CC BY-NC-ND 4.0 · Phlebologie 1998; 27(03): 27-34
DOI: 10.1055/s-0038-1639018
Original Article
Schattauer GmbH

Leitlinie[*]: Sklerosierungsbehandlung der Varikose

(ICD 10: I83.0, I83.1, I83.2, I83.9)
E. Rabe
1   Department of Dermatology, University of Bonn
,
F. Pannier
1   Department of Dermatology, University of Bonn
,
H. Gerlach
2   Department of Dermatology, University of Mannheim
,
F. X. Breu
3   Department of Dermatology, University of Rottach-Egern
,
S. Guggenbichler
4   Department of Dermatology, University of München
,
J. C. Wollmann
5   Department of Dermatology, University of Chemische Fabrik Kreussler & Co. GmbH, Wiesbaden
› Author Affiliations
Further Information

Publication History

Eingegangen: 22 November 2007



Publication Date:
06 March 2018 (online)

Leitlinien sind systematisch erarbeitete Empfehlungen, um den Kliniker und den Praktiker bei Entscheidungen über die angemessene Versorgung der Patienten im Rahmen spezifischer klinischer Umstände zu unterstützen.

Leitlinien gelten für „Standardsituationen“ und berücksichtigen die aktuellen, zu den entsprechenden Fragestellungen zur Verfügung stehenden, wissenschaftlichen Erkenntnisse. Leitlinien bedürfen der ständigen Überprüfung und eventuell der Änderung auf dem Boden des wissenschaftlichen Erkenntnisstandes und der Praktikabilität in der täglichen Praxis. Durch die Leitlinien soll die Methodenfreiheit des Arztes nicht eingeschränkt werden. Ihre Beachtung garantiert nicht in jedem Fall den diagnostischen und therapeutischen Erfolg. Leitlinien erheben keinen Anspruch auf Vollständigkeit. Die Entscheidung über die Angemessenheit der zu ergreifenden Maßnahmen trifft der Arzt unter Berücksichtigung der individuellen Problematik.

* Diese Leitlinie wurde im Auftrag der Deutschen Gesellschaft für Phlebologie (DGP) ausgearbeitet, vom Vorstand und im wissenschaftlichen Beirat der DGP am 15.06.2001 verabschiedet, am 26.09.2007 novelliert und ersetzt die Vorversion vom 12.05.2003 (75). Diese Leitlinie berücksichtigt den aktuellen Stand der Literatur, aber nicht die in jedem Fall unterschiedlichen Zulassungsbestimmungen für die verschiedenen Pharmaka. Gültigkeit: bis 31.12.2010


