Effect of polidocanol foam sclerotherapy for the treatment of venous ulcers: a randomized clinical trial protocol

Main Article Content

Melissa Andreia de Moraes Silva
https://orcid.org/0000-0001-8773-3095
Natália Leite Fortes
https://orcid.org/0009-0002-7242-7786
Luana de Andrade Oliveira
https://orcid.org/0009-0008-6229-5672
Rodolfo Souza Faria

Abstract

Objective: To evaluate the effect of polidocanol foam sclerotherapy in patients with venous ulcers (VU) undergoing clinical treatment with elastocompression. Method: This will be a randomized, prospective, single-center, exploratory clinical trial with two parallel groups and 1:1 allocation. Participants aged 18-80 years with active VU and vascular Doppler ultrasound findings indicating chronic superficial venous insufficiency in both sexes will be included. Participants will be randomized into two groups: the Clinical group (undergoing conservative treatment with elastocompression) and Foam group (undergoing treatment of varicose veins with polidocanol foam associated with elastocompression). Thirty-four patients will be selected for each group. Participants in the Foam group will undergo superficial vein sclerotherapy using the Tessari technique, with the aid of ultrasound. Patients will be reassessed 30, 90, and 180 days after the intervention. The primary outcome will be lesion healing within 180 days. The secondary outcomes will be the VU healing time, rate of lesion area reduction, side effects, pain, quality of life (QOL) using the EQ-5D, and the Venous Clinical Severity Score. The data will be subjected to inferential tests and Kaplan-Meier survival analysis, assuming a significance level of 5%.



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1.
de Moraes Silva MA, Fortes NL, Oliveira L de A, Faria RS. Effect of polidocanol foam sclerotherapy for the treatment of venous ulcers: a randomized clinical trial protocol. HSJ [Internet]. 2025 Feb. 28 [cited 2025 Mar. 9];15:e1469. Available from: https://portalrcs.hcitajuba.org.br/index.php/rcsfmit_zero/article/view/1469
Section
ORIGINAL ARTICLE
Author Biography

Melissa Andreia de Moraes Silva, Hospital de Clínicas de Itajubá, Itajubá - MG, Brasil

Possui graduação em Medicina pela Universidade Estadual do Oeste do Paraná, residência em Cirurgia Geral pela Santa Casa de São Paulo, residência em Cirurgia Vascular pelo Hospital Santa Marcelina e Mestrado em Ciência pela Universidade Federal de São Paulo - Escola Paulista de Medicina. Doutoranda em Ciência pela Universidade Federal de São Paulo - Escola Paulista de Medicina. Título de especialista em Cirurgia Vascular e certificado de área de atuação em Ecografia Vascular com Doppler pela Sociedade Brasileira de Angiologia e Cirurgia Vascular / AMB / CBR. Temas de interesse: Cirurgia Vascular e Ecografia Vascular com Doppler.

References

Eberhardt RT, Raffetto JD. Chronic venous insufficiency. Circulation. 2005;111(18):2398-409. http://doi.org/10.1161/01. CIR.0000164199.72440.08. PMid:15883226. DOI: https://doi.org/10.1161/01.CIR.0000164199.72440.08

Danneil O, Dörler M, Stockfleth E, Stücker M. Factors influencing superficial and deep vein thrombosis after foam sclerotherapy in varicose veins. J Dtsch Dermatol Ges. 2022;20(7):929-38. http://doi.org/10.1111/ddg.14748. PMid:35691945. DOI: https://doi.org/10.1111/ddg.14748

Lobastov K, Vorontsova A, Bargandzhiya A, Tsaplin S, Schastlivtsev I, Barinov V, et al. The frequency and clinical significance of nontarget superficial and deep vein occlusion after physician compounded foam sclerotherapy of varicose tributaries. Phlebology. 2020;35(6):430-9. http://doi. org/10.1177/0268355519898595. PMid:31924136. DOI: https://doi.org/10.1177/0268355519898595

Simka M, Majewski E. The social and economic burden of venous leg ulcers: focus on the role of micronized purified flavonoid fraction adjuvant therapy. Am J Clin Dermatol. 2003;4(8):573- 81. http://doi.org/10.2165/00128071-200304080-00007. PMid:12862500. DOI: https://doi.org/10.2165/00128071-200304080-00007

