Catheter-directed sclerotherapy.

Abstract:

BACKGROUND:Catheter directed sclerotherapy (CDS) involves the use of a long catheter to deliver a sclerosing agent into a target vessel (saphenous trunks or venous malformations) under ultrasound guidance. Aims and Methods This article reviews the history, current techniques and devices and the evidence as it relates to these procedures. RESULTS:CDS was developed to increase the safety and efficacy of ultrasound-guided sclerotherapy (UGS). With the advent of foam sclerosants and tumescent anaesthesia, the procedure has enjoyed a higher primary success rate. CDS has a better safety profile when compared with UGS with virtually no risk of intra-arterial injection or sclerosant extravasation. Compared with endovenous laser (EVLA) and radiofrequency ablation (RFA), CDS is a quicker procedure with less associated pain. Some balloon catheters, however, have been found to force the sclerosant down the perforators causing femoral vein occlusion. Based on the current level of evidence, no firm conclusion regarding the efficacy of CDS techniques can be drawn in comparison with EVLA or RFA, but the primary success rate is probably higher than the standard UGS. CONCLUSION:CDS ensures a safe intraluminal delivery of the sclerosing agent into the trunk of the saphenous veins using a single access point. This procedure preceded EVLA and RFA, and remains a safe alternative for the treatment of saphenous incompetence and venous malformations.

journal_name

Phlebology

journal_title

Phlebology

authors

Parsi K

doi

10.1258/phleb.2009.009010

subject

Has Abstract

pub_date

2009-06-01 00:00:00

pages

98-107

issue

3

eissn

0268-3555

issn

1758-1125

pii

24/3/98

journal_volume

24

pub_type

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