 
  • Literatur

  • 1 Alos J, Carreno P, Lopez JA, Estadella B, Serra-Prat M, Marinel-Lo J. Efficacy and safety of sclerotherapy using Polidocanol foam: A controlled clinical trial. Eur J Vasc Endovasc Surg 2006; 31,1: 101-107.
  • 2 Baccaglini U, Spreafico G, Castoro C, Sorrentino P. Consensus Conference on Sclerotherapy or Varicose Veins of the Lower Limbs. Phlebology 1997; 12: 2-16.
  • 3 Baccaglini U, Stemmer R, Partsch U. Internationale Fragebogenaktion zur Praxis der Verödungsbehandlung. Phlebologie 1997; 26: 129-142.
  • 4 Barrett JM, Allen B, Ockelford A, Goldman MP. Microfoam ultrasound-guided sclerotherapy of varicose veins in 100 legs. Dermatol Surg 2004; 20: 6-12.
  • 5 Benigni JP. Sclérothérapieàlamousse et migraines à aura. Phlébologie 2005; 58,4: 323-324.
  • 6 Bergan JJ, Weiss RA, Goldman MP. Extensive tissue necrosis following high concentration sclerotherapy for varicose veins. Dermatol Surg 2000; 26: 535-542.
  • 7 Bergan JJ, Pascarella L, Mekenas L. Venous disorders: Treatment with sclerosant foam. J Cardiovasc Surg 2006; 47,1: 9-18.
  • 8 Breu FX, Guggenbichler S. European consensus meeting on foam sclerotherapy. April, 4–6, 2003, Tegernsee, Germany. Dermatol Surg 2004; 30,5: 709-717.
  • 9 Breu FX, Guggenbichler Wollmann JC. 2nd European Consensus Meeting on Foam Sclerotherapy, 28 –30April 2006, Tegernsee, Germany. Vasa 2008; 37 Suppl (71) 1-32.
  • 10 Breu FX, Marshall M. Sklerotherapie mit Polidocanol in einer angiologisch-phlebologischen Spezialpraxis. Prospektive und retrospektive Erhebung über Ergebnisse und Komplikationen. Phlebologie 2003; 32: 76-80.
  • 11 Breu FX, Partsch B. Reversible neurologische Komplikationen bei der Schaum-Sklerotherapie. Phlebologie 2006; 3: 115-116.
  • 12 Brodersen JP. Catheter-assisted vein sclerotherapy: A new approach for sclerotherapy of the greater saphenous vein with a double-lumen balloon catheter. Dermatol Surg 2007; 33,4: 469-475.
  • 13 Bullens-Goessens YIJM, Mentink LF, Nelemans PJ, Van Geest AJ, Veraart JCJM. Ultrasound-guided sclerotherapy of the insufficient short saphenous vein. Phlebologie 2004; 33,3: 89-91.
  • 14 Cabrera J, Redondo P, Becerra A, Garrido C, Cabrera Jr J, Garcia-Olmedo MA, Sierra A, Lloret P. et al. Ultrasound-guided injection of Polidocanol microfoam in the management of venous leg ulcers. ArchDermatol 2004; 140: 667-673.
  • 15 Cavezzi A, Frullini A, Ricci S, Tessari L. Treatment of varicose veins by foam sclerotherapy: Two clinical series. Phlebology 2002; 17: 13-18.
  • 16 Ceulen RPM, Bullens-Goessens YIJM, Pi-Van De Venne SJA. Outcomes and side effects of duplex-guided sclerotherapy in the treatment of great saphenous veins with 1% versus 3% Polidocanol foam: Results of a randomized controlled trial with 1-year follow-up. DermatolSurg 2007; 33,3: 276-281.
  • 17 Coleridge Smith PD. Chronic venous disease treated by ultrasound guided foam sclerotherapy. Eur J Vasc Endovasc Surg 2006; 32,5: 577-583.
  • 18 Conrad P, Malouf GM, Stacey MC. The Australian Polidocanol (Aethoxysklerol) study. Results at 2 years. Dermatol Surg 1995; 21: 334-336.
  • 19 De Waard MM, Der Kinderen DJ. Duplex ultrasonography-guided foam sclerotherapy of incompetent perforator veins in a patient with bilateral venous leg ulcers. Dermatol Surg 2005; 31,5: 580-583.
  • 20 Darke SG, Baker SJ. Ultrasound-guided foam sclerotherapy for the treatment of varicose veins. Br J Surg 2006; 8: 969-974.
  • 21 Drake LA, Dinehart SM, Goltz RW, Graham GF, Hordinsky MK, Lewis CW, Pariser DM, Skouge JW, Webster SB, Whitaker DC, Butler B, Lowery BJ. Guidelines of care for sclerotherapy treatment of varicose and teleangiectatic leg veins. J Am Acad Dermatol 1996; 34: 523-528.
