Phlebology最新文献

{"title":"Effectiveness of liquid versus foam sclerotherapy with or without herbal gel in treating telangiectasia and reticular veins: A randomized controlled trial.","authors":"Moustafa Mabrouk, Ahmed Fouda, Mohamed Gaheed, Mohab Saeed, Reda Fawzy, Islam Atta","doi":"10.1177/02683555261451564","DOIUrl":"https://doi.org/10.1177/02683555261451564","url":null,"abstract":"<p><p>BackgroundTelangiectasia and reticular veins are usually not a medical problem. More often, people are concerned with the aesthetic issues they cause. Reticular veins, unlike telangiectasia, are often annoying or painful. The more reticular veins you have in an area, the more annoying they will become. Sclerotherapy is an accepted treatment modality for reticular varicose veins and telangiectasia, in this study we compare between liquid and foam sclerotherapy and the effect of herbal gel application post procedural to reach the optimum results.MethodsThis single-centre, prospective randomized controlled trial enrolled a total of 574 patients who were initially assessed for eligibility. Thirty-nine patients did not meet the inclusion criteria ultimately after exclusion, 508 patients were randomized, with approximately 127 patients allocated to each group. Seventeen patients did not complete follow-up. Patients were randomized into four equal groups: group A: Liquid sclerotherapy without herbal gel, group B: Liquid sclerotherapy with herbal gel, group C: Foam sclerotherapy without herbal gel and group D: Foam sclerotherapy with herbal gel. The primary outcomes were clinical or photographic resolution or improvement of telangiectasias and reticular veins and patient satisfaction. Secondary outcomes included adverse events (hyperpigmentation, bruising, anaphylaxis, pain at injection site (during and after procedure) and time to resolution.ResultsResolution differed significantly among groups (<i>p</i> = 0.021). Foam sclerotherapy (Groups C and D) demonstrated faster improvement and higher VAS satisfaction scores compared to liquid sclerotherapy, with Group D achieving the highest satisfaction (<i>p</i> < 0.001). Time to improvement was significantly shorter in Groups C and D (<i>p</i> < 0.001). Adverse events did not significantly differ between groups and were transient and self-limiting.ConclusionFoam sclerotherapy demonstrated superior efficacy, faster clinical improvement, and higher patient satisfaction compared to liquid sclerotherapy, particularly when combined with post-procedural herbal gel application, which further enhanced resolution rates and overall patient outcomes.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555261451564"},"PeriodicalIF":1.5,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gait, ankle mobility, muscle strength, and functional performance in chronic venous insufficiency: A CEAP-based analysis.","authors":"Vittor de Moura Colicchio, Nicholas Rassilan Guimarães, Cecília Alves Macedo, Gabriel Melo Fonseca, Marina Silva Reis, Antonielly Rocha de Souza Pereira, Dalyla Silva Lemos de Souza, Yasmmin França Eliziário, Sofia Fróis Fernandes de Oliveira, Keity Lamary Souza Silva, Lucas Fróis Fernandes de Oliveira, Matheus Ribeiro Ávila, Whesley Tanor Silva, Ana Cristina Rodrigues Lacerda, Vanessa Amaral Mendonça, Pedro Henrique Sheidt Figueiredo, Renato Guilherme Trede Filho, Henrique Silveira Costa","doi":"10.1177/02683555261451561","DOIUrl":"https://doi.org/10.1177/02683555261451561","url":null,"abstract":"<p><p>ObjectivesChronic venous disease (CVD) is a progressive condition affecting the lower limb venous system, leading to venous hypertension, muscle dysfunction, and gait alterations. Patients with CVD often experience muscle weakness, reduced ankle mobility, and impaired gait biomechanics. However, the impact of CVD severity on spatiotemporal gait parameters and plantar flexor strength remains little explored. The present study aimed to compare gait biomechanics, plantar flexor strength, dorsiflexion ankle range of motion, and functional performance among patients with mild, moderate, and severe CVD, classified according to the CEAP system.MethodsA cross-sectional study was conducted in two phases. Phase 1 compared gait parameters between healthy individuals and patients with CVD. Phase 2 examined variations in movement patterns across CVD severity groups, classified according to CEAP class into mild CVD (CEAP 1; n = 11), moderate CVD (CEAP 2-3; n = 12), and severe CVD (CEAP 4-6; n = 6). Gait parameters, including speed, stride length, and stance time, were assessed using a motion capture system. Plantar flexor strength was measured with a handheld dynamometer. Ankle dorsiflexion range of motion was assessed using the Weight-Bearing Lunge Test (WBLT), and functional performance was evaluated using the Human Activity