Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/1677-5449.8314
Jornal Vascular Brasileiro
Original Article

Evaluation of quality of life and photoplethysmography in patients with chronic venous insufficiency treated with foam sclerotherapy

Avaliação da qualidade de vida e fotopletismografia em pacientes com insuficiência venosa crônica tratados através de escleroterapia com espuma

Felipe Coelho Neto; Gilson Roberto Araújo; Iruena Moraes Kessler

Downloads: 0
Views: 94

Abstract

BACKGROUND: Ultrasound-guided foam sclerotherapy plays a major role in treatment of chronic venous insufficiency, providing clinical and hemodynamic improvement to patients undergoing treatment.OBJECTIVES: To examine the relationships between venous refilling time and impact of venous disease on quality of life and between changes in venous refilling time and improvement of symptoms after ultrasound-guided foam sclerotherapy for chronic venous insufficiency.METHODS: Thirty-two patients classified as C4, C5 or C6 answered a questionnaire on quality of life and symptoms and their venous filling time was measured using photoplethysmography before and 45 days after treatment of chronic venous insufficiency with ultrasound-guided foam sclerotherapy.RESULTS: Statistically significant improvements were observed in quality of life scores and in venous filling time and in the following symptoms: aching, heavy legs, restless legs, swelling, burning sensations, and throbbing (p<0.0001). A similar improvement was also seen in the work and social domains of quality of life (p<0.0001).CONCLUSIONS: As confirmed by questionnaire scores and venous refilling times, ultrasound-guided foam sclerotherapy demonstrated efficacy and resulted in high satisfaction levels and low rates of major complications.

Keywords

quality of life, chronic venous insufficiency, photoplethysmography, sclerotherapy, sclerosing solutions, color Doppler ultrasonography, varicose veins

Resumo

CONTEXTO: A escleroterapia com espuma guiada por ultrassom (EGUS) ocupa lugar de destaque no tratamento da insuficiência venosa crônica (IVC), proporcionando melhora clínica e hemodinâmica aos pacientes submetidos ao tratamento.OBJETIVOS: Verificar a correlação entre dados obtidos por questionário de qualidade de vida e de sintomas com dados obtidos por fotopletismografia (FPG), antes e depois do tratamento por escleroterapia com espuma guiada por ultrassom (EGUS) da insuficiência venosa crônica (IVC).MÉTODOS: Um grupo de 32 pacientes, classificados como C4, C5 e C6, foi submetido à aplicação de questionário de qualidade de vida e sintomas, sendo aferido o tempo de enchimento venoso (TEV) por FPG antes e 45 dias depois do tratamento da IVC através de EGUS. O teste do sinal foi utilizado para análise estatística da melhora dos escores dos questionários e do TEV. O teste de McNemar foi utilizado para avaliação da melhora nos sintomas e do impacto do tratamento nas atividades laborais e sociais dos pacientes.RESULTADOS: Houve melhora nos escores dos questionários de qualidade de vida e no TEV, com significância estatística (p<0,0001). Houve melhora estatisticamente significativa nos sintomas: dor, cansaço, edema, queimação, pernas inquietas e latejamento (p<0,0001). Incremento na qualidade laboral e social após o tratamento apresentou melhora estatisticamente significativa (p<0,0001). Não ocorreram complicações maiores ou efeitos adversos nesta série.CONCLUSÕES: A EGUS mostrou-se eficaz, com alto índice de satisfação e baixas taxas de complicacões maiores, ratificada pelos escores dos questionários e pelos TEVs aferidos pela FPG.

Palavras-chave

qualidade de vida, insuficiência venosa crônica, fotopletismografia, escleroterapia, soluções esclerosantes, ultrassonografia Doppler em cores, varizes

References

Silva MC. Chronic venous insufficiency of the lower limbs and its socio-economic significance. Int Angiol.. 1991;10(3):152-7.

Guex JJ, Isaacs MN. Comparison of surgery and ultrasound guided sclerotherapy for treatment of saphenous varicose veins: must the criteria for assessment be the same?. Int Angiol.. 2000;19(4):299-302.

Wright D, Gobin JP, Bradbury AW, et al. Varisolve(r) polidocanol microfoam compared with surgery or sclerotherapy in the management of varicose veins in the presence of trunk vein incompetence: European randomized controlled trial. Phlebology.. 2006;21(4):180-90.

Orsini C, Brotto M. Immediate pathologic effects on the vein wall of foam sclerotherapy. Dermatol Surg.. 2007;33(10):1250-4.

Figueiredo M, Araújo SP, Penha-Silva N. Microfoam ultrasound-guided sclerotherapy in primary trunk varicose veins. J Vasc Bras.. 2006;5(3):177-83.

Lamping DL, Schroter S, Kurz X, Kahn SR, Abenhaim L. Evaluation of outcomes in chronic venous disorders of the leg: development of a scientifically rigorous, patient-reported measure of symptoms and quality of life. J Vasc Surg.. 2003;37(2):410-9.

Kahn SR, Lamping DL, Ducruet T, et al. VEINES-QOL/Sym questionnaire was a reliable and valid disease-specific quality of life measure for deep venous thrombosis. J Clin Epidemiol.. 2006;59(10):1056e1-4.

