Clinical Report: Comparative Analysis of UGFS and Open Surgical Ligation for IPVs
Overview
This study compares the efficacy and safety of ultrasound-guided foam sclerotherapy (UGFS) and open surgical ligation for treating incompetent perforator veins (IPVs). UGFS demonstrated shorter operative times and lower complication rates, although open surgery had higher long-term occlusion rates, which are statistically significant.
Background
Chronic venous disease (CVD) is a significant public health issue, affecting a large portion of the adult population and leading to various clinical manifestations. Incompetent perforator veins (IPVs) are crucial in the progression of CVD, necessitating effective treatment strategies. The shift towards minimally invasive techniques like UGFS offers potential benefits over traditional surgical methods, warranting comparative analysis.
Data Highlights
Parameter
UGFS (Group A)
Open Surgery (Group B)
Operative Time (min)
56.27 ± 9.70
68.60 ± 9.41
Intraoperative Blood Loss (mL)
4.18 ± 2.37
8.85 ± 4.48
24-hour VAS Score
1 (2)
3 (1)
12-month Occlusion Rate
86.8%
95.3%
Total Complication Rate
10.2% (not statistically significant)
22.9%
Key Findings
UGFS resulted in shorter operative times compared to open surgery (56.27 vs. 68.60 min).
Intraoperative blood loss was significantly lower in the UGFS group (4.18 mL vs. 8.85 mL).
UGFS had a lower 24-hour postoperative VAS score (1 vs. 3).
At 12 months, the occlusion rate was significantly higher in the open surgery group (95.3% vs. 86.8%).
The total complication rate was lower in the UGFS group (10.2% vs. 22.9%), though this difference did not reach statistical significance (P = 0.092).
Independent risk factors for recanalization post-UGFS included perforator vein diameter >4.5 mm and BMI >27.2 kg/m2.
Clinical Implications
The findings suggest that UGFS is a viable minimally invasive alternative to open surgical ligation for treating IPVs, with advantages in operative time and immediate postoperative recovery. However, clinicians should consider individual patient characteristics, such as vein diameter and BMI, as well as the statistical significance of outcomes when deciding on treatment strategies.
Conclusion
UGFS presents a favorable safety and efficacy profile for treating IPVs, supporting its use as a minimally invasive option. Individualized treatment approaches, based on statistical findings and patient characteristics, are essential for optimizing patient outcomes.