Profile (HAP) questionnaire.ResultsNo significant differences were observed in spatiotemporal gait parameters between healthy individuals and patients with CVD or across disease severity groups. In contrast, normalized plantar flexor strength differed significantly among groups (p = .041). Ankle dorsiflexion range of motion was also reduced with increasing disease severity (p = .005), particularly in the severe group. No significant differences were found for HAP scores.ConclusionCVD severity was associated with reduced plantar flexor strength and ankle dorsiflexion range of motion, while spatiotemporal gait parameters remained unchanged. These findings suggest that musculoskeletal impairments may precede detectable alterations in gait, highlighting the importance of early assessment and targeted rehabilitation strategies in patients with CVD.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555261451561"},"PeriodicalIF":1.5,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of sarcopenia and its functional correlates in women with lower-extremity lipedema: A cross-sectional observational study.","authors":"Ilhan Celil Ozbek, Ozlem Kuculmez, Emine Dundar Ahi","doi":"10.1177/02683555261451570","DOIUrl":"https://doi.org/10.1177/02683555261451570","url":null,"abstract":"<p><p>BackgroundLipedema is a chronic, progressive adipose tissue disorder affecting mainly women, characterized by bilateral, disproportionate fat accumulation in the lower extremities. The condition is often associated with pain, heaviness, and functional limitations. While the adipose tissue changes in lipedema are well-described, its impact on muscle mass, strength, and functional performance remains underexplored. This study aimed to evaluate the prevalence of sarcopenia and its relationship with lipedema severity.Materials and methodsA cross-sectional observational study was conducted on 48 women with clinically diagnosed lower-extremity lipedema. Diagnosis followed the International Lipoedema Association and German S2k guidelines. Sarcopenia was assessed using a multidimensional approach, including ultrasonographic rectus femoris thickness, handgrip strength, the Five Times Sit-to-Stand Test, and four-m walking speed. The lipedema stage was determined using morphological criteria. Statistical analyses evaluated the relationships between sarcopenia, functional parameters, and lipedema stage.ResultsParticipants had a mean age of 47.2 ± 8.4 years and a BMI of 33.0 ± 4.3 kg/m². Sarcopenia was identified in 33.3% of participants, with 14.6% classified as severe. Those with sarcopenia exhibited lower rectus femoris thickness and slower walking speed (<i>p</i> < .05). Advancing lipedema stage correlated with reduced muscle thickness, weaker handgrip strength, slower gait, and prolonged Five Times Sit-to-Stand Test duration (<i>p</i> < .05). Stage 3 patients demonstrated the highest prevalence of sarcopenia, indicating progressive impairment in muscle mass and functional performance with disease severity (<i>p</i> < .05). No significant associations were found between age or BMI and muscle parameters (<i>p</i> > .05).ConclusionsSarcopenia is prevalent in women with lower-extremity lipedema and increases with disease stage. Comprehensive musculoskeletal assessment should be integrated into lipedema management to address functional impairment and optimize patient care.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555261451570"},"PeriodicalIF":1.5,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating right ventricle and pulmonary pressure changes after foam sclerotherapy injection for great saphenous vein incompetence.","authors":"Gianluigi Rosi, Carlo Cordiano, Daniele Ceccaroni, Daniele Bissacco","doi":"10.1177/02683555261451569","DOIUrl":"https://doi.org/10.1177/02683555261451569","url":null,"abstract":"<p><p>BackgroundUltrasound-guided foam sclerotherapy (UGFS) is a minimally invasive procedure recommended for the management of chronic venous disease, particularly for varicose veins and saphenous trunk insufficiency, although rare, systemic effects may occur. The study aims to evaluate the impact of UGFS on pulmonary artery pressure and right ventricular function through indirect echocardiographic measurements.Material and MethodsA total of 50 patients with incompetent great saphenous veins underwent UGFS. Preoperative assessments and echocardiographic monitoring of right heart function were conducted at baseline (T0), 5 min (T5), 10 min (T10), and 15 min (T15) after FS injection. Primary endpoint included changes in systolic pulmonary artery pressure (PAPs), while secondary endpoints focused on tricuspid annular plane systolic excursion (TAPSE) and right ventricular diameter (RVD1). Statistical analyses were performed using paired t-tests and linear mixed