEarlyResultsofRadiologicallyGuidedFoamSclerotherapyforTreatmentofVaricoseVeinsLONGLI,MD,XUAN-YANGHONG,MB,XIN-QIAOZENG,MB,PEI-LINLUO,MB,QIONGYI,MB�BACKGROUNDDuplexultrasoundguidanceoffoamsclerotherapyhasbeenestablishedasaroutineandstandardtreatmentofvaricoseveins,butduplex-guidedtechniqueisnotperfectbecauseofitsinherentshortcomings,andcorrelativecomplicationshavebeenreported.Moreover,noteverycountryorregionoftheworldcanuseduplexultrasoundguidanceforfoamsclerotherapy.OBJECTIVETodescribeanoriginaltechniqueofusingradiologicallyguidedfoamsclerotherapyforthetreatmentoflegvaricoseveinsandtoevaluatethetechnicalfeasibilityandearlyresults.MATERIALSANDMETHODSFifty-ninelegsof41patients(23male,18female;medianage47,range25–75)withlegvaricoseveinstreatedusingradiologicallyguidedfoamsclerotherapywereassessed.Polidocanol1%wasfoamed1:4withairusingtheTessarimethod.Foamsclerotherapyofthesuperficialvaricositiesandthegreatsaphenousveins(GSVs)wereperformedusingthefilling-defectstechniqueunderradiologicguidance.Postoperativecompressionwasmaintainedfor15days.Clinicaloutcomewasassessedaccordingtoclinicalcriteria.RESULTSTheprocedurewastechnicallysuccessfulinall59legs.Atamedian9.0months(range6–12months)offollow-up,theclinicaloutcomewasfullsuccessin53legs(89.8%),andpartialsuccessinsixlegs(10.2%).TherewasnoevidenceofrecurrenceofvaricesorGSVrefluxduringfollow-up.Minorcomplicationsincludedskinpigmentationin27legs(45.8%),andsuperficialthrombophlebitisin18legs(30.5%).Nomajorcomplicationsorsystemiceventsoccurred.CONCLUSIONSRadiologicallyguidedfoamsclerotherapycouldbeasafe,effective,andtechnicallyfeasibletreatmentforvaricoseveins.Theauthorshaveindicatednosignificantinterestwithcommercialsupporters.Overthelastdecade,theadventoffoamsclerotherapyhasbeenoneofthemostim-portantdevelopmentsinthefieldofphlebology.Foamsclerotherapyisquick,efficient,safe,easytouse,andcheap,anditiswidelybelievedthatitwillbecomethedominantformoftherapyforvenousdisorders.1Intheliterature,thevastmajorityoffoamsclerotherapyisperformedunderultrasoundguidance,inparticularcolorduplexultrasound,2,3butthecurrentsituationintheuseofultrasoundisvariable,reflectingeachcountry’shabitsandregu-lations.Somecountries,suchasFrance,havenovasculartechniciansandrelyonphysicianstoper-formtheultrasoundexaminationandthetreatment.InothercountriessuchastheUnitedStatesandtheUnitedKingdom,registeredvasculartechnologistsareavailabletoperformduplexscans.InChina,aphysiciancannotusecolorduplexultrasoundwith-outalicense,sotheapplicationofultrasound-guidedfoamsclerotherapyhasbeenrestricted.Furthermore,ultrasoundhasthedisadvantageofanarrowfieldofviewthatoftendoesnotencompassalongsegmentofvein,soultrasoundguidancecannotcompre-hensivelymonitortheinjectionproceduresoffoamsclerosant,andlowspatialresolutionandoperatordependencyarecommonlimitationsofultrasonography.4Interventionalradiologistshaveaccumulatedawealthofexperienceinendovascularembolizationoftumordisordersandscleroembolizationofvasculardisordersusingliquidsclerosantsunder&2011bytheAmericanSocietyforDermatologicSurgery,Inc.�PublishedbyWileyPeriodicals,Inc.�ISSN:1076-0512�DermatolSurg2011;37:992–998�DOI:10.1111/j.1524-4725.2011.02021.x992�AllauthorsareaffiliatedwithDepartmentofRadiology,GuangdongProvincialCorpsHospitalofChinesePeople’sArmedPoliceForces,GuangzhouMedicalCollege,Guang...