Randomised clinical trial of foam sclerotherapy for patients with a venous leg ulcer

Eur J Vasc Endovasc Surg. 2010 Apr;39(4):495-9. doi: 10.1016/j.ejvs.2009.11.025. Epub 2009 Dec 16.

Abstract

Objectives: To assess whether routine use of foam sclerotherapy, in addition to four-layer compression bandaging, could speed up the healing of venous ulcers.

Design: Randomised controlled trial involving patients recruited from a nurse-led leg ulcer clinic. A total of 315 new patients were assessed, and eleven patients were identified from follow-up clinics.

Methods: Inclusion criteria were: patients with an active venous leg ulcer, in the presence of superficial truncal venous incompetence and without total deep venous incompetence on duplex imaging. Patients were randomised to four-layer compression bandages alone (control) or with additional foam sclerotherapy to incompetent superficial truncal veins. The primary endpoint was ulcer healing 24 weeks after randomisation.

Results: It was only possible to recruit 40 patients who were suitable for analysis: 22 control, 18 additional foam sclerotherapy. There was no complication from the foam treatment and at six months the target vein was occluded in 9 of 11 evaluable patients that had foam. One patient died before 24 weeks from an unrelated cause. At 24 weeks, 17 of 20 (85% - 1 died) in the control group and 12 of 13 (92%) patients with additional foam sclerotherapy had ulcer healing (P=0.72, log rank testing).

Conclusion: This trial failed to recruit sufficient patients for formal comparison, but foam sclerotherapy was feasible as an adjunct to compression therapy for venous ulceration.

Trial registration: Eudra CT 2005-001551-38.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Combined Modality Therapy
  • Feasibility Studies
  • Humans
  • Kaplan-Meier Estimate
  • Middle Aged
  • Patient Selection
  • Recurrence
  • Sample Size
  • Sclerosing Solutions / adverse effects
  • Sclerosing Solutions / therapeutic use*
  • Sclerotherapy* / adverse effects
  • Stockings, Compression
  • Time Factors
  • Treatment Outcome
  • Varicose Ulcer / physiopathology
  • Varicose Ulcer / therapy*
  • Wound Healing*

Substances

  • Sclerosing Solutions