Work

Controlled venospasm-assisted foam sclerotherapy combined with high ligation—a novel minimally invasive approach for primary great saphenous vein varicosities

Year: 2026

Type: article

Abstract: Purpose This study aimed to evaluate the efficacy and safety of Controlled Venospasm-Assisted Foam Sclerotherapy (CVAFS) combined with high ligation (HL) for treating primary great saphenous vein (GSV) varicosities. Materials and methods A retrospective cohort of 127 patients with primary GSV varicosities underwent CVAFS with high ligation between 1 Jan 2023 and 1 October 2023. Venospasm was induced by rotational mechanical stimulation of the catheter combined with external compression, resulting in a transient reduction of vessel diameter by 50%–70%, followed by DSA (Digital subtraction angiography)-guided foam injection (1:4 liquid-to-gas ratio). Technical success was defined as complete procedural execution under imaging guidance. Primary endpoints included 1-year GSV occlusion rate (assessed by duplex ultrasound) and reduction in Venous Clinical Severity Score (VCSS). Complications were recorded and managed conservatively. Results Technical success was achieved in 100% of limbs (145/145). Among 127 enrolled patients, 109 patients (125 limbs) completed the 12-month follow-up, yielding a follow-up rate of 85.8% (109/127). At 12 months, 93.6% of great saphenous veins (117/125 limbs) maintained complete occlusion. The Venous Clinical Severity Score (VCSS) significantly decreased from 6.18 ± 3.90 preoperatively to 0.86 ± 0.90 postoperatively ( V = 7,875, p < 0.001). Thrombophlebitis observed in 9.6% of limbs (12/125), all cases resolved spontaneously within 2 weeks with conservative management (warm compression and NSAIDs). Saphenous Junction Pain occurred in 32.8% of limbs (41/125), with complete resolution within 2 weeks without intervention. No deep venous thrombosis (DVT), pulmonary embolism, skin necrosis, or neurological injuries were documented. Conclusion CVAFS leverages controlled venospasm to enhance foam-endothelium contact, significantly improving occlusion rates and symptom relief with acceptable safety. This approach offers a promising minimally invasive alternative for GSV varicosities.

Source: Frontiers in Surgery

DOI: 10.3389/fsurg.2025.1730329

Authors: Chen Ya, Liu Zechao, Zhu Xuchang, Chen Boyu, Liu Zhengli, Kong Jie

Institutions: Yangtze University, Nanjing First Hospital, Nanjing Medical University

Language: English

Topic: Diagnosis and Treatment of Venous Diseases

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801