Safety and efficiency of perilesional sclerotherapy in leg ulcer patients with postthrombotic syndrome and/or oral anticoagulation with phenprocoumon.

Abstract

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.

• Authors: Markus Stücker, Stefanie Reich, Nico Hermes, Peter Altmeyer
• Journal: Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG (J Dtsch Dermatol Ges) Vol. 4 Issue 9 Pg. 734-8 (Sep 2006) ISSN: 1610-0387 [Electronic] Germany
• PMID: 16928241 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Anticoagulants
• Phenprocoumon

Topics

• Administration, Oral
• Anticoagulants (administration & dosage, adverse effects)
• Chemotherapy, Adjuvant
• Female
• Humans
• Leg Ulcer (therapy)
• Male
• Middle Aged
• Phenprocoumon (administration & dosage, adverse effects)
• Postphlebitic Syndrome (therapy)
• Risk Assessment
• Sclerotherapy (adverse effects, methods)
• Syndrome
• Treatment Outcome