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Safety and efficiency of perilesional sclerotherapy in leg ulcer patients with postthrombotic syndrome and/or oral anticoagulation with phenprocoumon
Author(s) -
Stücker Markus,
Reich Stefanie,
Hermes Nico,
Altmeyer Peter
Publication year - 2006
Publication title -
jddg: journal der deutschen dermatologischen gesellschaft
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 60
eISSN - 1610-0387
pISSN - 1610-0379
DOI - 10.1111/j.1610-0387.2006.06085.x
Subject(s) - medicine , polidocanol , sclerotherapy , phenprocoumon , surgery , thrombosis , varicose veins , post thrombotic syndrome , vein , venous thrombosis , electrocoagulation , warfarin , atrial fibrillation
Summary Background: The positive effects of perilesional sclerotherapy for venous leg ulcers is well documented. Although many patients with venous leg ulcers require oral anticoagulation or have had a deep vein thrombosis, the effects of these factors on perilesional sclerotherapy are unknown. The aim of this study was to review effects of oral anticoagulation and/or postthrombotic syndrome on perilesional sclerotherapy. Patients and methods: 28 patients with venous leg ulcers were observed. 12/28 had a postthrombotic syndrome, 5/12 were on oral anticoagulants (phenprocoumon with INR 2‐3). During each treatment session, 1 ml sclerosing foam (1:5, polidocanol 2 %, method of Tessari) was injected.Treatment was continued until all extrafascial veins in the 15cm surrounding the ulcer were closed. Results: Closure of the perilesional veins was achieved in all patients with 2.5 ± 1.8 injections. In 10 of 28 patients (35.7 %),just one injection was needed.More injections were needed, both in patients with postthrombotic syndrome (3.3 ± 2.1 vs. 1.8 ± 1.3) and on anticoagulation with phenprocoumon (4.2 ± 1.2 vs. 2.1 ± 1.7). There were only two complications: an ascending phlebitis up to the accessory saphenous vein and a superficial erosion at an injection site which healed within 1 week. Conclusions: Perilesional sclerotherapy with foam is a safe and efficient therapy for patients with chronic venous leg ulcers even with postthrombotic syndrome and/ or ongoing anticoagulation.