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Second Congress of Cardiology and Angiology of Bosnia & Herzegovina

 

SCLEROTHERAPY IN THE MANAGEMENT OF VARICOSE VEINS AND DISORDERS OF THE VENOUS CIRCULATION - PART II
S. Pehar, M. Dilić and S. Švrakić .
Institute of Vascular Diseases, Clinical Center University of Sarajevo, Bosnia and Herzegovina

Sclerotherapy is one of the treatment options in varicose veins of the lower limbs. Percentage of adult patiens suffering from varioce veins ranges between 25-32% in females, and 15-20% in males. The new concepts in the management of the varicose syndrome include combination and simultaneosly applied measures - elimination of risk factors, bandage protection, medication, sclerotherapy, surgical treatment. First step of any serious approach to pts. with varicose veins is: (i) constant and long term elimination of risk and provocating factors, (ii) futher step is appropriate bandage prevention with multilevel grading elastic stockings, (iii) medication, (iv) sclerotherapy by the injection of sclerosing solutions, (v) surgical treatment. Sclerotherapy and surgery are used to remove the varicose veins and heal terminal stage of the disease. Both methods show good results only if they are applied following a valid assessment of deep venous flow, valve condition, and perforating vein condition. Additionally, a careful planning of the treatment is nessesary. Due to the complexity of the problem an expert teams should be in the charge of the planning and overall management. The techniques differ in many respects due to clinical aspects, sclerosant drugs, approach to risk-areas, possible complications, and cost-effectivness of treatment. Combination of sclerotherapy and operative therapy shows good results and maximum success. The criteria for application of sclerotherapy, as well as the equipment needed for the application, are specified in the paper but special point is perforating and reccurent varicose veins. The effect of the sclerosing solutions upon the blood vessels and contraindications are also described.

Drugi kongres kardiologa i angiologa Bosne i Hercegovine
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