Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/1677-5449.190049
Jornal Vascular Brasileiro
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Influência da escleroterapia ecoguiada com espuma de polidocanol na qualidade de vida na insuficiência venosa crônica de membros inferiores: resultados iniciais

Influence of polidocanol ultrasound-guided foam sclerotherapy on quality of life in lower extremity chronic venous disease: initial results

Afonso César Polimanti; Lucas Abdo Pereira; Tainan Montecorado Carmine; Rafael Vilhena de Carvalho Fürst; Alexandre Sacchetti Bezerra; João Antônio Corrêa

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Resumo

Resumo: A insuficiência venosa crônica (IVC) não só representa um prejuízo na qualidade de vida (QV), como também gera um ônus aos recursos de saúde pública. A escleroterapia ecoguiada com espuma (EEE) vem se mostrando uma boa opção, porém, seu real impacto na QV ainda é incerto. Apresentamos aqui os resultados dos primeiros 27 casos de um estudo prospectivo longitudinal não controlado para avaliação da clínica e QV submetidos a EEE em portadores de IVC CEAP C4 a C6 com contraindicação de cirurgia convencional, com avaliação seriada da clínica por meio do Venous Clinical Severity Score (VCSS) e da QV com o questionário Assessment of Burden Chronic Disease – Venous (ABC-V). Observamos redução do VCSS de 22,2% (p < 0,001) na primeira semana e do score ABC-V de 37,8% (p = 0,003) no primeiro trimestre.

Palavras-chave

estudos prospectivos, qualidade de vida, escleroterapia/efeitos adversos/métodos, inquéritos e questionários, resultado do tratamento, insuficiência venosa/terapia

Abstract

Abstract: Chronic Venous Insufficiency (CVI) is not only detrimental to patients’ Quality of Life (QoL) but also places a considerable burden on public health resources. Ultrasound guided foam sclerotherapy (USFS) is a good treatment option, but its effect on patients’ QOL is still unclear. This article presents the results from the first 27 patients in a prospective, longitudinal, non-controlled study for evaluation of the clinical and QOL impact of USFS treatment for CEAP C4 to C6 grade CVI with contraindications for open surgery. Clinical symptoms were measured with the Venous Clinical Severity Score (VCSS) and QOL by the Assessment of Burden Chronic Disease - Venous questionnaire (ABC-V). We observed 22.2% reductions in VCSS (p<0.001) in the first week after the procedure, and a 37.8% reduction in ABC-V scores (p=0.03) over the first 3 months.
 

Keywords

prospective studies, quality of life, sclerotherapy/adverse effects/methods, surveys and questionnaires, treatment outcome, venous insufficiency/therapy

References

Gloviczki P, Comerota AJ, Dalsing MC, et al. The care of patients with varicose veins and associated chronic venous diseases: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg. 2011;53(5, Suppl):2S-48S. http://dx.doi.org/10.1016/j.jvs.2011.01.079. PMid:21536172.

Chiesa R, Marone EM, Limoni C, Volonte M, Petrini O. Chronic venous disorders: correlation between visible signs, symptoms, and presence of functional disease. J Vasc Surg. 2007;46(2):322-30. http://dx.doi.org/10.1016/j.jvs.2007.04.030. PMid:17600668.

Douglas WS, Simpson NB. Guidelines for the management of chronic venous leg ulceration. Report of a multidisciplinary workshop. British Association of Dermatologists and the Research Unit of the Royal College of Physicians. Br J Dermatol. 1995;132(3):446-52. http://dx.doi.org/10.1111/j.1365-2133.1995.tb08681.x. PMid:7718464.

Nicolaides AN, Allegra C, Bergan J, et al. Management of chronic venous disorders of the lower limbs. Guidelines according to scientific evidence. Int Angiol. 2008;27(1):1-59. PMid:18277340.

Campos W Jr, Torres IO, Silva ES, Casella IB, Puech-Leão P. A prospective randomized study comparing polidocanol foam sclerotherapy with surgical treatment of patients with primary chronic venous insufficiency and ulcer. Ann Vasc Surg. 2015;29(6):1128-35. http://dx.doi.org/10.1016/j.avsg.2015.01.031. PMid:26004968.

Castro e Silva M, Cabral ALS, Barros N Jr, et al. Diagnóstico e tratamento da doença venosa crônica. Normas de orientação clínica da Sociedade Brasileira de Angiologia e Cirurgia Vascular. J Vasc Bras. 2005;4(4):185-94.

Darvall KAL, Bate GR, Adam DJ, Silverman SH, Bradbury AW. Ultrasound-guided foam sclerotherapy for the treatment of chronic venous ulceration: a preliminary study. Eur J Vasc Endovasc Surg. 2009;38(6):764-9. http://dx.doi.org/10.1016/j.ejvs.2009.05.027. PMid:19616975.

