Efeitos colaterais em escleroterapia com espuma da Safena Magna e Parva
Autor: José Amorim de Andrade | Publicado: 2009-11-09T23:39:00-02:00

A escleroterapia das veias safenas é um procedimento que precisa ser bem  avaliado por aqueles especialistas que se dispoem a aplicá-lo em seus pacientes.  A técnica de esleroterapia com espuma já se revelou uma ótima solução para o  tratamento das varizes e das microvarizes. Não é uma técnica nova como parecem  mostrar algumas páginas da internet e principalmente alguns programas de  televisão. Entretanto, a sua aplicação nas veias safenas vem apresentando uma  série de efeitos colaterais que precisam ser seriamente levados em  consideração.Na medida do possível disponibilizarei neste blog publicações  concernentes ao tema.Abaixo um resumo de um controle prospectivo  multicêntrico publicado em 01 de junho de 2009 na revista PHLEBOLOGY,  envolvendo 1025 pacientes de 20 clínicas de flebologia na  França.__________________________________________________________________________________________Side-effects  and complications of foam sclerotherapy of the great and small saphenous veins:  a controlled multicentre prospective study including 1025  patientsJ-L Gillet * , J M Guedes , J-J Guex , C Hamel-Desnos , M  Schadeck **, M Lauseker and F A Allaert* 51 bis Avenue Professeur Tixier,  38300 Bourgoin-Jallieu, France; 31 rue Amiral Gourbeyre, 63200 Riom, France; 32  boulevard Dubouchage, 06000 Nice, France; 18 rue des Rocquemonts, 14050 Caen,  France; ** 5 rue Michel Charles, 75012 Paris, France; 7 B rue de l’Hopital,  67600 Selestat, France; Chaire d’Evaluation Médicale Ceren ESC &amp;  Cenbiotech/dim CHU du Bocage, 21000 Dijon, France  Correspondence: J-L Gillet MD, Vascular Medicine – Phlebology, 51 bis Avenue  Professeur Tixier, 38300 Bourgoin-Jallieu, France. Email:  gilletjeanluc@aol.com Objectives: Increasing interest in foam sclerotherapy (FS) for saphenous  insufficiency has highlighted the need to study the side-effects and  complications of this treatment. The aim of this study is to better assess their  nature and incidence.  Methods: A multicentre, prospective and controlled study was carried out in  which patients treated with FS for great (GSV) and small saphenous veins (SSV)  trunk incompetence were included. Immediate untoward events were reported.  Duplex ultrasound (DUS) examination was carried out to assess all patients  between the eighth and 30th day. In addition, 20% of patients were called by an  external auditor.  Results: In total, 818 GSV and 207 SSV were treated in 1025 patients in 20  phlebology clinics. Ninety-nine percent of patients were controlled with DUS and  non-duplex-checked patients were all called. The saphenous trunk was occluded in  90.3% of patients. Twenty-seven (2.6%) side-effects were reported: migraine (n =  8, 4 with visual disturbance); visual disturbance alone (n = 7); chest pressure  alone (n = 7); and chest pressure associated with visual disturbance (n = 5).  Eleven thrombo-embolic events occurred: 10 deep vein thrombosis (DVT) but only  five in symptomatic patients, and one pulmonary embolism that occurred 19 days  following the FS without DVT identified by DUS. One transient ischaemic stroke,  with complete clinical recovery in 30 minutes, and one septicaemia with  satisfactory outcome were reported as well.  Conclusion: This study demonstrates in a large sample of patients a low rate  of adverse reactions after FS of great and small saphenous trunks. However, but  the eventuality of exceptional but more serious complications has to be taken  into account in the management of patients. A multicentre study like this one  takes into account different practices and reports all possible complications,  thus demonstrating the need for a common validated protocol.