Sclerotherapy of varicose veins in patients with documented thrombophilia: a prospective controlled randomized study of 105 cases

Phlebology. 2009 Aug;24(4):176-82. doi: 10.1258/phleb.2009.008081.

Abstract

Objectives: The aim of this study was to assess thrombotic complications following sclerotherapy in thrombophilic patients in combination with thromboprophylaxis, in two randomized arms using low molecular weight heparin (LMWH) or warfarin. Patients and methods This study received approval from the Ethics Committee. A total of 105 patients (81 females, 24 males) ranging in age from 20 to 82 years (mean 50) were selected: 75 with Factor V Leiden mutation, 18 with prothrombin 20210A mutation, 7 with high level of Factor VIII, 5 combinations of these. After randomization, 51 and 54 patients received warfarin and LMWH, respectively. A total of 199 sclerotherapy sessions were performed. Foam was used in 160 treatments.

Results: No episodes of symptomatic deep vein thrombosis (DVT) or pulmonary embolism (PE) occurred; no instances of DVT were revealed by ultrasound-monitoring.

Conclusions: This study suggests that in the three most common forms of thrombophilia, sclerotherapy, in combination with thromboprophylaxis, can be performed safely. Prophylaxis with LMWH is easier to use than warfarin.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Factor V / genetics
  • Female
  • Heparin, Low-Molecular-Weight / therapeutic use
  • Humans
  • Male
  • Middle Aged
  • Mutation
  • Prospective Studies
  • Sclerosing Solutions / therapeutic use
  • Sclerotherapy / methods*
  • Thrombophilia / complications*
  • Thrombophilia / genetics
  • Thrombophilia / therapy*
  • Thrombosis
  • Varicose Veins / complications*
  • Varicose Veins / therapy*
  • Warfarin / therapeutic use

Substances

  • Heparin, Low-Molecular-Weight
  • Sclerosing Solutions
  • factor V Leiden
  • Warfarin
  • Factor V