Rabe E, Otto J, Schliephake D, Pannier F. Efficacy and safety of great saphenous vein sclerotherapy using standardised polidocanol foam: a randomised controlled multicentre clinical trial. Eur J Vasc Endovasc Surg. 2008;35(2):238-45. http://dx.doi.org/10.1016/j.ejvs.2007.09.006. PMid:17988905.

Almeida RC, Zachêu PRZ, Diniz MT, et al. Portuguese translation and Brazilian cultural adaptation of the Assessment of Burden in Chronic Venous Disease questionnaire (ABC-V). J Hum Growth Dev. 2018;28(1):89-94. http://dx.doi.org/10.7322/jhgd.143885.

Carpentier PH, Maricq HR, Biro C, Poncot-Makinen CO, Franco A. Prevalence, risk factors, and clinical patterns of chronic venous disorders of lower limbs: a population-based study in France. J Vasc Surg. 2004;40(4):650-9. http://dx.doi.org/10.1016/j.jvs.2004.07.025. PMid:15472591.

Porter JM, Moneta GL. Reporting standards in venous disease: an update. International Consensus Committee on Chronic Venous Disease. J Vasc Surg. 1995;21(4):635-45. http://dx.doi.org/10.1016/S0741-5214(95)70195-8. PMid:7707568.

Bradbury A, Evans C, Allan P, Lee A, Ruckley CV, Fowkes FG. What are the symptoms of varicose veins? Edinburgh Vein Study cross sectional population survey. BMJ. 1999;318(7180):353-6. http://dx.doi.org/10.1136/bmj.318.7180.353. PMid:9933194.

Van den Oever R, Hepp B, Debbaut B, Simon I. Socio-economic impact of chronic venous insufficiency: an underestimated public health problem. Int Angiol. 1998;17(3):161-7. PMid:9821029.

Lafuma A, Fagnani F, Peltier-Pujol F, Rauss A. La maladie veineuse en France: un problème de santé publique méconnu (Venous disease in France: An unrecognized health problem). J Mal Vasc. 1994;19(3):185-9. PMid:7798803.

Ghauri AS, Nyamekye I, Grabs AJ, Farndon JR, Whyman MR, Poskitt KR. Influence of a specialised leg ulcer service and venous surgery on the outcome of venous leg ulcers. Eur J Vasc Endovasc Surg. 1998;16(3):238-44. http://dx.doi.org/10.1016/S1078-5884(98)80226-8. PMid:9787306.

Ruckley CV. Socioeconomic impact of chronic venous insufficiency and leg ulcers. Angiology. 1997;48(1):67-9. http://dx.doi.org/10.1177/000331979704800111. PMid:8995346.

Nicolaides AN. The investigation of chronic venous disorders: a consensus statement. Circulation. 2000;102(20):E126-63. http://dx.doi.org/10.1161/01.CIR.102.20.e126. PMid:11076834.

Silva MAM, Araujo AZP, Amaral JF, Silva SG, Cardoso RS, Miranda F. Impacto da escleroterapia com espuma de polidocanol guiada por ultrassom em pacientes com úlcera venosa. J Vasc Bras. 2017;16(3):239-43. http://dx.doi.org/10.1590/1677-5449.002717. PMid:29930653.

Abreu GCG, Camargo O, Abreu MFM, Aquino JLB. Escleroterapia ecoguiada com espuma para tratamento da insuficiência venosa crônica grave. Rev Col Bras Cir. 2017;44(5):511-20. PMid:29019582.

Lattimer CR, Kalodiki E, Azzam M, Geroulakos G. The Aberdeen varicose vein questionnaire may be the preferred method of rationing patients for varicose vein surgery. Angiology. 2014;65(3):205-9. http://dx.doi.org/10.1177/0003319712474953. PMid:23378194.

Masuda EM, Kessler DM, Lurie F, Puggioni A, Kistner RL, Eklof B. The effect of ultrasound-guided sclerotherapy of incompetent perforator veins on venous clinical severity and disability scores. J Vasc Surg. 2006;43(3):551-6, discussion 6-7. http://dx.doi.org/10.1016/j.jvs.2005.11.038. PMid:16520171.

Todd KL 3rd, Wright DI. The VANISH-2 study: a randomized, blinded, multicenter study to evaluate the efficacy and safety of polidocanol endovenous microfoam 0.5% and 1.0% compared with placebo for the treatment of saphenofemoral junction incompetence. Phlebology. 2014;29(9):608-18. http://dx.doi.org/10.1177/0268355513497709. PMid:23864535.

Guex JJ, Rahhali N, Taïeb C. The patient’s burden of chronic venous disorders: construction of a questionnaire. Phlebology. 2010;25(6):280-5. http://dx.doi.org/10.1258/phleb.2010.010039. PMid:21107000.
 

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