  • 22 Dover J, Sadick N, Goldman MP. The role of lasers and light sources in the treatment of leg veins. Derm Surg 1999; 25: 328-336.
  • 23 Duffy DM. Cutaneous necrosis following sclero-therapy. J Anesthetic Dermatol Cosmetic Surg 1999; 1,2: 157-168.
  • 24 Einarsson E, Eklöf B, Neglén P. Sclerotherapy or surgery as treatment for varicose veins: A prospective randomized study. Phlebology 1993; 8: 22-26.
  • 25 Fegan WG. Continous compression technique of injecting varicose veins. Lancet 1963; 2: 109-112.
  • 26 Feied CF. Deep vein thrombosis: The risks of sclerotherapy in hypercoagulable states. Sem Dermatol 1993; 12,2: 135-149.
  • 27 Feied CF, Jackson JJ, Bren TS, Bond OB, Fernando CE, Young VC, Hashemiyoon RB. Allergic reactions to polidocanol for vein sclerosis. J Dermatol Surg Oncol 1994; 20: 466-468.
  • 28 Feuerstein W. Schwere anaphylaktische Reaktion auf Hydroxypolyaethoxydodecan. VASA 1973; 3,2: 292-294.
  • 29 Fisher DC, Fisher EA, Budd JH. et al. The incidence of patent foramen ovale in 1000 consecutive patients. Chest 1995; 107,6: 1504-1509.
  • 30 Fisher DA. Regarding extensive tissue necrosis following high concentration sclerotherapy for varicose veins. Dermatol Surg 2000; 26,11: 1081.
  • 31 Flückiger P. Nicht-operative retrograde Varicenverödung mit Varisylschaum. Schweiz Med Wochenschr 1956; 48: 1368-1370.
  • 32 Forlee MV, Grouden M, Moore DJ. et al. Strokeafter varicose vein foam injection sclerotherapy. J Vasc Surg 2006; 43,1: 162-164.
  • 33 Frullini A, Cavezzi A. Ultrasound guided sclerotherapy in the treatment of long saphenaous vein insufficiency. Vasomed 1999; 11 Suppl (01) 8.
  • 34 Frullini A, Cavezzi A. Sclerosing foam in the treatment of varicose veins and telangiectasases: History and analysis of safety and complications. Derm Surg 2002; 28: 11-15.
  • 35 Geerts WH, Pineo GF, Heit JA, Bergqvist D. et al. Prevention of venous thromboembolism. The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 2004; 126: 338S-400S.
  • 36 Georgiev M.. Post sclerotherapy hyperpigmentations. J Dermatol Surg Oncol 1993; 19: 649-652.
  • 37 Geukens J, Rabe E, Bieber T. Embolia cutis medicamentosa of the foot after sclerotherapy. Eur J Dermatol 1999; 9: 132-133.
  • 38 Goldman PM, Beaudoing D, Marley W, Lopez L, Butie A. Compression in the treatment of leg teleangiectasia: A preliminary report. J Dermatol Surg Oncol 1990; 16: 322-325.
  • 39 Goldmann PM, Bergan JJ, Guex JJ. Sclerotherapy–Treatment of varicose veins and telangiectatic leg veins. 4th Ed. Philadelphia:: Mosby Elsevier; 2007
  • 40 Goldman MP, Sadick NS, Weiss RA. Cutaneous necrosis, telangiectatic matting and hyperpigmentation following sclerotherapy. Dermatol Surg 1995; 21: 19-29.
  • 41 Grondin L, Young R, Wouters L. Sclérothérapie ècho-guidée et sécurité: Comparison des techniques. Phlebologie 1997; 50,2: 241-245.
  • 42 Guex JJ. Ultrasound guided sclerotherapy (USGS) for perforating veins. Hawaii Med J 2000; 59,6: 261-262.
  • 43 Guex JJ, Allaert F-A, Gillet J-L. Immediate and midterm complications of sclerotherapy: Report of a prospective multicenter registry of 12,173 sclerotherapy sessions. Dermatol Surg 2005; 31,2: 123-128.
  • 44 Hamel-Desnos C, Desnos P, Wollmann JC. et al. Evaluation of the efficacy of Polidocanol in the form of foam compared with liquid form in sclerotherapy of the long saphenous vein: Initial results. Dermatol Surg 2003; 29,12: 1170-1175.
  • 45 Hamel-Desnos C, Ouvry P, Benigni JP, Boitelle G, Schadeck M, Desnos P, Allaert FA. Comparison of 1% and 3% polidocanol foam in ultrasound guided sclerotherapy of the great saphenousvein: a randomised, double-blind trial with 2year-follow-up. „The 3/1 Study“. Eur J Vasc Endovasc Surg 2007; 34: 723-729.