models.ResultsThe results indicated a significant increase in PAPs from T0 to T10 (mean increase of 8.13 mmHg, p < .01) and T5, with a reduction at T15 that remained above baseline (mean difference of 3.01 mmHg, p < .01). TAPSE showed a significant increase at T15 compared to T0 (mean increase of 1.6 mm, p = .04). No significant changes were observed in RVD1. Importantly, no local or systemic complications occurred, and all patients remained asymptomatic.ConclusionUGFS is a safe and effective treatment for chronic venous disease, with transient and benign alterations in right heart hemodynamic likely attributable to foam degradation products. Further studies with larger cohorts and longer follow-up are warranted to enhance understanding of the long-term effects of UGFS on pulmonary hemodynamic and right ventricular function.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555261451569"},"PeriodicalIF":1.5,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-ablation deep vein material extension (PDME) - classification, treatment considerations and future research objectives.","authors":"Jessica Bowie, Lowell S Kabnick, Sarah Onida, Alun H Davies","doi":"10.1177/02683555261449980","DOIUrl":"https://doi.org/10.1177/02683555261449980","url":null,"abstract":"<p><p>With excellent outcomes achievable using endovenous treatment of refluxing truncal veins, extension of ablative material and/or thrombus into adjacent deep veins is an important complication which can lead to deep venous thrombosis (DVT) or pulmonary embolism (PE). Previous work has used poorly defined terminology to identify patients with material in the deep venous system following ablation, limiting synthesis of results and the formation of treatment guidelines. We propose the term Post-ablation Deep vein Material Extension (PDME) to identify cases of ablative material and/or thrombus in the adjacent deep veins, with sub-categorisations according to mode of ablation used. PDME is a distinct entity from DVT, with often a shorter clinical course, few symptoms reported by patients, and possibility of resolution without treatment in some cases. This article explores the different forms of PDME, their classifications, and possible aetiology. A precise classification is proposed to ensure transparency in future research into this area.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"2683555261449980"},"PeriodicalIF":1.5,"publicationDate":"2026-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147825489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovenous welding: Basics and 5-year experience in the use of automatic thermal ablation in the treatment of patients with chronic vein diseases.","authors":"Larisa M Chernukha, Vladislav S Horbovets, Mykhailo V Chekhlov, Sofiia-Solomiia V Horbovets","doi":"10.1177/02683555251360610","DOIUrl":"10.1177/02683555251360610","url":null,"abstract":"<p><p>ObjectivesWe proposed a method of endovenous welding (EVW) in which automatic ablation mode is implemented. The results of clinical studies in short follow-up periods, which were published earlier, showed a high level of effectiveness and safety of EVW.AimsTo analyze the results of the use of EVW in the treatment of patients with CVD in different terms of follow-up.MethodsThe 5-year results of 236 cases of EVW use in 184 consecutive patients with CVD C2-C6 (48 men, 136 women, aged 21 to 74 years) with ostial diameters from 5.7 to 31 mm were studied. EW was performed using EK 300M generator and welding catheters (Svarmed, Ukraine) in accordance with mini-invasive methodology. The results were evaluated according to the ultrasound data, the level of postoperative pain (РР), complications.ResultsAfter the intervention and in the following 6 months and 12 months, successful ablation was noted in 100% of cases. In the next 4 years, no cases of recanalization were noted. In 38 cases (16.1%) progression of the disease was observed as a result of reflux in the previously unchanged veins. Absence of PP was noted in 85.6% of cases, in 14.4% PP did not exceed a moderate level. Serious complications were not detected.ConclusionsEVW is an effective alternative to other thermal methods with a better control algorithm. The automatic welding mode allows to eliminate the influence of subjective factors on the treatment results and significantly reduce the risk of recanalization and complications. The characteristics of EVW expand the possibilities of using thermal ablation in patients with severe forms of CVD with veins of large diameter, their extrafascial location, as well as in patients with incompetent venous trunks below the knee.