Phillips T, Stanton B, Provan A, Lew R. A study of the impact of leg ulcers on quality of life: Financial, social, and psychological implications. J Am Acad Dermatol. 1994;31(1):49-53. http:// doi.org/10.1016/S0190-9622(94)70134-2. PMid:8021371. DOI: https://doi.org/10.1016/S0190-9622(94)70134-2

Leclère FM, Puechguiral IR, Rotteleur G, Thomas P, Mordon SR. A prospective randomized study of 980 nm diode laser-assisted venous ulcer healing on 34 patients. Wound Repair Regen. 2010;18(6):580-5. http://doi.org/10.1111/j.1524- 475X.2010.00637.x. PMid:20958856. DOI: https://doi.org/10.1111/j.1524-475X.2010.00637.x

Callam MJ. Epidemiology of varicose veins. Br J Surg. 1994;81(2):167-73. http://doi.org/10.1002/bjs.1800810204. PMid:8156326. DOI: https://doi.org/10.1002/bjs.1800810204

Shi C, Dumville JC, Cullum N, Connaughton E, Norman G. Compression bandages or stockings versus no compression for treating venous leg ulcers. Cochrane Database Syst Rev. 2021;2021(7):CD013397. PMid:34308565. DOI: https://doi.org/10.1002/14651858.CD013397.pub2

Nelson EA, Bell‐Syer SE. Compression for preventing recurrence of venous ulcers. Cochrane Database Syst Rev. 2014;7(9):CD002303. http://doi.org/10.1002/14651858. CD002303.pub3. PMid:25203307. DOI: https://doi.org/10.1002/14651858.CD002303.pub3

Tessari L, Cavezzi A, Frullini A. Preliminary experience with a new sclerosing foam in the treatment of varicose veins. Dermatol Surg. 2001;27(1):58-60. PMid:11231246. DOI: https://doi.org/10.1046/j.1524-4725.2001.00192.x

Silva MAM, Araujo AZP, Amaral JF, Jesus-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://doi.org/10.1590/1677- 5449.002717. PMid:29930653. DOI: https://doi.org/10.1590/1677-5449.002717

O’Hare JL, Earnshaw JJ. Randomized clinical trial of foam sclerotherapy for patients with a venous leg ulcer. Eur J Vasc Endovasc Surg. 2010;39(4):495-9. http://doi.org/10.1016/j. ejvs.2009.11.025. PMid:20006528. DOI: https://doi.org/10.1016/j.ejvs.2009.11.025

Neaume N. Management of venous ulceration (interventional treatments) with perspectives from a recent meta-analysis and recommendations. Phlebolymphology [Internet]. 2021 [cited 2023 Sept 3];28(3):119-27. Available from: https://www. phlebolymphology.org/management-of-venous-ulceration-interventional-treatments-with-perspectives-from-a-recent-meta-analysis-and-recommendations/

Cavezzi A, Frullini A, Ricci S, Tessari L. Treatment of varicose veins by foam sclerotherapy: two clinical series. Phlebology. 2002;17(1):13-8. http://doi.org/10.1177/026835550201700105. DOI: https://doi.org/10.1007/BF02667958

Passman MA, McLafferty RB, Lentz MF, Nagre SB, Iafrati MD, Bohannon WT, et al. Validation of Venous Clinical Severity Score (VCSS) with other venous severity assessment tools from the American Venous Forum, National Venous Screening Program. J Vasc Surg. 2011;54(6, Suppl):2S-9S. http://doi.org/10.1016/j. jvs.2011.05.117. PMid:21962926. DOI: https://doi.org/10.1016/j.jvs.2011.05.117

Lurie F, Passman M, Meisner M, Dalsing M, Masuda E, Welch H, et al. The 2020 update of the CEAP classification system and reporting standards. J Vasc Surg Venous Lymphat Disord. 2020;8(3):342-52. http://doi.org/10.1016/j.jvsv.2019.12.075. PMid:32113854. DOI: https://doi.org/10.1016/j.jvsv.2019.12.075

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