  • 46 Hamel-Desnos C, Ouvry P, Desnos P, Escalard JM, Allaert FA. Sclérothérapie et thrombophilie: Démarche pour un consensus dans la sclérothérapie chez les thrombophiles. Phlébologie 2003; 56: 165-169.
  • 47 Henriet JP. One year experiencewith sclerotherapy of reticular veins and telangiectases using polidocanol foam in daily routine: Feasibility results, complications. Phlébologie 1997; 50,3: 355-360.
  • 48 Hertzman PA, Owens R. Rapid healing of chronic venous ulcers following ultrasound-guided foam sclerotherapy. Phlebology 2007; 22,1: 34-39.
  • 49 Hohlbaum G. Überiatrogene Schäden bei der Varizensklerosierung. In: Staubesand J, Schöpf E. (Hrsg). Neuere Aspekte der Sklerosierungstherapie. Berlin, Heidelberg:: Springer; 1990: 70-81.
  • 50 Hübner K. Ambulante Therapie der Stammvarikose mittels Krossektomie und Sklerotherapie-ein Beitrag aus der Praxis des niedergelassenen Phlebologen. Phlebologie 1991; 20: 104-108.
  • 51 Kahle B. Effizienz der Sklerosierungstherapie von Besenreisern. Eine prospektive, randomisierte, doppelblinde, placebokontroliierte Studie. Vasomed 2006; 18,4: 148.
  • 52 Kahle B, Leng K. Efficacy of sclerotherapy in varicose veins –a prospective, blinded placebo controlled study. Dermatol Surg 2004; 30: 723-728.
  • 53 Kakkos SK, Bountouroglou DG, Azzam M. et al. Effectiveness and safety of ultrasound-guided foam sclerotherapy for recurrent varicose veins: Immediate results. J Endovasc Ther 2006; 13,3: 357-364.
  • 54 Kern P, Ramelet AA, Wütschert R. et al. Single-blind, randomized study comparing Chromated Glycerin, Polidocanol solution and Polidocanol foam for treatment of telangiectatic leg veins. Dermatol Surg 2004; 3: 367-372.
  • 55 Kern P, Ramelet AA, Wütschert R, Hayoz D. Compression after sclerotherapy for telangiectasias and reticular leg veins. A randomized controlled study. J Vas Surg 2007; 45,6: 1212-1216.
  • 56 Kersting E, Hornschuh B, Bröcker E-B. Embolia cutis medicamentosa nach Varizensklerosierung mit Polidocanol. Phlebologie 1998; 27: 55-57.
  • 57 Kreussler:. Fachinformationen Aethoxysklerol 0,25% /0,5%/1%/2%Stand 06/2005, Aethoxysklerol 3% /4%. Stand 09/2005. Chemische Fabrik Kreussler &Co. GmbH,; Wiesbaden.:
  • 58 Künzelberger B, Pieck C, Altmeyer P, Stücker M. Migraine ophthalmique with reversible scotomas after sclerotherapy with liquid 1% polidocanol. Derm Surg 2006; 32: 1410.
  • 59 Malouf GM. Ambulatory venous surgery versus sclerotherapy. Hawaii Med J 2000; 59: 248-249.
  • 60 Massay RA. Regarding the use of compression stockings after sclerotherapy. Dermatol Surg 1999; 25: 517.
  • 61 Mayer H, Brücke H. Zur Ätiologie und Behand-lung der Varizen der unteren Extremität. Chir Praxis 1957; 4: 521-528.
  • 62 McCoy S, Evans A, Spurrier N. Sclerotherapy for legtelangiectasia –ablinded comparative trial of polidocanol and hypertonic saline. Dermatol Surg 1999; 25: 381-386.
  • 63 Mc Donagh B. Comments on the use of post-sclerotherapy compression. Dermatol Surg 1999; 25,6: 519-521.
  • 64 Milleret R, Garandeau C. Sclérose des grandes veines saphénes à la mousse délivrée par cathéter écho-guidé sur veine vide: Alpha-technique –Bilan des 1.000 treatments. Phlébologie 2006; 59,1: 53-58.
  • 65 Monfreux A. Traitement sclérosant des troncs saphèniens et leurs collatèrales de gros calibre par la méthode mus. Phlébologie 1997; 50,3: 351-353.
  • 66 Morrison N, Cavezzi A, Bergan J, Partsch H. Regarding „stroke after varicose vein foam injection sclerotherapy“. J Vasc Surg 2006; 44,1: 224-225.
  • 67 Munavalli GS, Weiss RA. Complications of sclerotherapy. Semin Cutan MedSurg 2007; 26,1: 22-28.
