Role Of Duplex Guided Foam Sclerotherapy For The Treatment Of Chronic Venous Ulcers

Abstract

Venous ulceration is the most common type of leg ulceration. 60 to 80% of leg ulcers have a venous component. Chronic venous leg ulceration has an estimated prevalence increases with age. Approximately 1% of the population will suffer from leg ulceration at some point in their lives. Chronic venous leg ulcer is defined as an open lesion between the knee and the ankle joint that remains unhealed for at least four weeks and occurs in the presence of venous disease. Venous ulcers arise from venous valve incompetence and calf muscle pump insufficiency which leads to venous stasis and hypertension. This results in microcirculatory changes and localised tissue ischaemia. The natural history of the disease is of a continuous cycle of healing and breakdown over decades and chronic venous leg ulcers are associated with considerable morbidity and impaired quality of life. Leg ulcers in patients from the most deprived communities take longer to heal and are more likely to be recurrent. There are a number of noninvasive and invasive techniques to assist in the diagnosis and management. The most commonly used is the venous Duplex ultrasound to confirm the diagnosis and provide anatomic detail. Treatment of venous insufficiency has recently been revolutionized by introduction of new, less-invasive procedures for saphenous closure as alternatives to surgery. Foam Sclerotherapy by the injection of sclerosent capable of transforming the walls of veins into fibrotic cords is the most simple technique of them