[Sclerosing agents in clinical practice]

The objective of all forms of sclerotization by substances irritating the endothelium is the production of a permanent fibrous venous occlusion and reflux points controlling the abnormal flow of venous blood. The high percentage of relapses after surgery-as high as 65% within five years after surgery was the authors' motivation for the evaluation of results of two sclerotization technique: Sigg's Swiss method using Aethoxysclerol as the sclerotizing substance and Fegan's English method using S.T.D. substance.

In 1974 to 1994 the authors sclerotized a total of 3161 patients, 84% women (mean age 43.7 years-range 15 to 78) and 16% men (men age 47.3 years-range 17 to 73). In 1973 to 1983 they used Sigg's technique with Aethoxysclerol (0.5 to 4% concentration). This group comprised 1325 patients. In 1983 to 1994 they used only the English technique described by Fegan, using S.T.D. The latter group comprised 1836 patients. In patients where there were doubts about the condition of the deep and perforating venous system they used as a diagnostic method aimed phlebography under sciascopic control (134 patients-4.2%) and as to non-invasive examination methods duplex sonography (235 patients-7.45%) and light reflex rheography (50 patients-1.5%). Comparison of the results did not reveal any statistically significant differences. The best effect was achieved with rapid and complete healing of ulcerations in chronic venous insufficiency in as many as 93/92%. More complications were recorded when using S.T.D., such as necroses at the site of administration, temporary teleangiectasias and hyperpigmentations, the statistical significance being p < 0.05. The most frequent complication when using Aethoxysclerol were collapses in hypotensive patients, the statistical significance being similar.

The authors evaluate the two techniques as simple, effective and safe. They can be used as alternatives of surgical treatment. The advantage is that treatment is ambulatory, it leaves the vena saphena intact in situ and does not involve anaesthetic and surgical risks.