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"300-309"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144746718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computed tomography pulmonary angiography for detection of pulmonary embolisms in Chinese patients.","authors":"Zhen-Yi Jin, Chun-Min Li, Jia-Hao Wen, Hua-Liang Ren","doi":"10.1177/02683555251363305","DOIUrl":"10.1177/02683555251363305","url":null,"abstract":"<p><p>ObjectiveTo describe the trends in computed tomography pulmonary angiography (CTPA) utilization and pulmonary embolism (PE) positivity rate among patients at a tertiary hospital in China between January 2018 and December 2021 and explore the incidence of isolated PE.MethodsA total of 4378 patients who underwent CTPA examinations between January 2018 and December 2021 were included in the study, retrospectively. The demographic characteristics and PE positivity rate of the included population were compared each year. The incidence of deep venous thrombosis (DVT)-related and isolated PEs and the relationship between the two were explored.ResultsThe mean age of the included patients was 63.0 ± 14.9 years. A total of 1905 (43.5%) patients were male. CTPA showed positive PE results in 901 (20.6%) patients. There was no statistical difference in terms of sex (<i>p</i> = 0.078) and age (<i>p</i> = 0.225) or PE positivity rate (<i>p</i> = 0.393) among the included individuals in each year. DVT-related PE occurred more often, manifested as central (<i>p</i> = 0.003) and multiple (<i>p</i> = 0.007) PE, when compared to isolated PE.ConclusionIn a retrospective study conducted at a tertiary hospital in China, the CTPA positivity rate for PE was 20.6%. There was no statistical difference in the annual PE positivity rate. The clinical features of patients with DVT-related PE were more severe than of those with isolated PE.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"310-317"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144985109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors influencing the extent of contralateral iliac vein orifice overlap by iliac vein stents.","authors":"Liang-Peng Wang, Zi-Hui Chen, Min-Yong Peng, Chao Li, Wen Huang","doi":"10.1177/02683555251365132","DOIUrl":"10.1177/02683555251365132","url":null,"abstract":"<p><p>ObjectiveTo evaluate the factors influencing the extent of contralateral iliac vein orifice coverage by stents extending into the inferior vena cava (IVC) in patients with iliac vein compression syndrome (IVCS).MethodsThis retrospective study included 150 patients with IVCS who underwent unilateral stent placement between September 2018 and October 2020. Diagnosis was based on clinical symptoms, venography showing ≥50% iliac vein narrowing, and exclusion of thrombosis or external compression. Patients received either a braided Wallstent or a laser-cut Smart Control stent. Three-dimensional rotational venography was used in all cases, and intravascular ultrasound (IVUS) was performed in selected patients to guide stent sizing and placement. Postoperative imaging was used to measure stent protrusion into the IVC, iliac vein-IVC angulation, and the percentage of contralateral vein orifice obstruction. Univariate and multivariate regression analyses were conducted to identify factors associated with orifice coverage.ResultsUnivariate analysis showed that stent protrusion length, lateral angulation between the iliac vein and IVC, and stent type were significantly associated with orifice coverage (all <i>p</i> < .001). Age, sex, stent diameter, and anteroposterior angulation were not significant predictors. Multivariate analysis confirmed that stent protrusion length was the strongest predictor (β = 0.595, <i>p</i> < .001), followed by stent type (β = 0.249, <i>p</i> < .001) and lateral angulation (β = -0.242, <i>p</i> = .002), with the model explaining 76.6% of the variation in orifice coverage.ConclusionThe degree of contralateral iliac vein orifice coverage in IVCS is primarily determined by the stent's protrusion length into the IVC, the lateral angulation of the affected iliac vein relative to the IVC, and the mechanical design of the stent. These findings highlight the importance of individualized stent selection and precise deployment to minimize contralateral venous obstruction.