gms | German Medical Science

10th Munich Vascular Conference

01.-03.12.2021, online

Management of Acute Bleeding Varicose Veins

Meeting Abstract

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10th Munich Vascular Conference. sine loco [digital], 01.-03.12.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. Doc18

doi: 10.3205/21mac18, urn:nbn:de:0183-21mac188

Published: December 22, 2021

© 2021 Kamhawy.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at



Aim: To assess the safety and efficacy of combined surgical and Polidocanol foam sclerotherapy for management of acute bleeding reticular varicose veins (v. v) of the lower limb.

Methods: A prospective clinical study including 125 patients with mean age 43 years, were diagnosed as having acute bleeding reticular varicose veins clinically and with duplex examination. Blood tests for bleeding tendency was done They were treated with elastic bandage local compression as the first line of treatment to give time for stable crust and skin creeping, then Duplex Scanning to detect patency and competency of deep, perforators and superficial venous system. Sapheno-Femoral disconnection (SFD) was done in incompetent group and peroperative Polidocanol (POL) foam sclerotherapy 0.5 to 1% using easy foam syringes, Accuvein AV400, magnification and following patients clinically and with Duplex at one week, 1, 3, 6 months for complications, recurrence and incidence of DVT was reported.

Results: 75 males and 50 females with acute perforative and ulcerative bleeding. Superficial Thrombophlebitis ( STP) was noted distally in 35 cases. Seventeen patients without SFJ reflux with bleeding from medial aspect of the ankle, 34 patients had previous SFD with bleeding from ankle area and chin of the tibia, and 74 with SFJ reflux with bleeding from ankle area and medial side of the leg. In these 74 cases surgery was don under spinal anesthesia plus intraoperative foam sclerotherapy of bleeding reticular v. v. Maximum dose of foam was 10 ml.

No recurrence of bleeding and no DVT.

Conclusion: Using foam sclerotherapy during surgery as a treatment of acute bleeding (v. v). The technique is simple, safe and effective.