Rosfors S. Venous photoplethysmography: relationship between transducer position and regional distribution of venous insufficiency. J Vasc Surg.. 1990;11(3):436-40.

Abramowitz HB, Queral LA, Finn WR, et al. The use of photoplethysmography in the assessment of venous insufficiency: a comparison to venous pressure measurements. Surgery.. 1979;86(3):434-41.

Nicolaides AN, Miles C. Photoplethysmography in the assessment of venous insufficiency. J Vasc Surg.. 1987;5(3):405-12.

Bradbury AW, Bate G, Pang K, Darvall KA, Adam DJ. Ultrasound-guided foam sclerotherapy is a safe and clinically effective treatment for superficial venous reflux. J Vasc Surg.. 2010;52(4):939-45.

Kulkarni SR, Barwell JR, Gohel MS, Bulbulia RA, Whyman MR, Poskitt KR. Residual venous reflux after superficial venous surgery does not predict ulcer recurrence. Eur J Vasc Endovasc Surg.. 2007;34(1):107-11.

Eklöf B, Rutherford RB, Bergan JJ,. Revision of the CEAP classification for chronic venous disorders: consensus statement. J Vasc Surg.. 2004;40(6):1248-52.

Labropoulos N, Tiongson J, Pryor L. Definition of venous reflux in lower-extremity veins. J Vasc Surg.. 2006;38(4):793-8.

Sandri JL, Barros FS, Pontes S, Jacques C, Salles-Cunha SX. Diameter-reflux relationship in perforating veins of patients with varicose veins. J Vasc Surg.. 1999;30(5):867-74.

Sam RC, Darvall KA, Adam DJ, Silverman SH, Bradbury AW. Digital venous photoplethysmography in the seated position is a reproducible noninvasive measure of lower limb venous function in patients with isolated superficial venous reflux. J Vasc Surg.. 2006;43(2):335-41.

Moura RMF, Gonçalves GS, Navarro TP, Britto RR, Dias RC. Transcultural adaptation of VEINES/QOL-Sym questionnaire: evaluation of quality of life and symptoms in chronic venous disease. J Vasc Bras.. 2011;10(1):17-23.

Coelho F No, Araujo GR, Kessler IM, Amorim RF, Falcao DP. Treatment of severe chronic venous insufficiency with ultrasound-guided foam sclerotherapy: a two-year series in a single center in Brazil. Phlebology.. 2006;30(2):113-8.

Darwood RJ, Gough MJ. Endovenous laser treatment for uncomplicated varicose veins. Phlebology.. 2009;24(Suppl 1):50-61.

Gohel MS, Davies AH. Radiofrequency ablation for uncomplicated varicose veins. Phlebology.. 2009;24(Suppl 1):42-9.

Smith PC. Foam and liquid sclerotherapy for varicose veins. Phlebology.. 2009;24(Suppl 1):62-72.

Proebstle TM, Vago B, Alm J, Göckeritz O, Lebard C, Pichot O. Treatment of the incompetent great saphenous vein by endovenous radiofrequency powered segmental thermal ablation: first clinical experience. J Vasc Surg.. 2008;47(1):151e1-6e1.

Garratt AM, Macdonald LM, Ruta DA, Russell IT, Buckingham JK, Krukowski ZH. Towards measurement of outcome for patients with varicose veins. Qual Health Care.. 1993;2(1):5-10.

Smith JJ, Garratt AM, Guest M, Greenhalgh RM, Davies AH. Evaluating and improving health-related quality of life in patients with varicose veins. J Vasc Surg.. 1999;30(4):710-9.

Nicolaides AN. Cardiovascular Disease Educational and Research Trust, European Society of Vascular Surgery, The International Angiology Scientific Activity Congress Organization, International Union of Angiology, Union Internationale de Phlebologie at the Abbaye des Vaux de Cernay. Investigation of chronic venous insufficiency: a consensus statement (France, March 5-9, 1997). Circulation.. 2000;102(20):E126-63.

Engelhorn CA, Beffa CV, Bochi G. Can air plethysmography evaluate the severity of chronic venous insufficiency?. J Vasc Bras.. 2004;3:311-6.

Rasmussen LH, Lawaetz M, Bjoern L, Vennits B, Blemings A, Eklof B. Randomized clinical trial comparing endovenous laser ablation, radiofrequency ablation, foam sclerotherapy and surgical stripping for great saphenous varicose veins. Br J Surg.. 2011;98(8):1079-87.

Ruckley CV. Socioeconomic impact of chronic venous insufficiency and leg ulcers. Angiology.. 1997;48(1):67-9.

Cavezzi A, Parsi K. Complications of foam sclerotherapy. Phlebology.. 2012;27(Suppl 1):46-51.

Jia X, Mowatt G, Burr JM, Cassar K, Cook J, Fraser C. Systematic review of foam sclerotherapy for varicose veins. Br J Surg.. 2007;94(8):925-36.

Couto RC, Leal FJ, Pitta GBB, Bezerra RCB, Segundo Walmir SS, Porto TM. Tradução e adaptação cultural do Charing Cross Venous Ulcer Questionnaire - Brasil. J Vasc Bras.. 2012;11(2):102-7.

5de7f2980e88257a18e31d41 jvb Articles
Links & Downloads

J Vasc Bras

Share this page
Page Sections