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"327-336"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic efficacy of the polidocanol versus pingyangmycin in the treatment of maxillofacial vascular disorders.","authors":"Jing Yang, Zhi Tan, Qirong Liu, Li Shen, Hao Zhang, Ping Liu","doi":"10.1177/02683555251365067","DOIUrl":"10.1177/02683555251365067","url":null,"abstract":"<p><p>ObjectiveTo study the clinical therapeutic effect of polidocanol injection in the treatment of maxillofacial vascular disorders, and to compare the therapeutic effect with that of Pingyangmycin.MethodsA total of 300 patients with maxillofacial vascular abnormalities from March 14, 2021 to January 9, 2022 were selected from a hospital and divided into hemangioma group, lymphatic vessel malformation group and venous malformation group. The treatment was divided into two groups: Pingyangmycin and polidocanol injection. By comparing the pain coefficient, adverse reactions, therapeutic effect and the effect of the two drugs on cells, the therapeutic effect and safety of the two drugs were comprehensively analyzed.ResultsUnder the same conditions, the infiltration rates of 5-bromodeoxyuracil into lymphoendothelial cells with different concentrations of polidocanol injection were 0.62%, 0.59%, 0.36%, 0.18% and 0.15%, respectively, which were better than Pingyangmycin. The protein kinase C expression levels of polidocanol injection with different concentrations were 1.01, 1.21, 1.02, 0.75 and 0.61, respectively, which were better than Pingyangmycin. The adverse reaction rate, cure rate, effective rate and total effective rate of hemangioma patients treated with polidocanol injection were 88.64%, 80.77%, 94.23% and 100.00%, respectively. The adverse reaction rate, cure rate, effective rate and total effective rate were 91.30%, 71.74%, 84.78% and 95.65%, respectively. The adverse reaction rate, cure rate, effective rate and total effective rate of venous malformation patients were 90.00%, 92.00%, 98.00% and 100.00%, respectively. The adverse reaction rate, cure rate, effective rate and total effective rate of hemangioma patients treated with Pingyangmycin were 92.59%, 64.81%, 88.89% and 98.15%, respectively. The adverse reaction rate, cure rate, effective rate and total effective rate of patients with lymphatic vessel malformation were 94.00%, 54.00%, 84.00% and 94.00% respectively. The adverse reaction rate, cure rate, effective rate and total effective rate of venous malformation patients were 95.83%, 75.00%, 91.67% and 100.00%, respectively.ConclusionPolidocanol injection is better than Pingyangmycin in the treatment of maxillofacial vascular disorders, and the drug is milder, less adverse reactions and higher safety.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"337-347"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144985008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of recurrent varicose veins: Redo open surgery versus endovascular approaches.","authors":"Vincenzo Ardita, Nicola Galati, Sarah Tinaglia, Carlo Campesi, Elena Miglioranza, Roberto Chiesa, Domenico Baccellieri","doi":"10.1177/02683555251353002","DOIUrl":"10.1177/02683555251353002","url":null,"abstract":"<p><p>ObjectiveRecurrent varicose veins (RVVs) following open surgical procedures are common and present significant treatment challenges. Redo open surgery (rOS) presents risks leading to a need for alternative treatment options. This study compares the safety and efficacy of ultrasound-guided foam sclerotherapy (UGFS), used to treat recurrent reflux and remove neovascular and tributary venous networks in the thigh, to redo open surgery (rOS) for the treatment of C2r.Materials and methodsA retrospective review was conducted on 133 patients with symptomatic C2r treated between 2018 and 2020. Of these, 91 patients received UGFS-based mini-invasive treatment (Group A), and 42 underwent rOS (Group B). Data were collected during perioperative, intraoperative, and postoperative times. Clinical outcomes were assessed using the CEAP and rVCSS scoring systems. Follow-up occurred within 1 week, at 1-6 months, and annually thereafter.ResultsUGFS showed a significantly shorter average procedure time (21 ± 7 minutes) compared to rOS (47 ± 13 minutes, <i>p</i> < .001) and time spent in the hospital (3 ± 0.5 hours vs 16 ± 2 hours, <i>p</i> < .001). Both groups achieved high technical success rates. The anterior saphenous vein (ASV) was found to be incompetent in 32 patients (24%). In Group A, it was treated with radiofrequency ablation (RFA) in 10 cases and with foam sclerotherapy in 11. In contrast, all ASV cases in Group B were managed with surgical stripping. UGFS patients experienced a more rapid clinical improvement within the first-week post-treatment (<i>p</i> < .001). The freedom from recurrences was 88.9% in the Group A, and 87.8% in the Group B at 3-year (<i>p</i> = .85). The freedom from reintervention was 90.9% in the Group A, and 88.5% in the Group B at 3-year (<i>p</i> = .89).ConclusionsUGFS is a safe and effective alternative to rOS for treating C2r, offering significant advantages in shorter procedure times, faster recovery, and similar medium-term outcomes. This approach provides a viable option for C2r patients seeking effective treatment with reduced recovery periods.</p>","PeriodicalId":94350,"journal":{"name":"Phlebology","volume":" ","pages":"288-299"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}