  • 68 Myers KA, Jolley D, Clough A. et al. Outcome of ultrasound-guided sclerotherapy for varicose veins: Medium-term results assessed by ultra-sound surveillance. Eur J Vasc Endovasc Surg 2007; 33,1: 116-121.
  • 69 Norris MJ, Carlin MC, Ratz JL. Treatment of essential telangiectasia: Effects of increasing concentrations of polidocanol. J Am Acad Dermatol 1989; 20, 4: 643-649.
  • 70 Oesch A, Stirnemann P, Mahler F. The acute ischemic syndrome of the foot after sclerotherapy of varicose veins. Schweiz Med Wochenschr 1984; 114: 1155-1158.
  • 71 Passariello F. Sclerosing foamand patent foramen ovale. The final report. In: Word Congress of the International Union of Phlebology; 2007 Jun 18–20; Kyoto, Japan. Int Angiol 2007; 26 (02) Suppl 1 87.
  • 72 Pradalier A, Vincent D, Hentschel V, Cohen-Jonathan AM, Daniel E. Allergie aux sclérosants des varices. Rev Fr Allergol 1995; 35,5: 440-443.
  • 73 Rabe E. (Hrsg). Grundlagen der Phlebologie. Köln:: Viavital; 2003
  • 74 Rabe E, Otto J, Schliephake D, Pannier F. Efficacy and safety of great saphenous vein sclerotherapy using standardised polidocanol foam (ESAF): A randomised controlled multicentre clinical trial. Eur J Endovasc Vasc Surg (accepted for publication).;
  • 75 Rabe E, Pannier-Fischer F, Gerlach H, Breu FX. et al. Guidelines for sclerotherapy of varicose veins (ICD 10: I83.0, I83.1, I83.2, and I83.9). Dermatol Surg 2004; 30,5: 687-693.
  • 76 Rao J, Wildemore JK, Goldmann MP. Double-blind prospective comparative trial between foamed and liquid Polidocanol and Natrium Tetradecyl Sulfate in the treatment of varicose and telangiectatic leg veins. Dermatol Surg 2005; 31,6: 631-635.
  • 77 Ratanahirana H, Benigni JP, Bousser MG. Injection of Polidocanol foam(PF) in varicose veins as a trigger for attacks of migraine with visual aura. Cephalalgia 2003; 23: 850-851.
  • 78 Reddy P, Wickers J, Terry T, Lamont P, Moller J, Dormandy JA. What is the correct period of bandaging following sclerotherapy?. Phlebology 1986; 1: 217-220.
  • 79 Remy W, Vogt H-J, Borelli S. Embolia cutis medicamentosa-artige Hautnekrosen nach Sklerosierungsbehandlung. Phlebol Proktol 1978; 7: 67-72.
  • 80 Sadoun S, Benigni JP, Sica M. Étude prospective de l′efficacité de la mousse de sclérosant dans le traitement des varices tronculaires des membres inférieurs. Phlébologie 2002; 55: 259-262.
  • 81 Schadeck M. Duplex-kontrollierte Sklerosierungsbehandlung der Vena saphena magna. Phlebologie 1996; 25: 78-82.
  • 82 Schadeck M, Allaert FA. Résultatsàlong terme de la Sclérothérapie des Saphènes internes. Phlebologie 1997; 50,2: 257-262.
  • 83 Schadeck M. Sclérosedelapetite veine saphéne éviter les mauvais résultats?. Phlébologie 2004; 2: 165-169.
  • 84 Schultz-Ehrenburg U, Tourbier H. Doppler-kontrollierte Verödungsbehandlung der Vena saphena magna. Phlebol Proktol 1984; 13: 117-122.
  • 85 Seydewitz V, Staubesand J. Das ultrastrukturelle Substrat der Wirkung paravasal und intraarteriell applizierter Sklerosierungsmittel: Ein experimen-teller Beitrag zum Problem iatrogener Schäden nach Sklerotherapie. In: Staubesand J, Schöpf E. (Hrsg). Neuere Aspekte der Sklerosierungstherapie. Heidelberg: Springer; 1990: 40-65.
  • 86 Sigg K. Neuere Gesichtspunkte zur Technikder Varizenbehandlung. Ther Umschau 1949; 6: 127-134.
  • 87 Snow V, Qaseem A, Barry P, Hornbake ER. et al. Management of venous thromboembolism: A clinical practice guideline from the American College of Physicians and the American Academy of Family Physicians. Ann Intern Med 2007; 146: 204-210.
  • 88 Stanley PRW, Bickerton DR, Campbell WB. Injection sclerotherapy for varicose veins – a comparison of materials for applying local compression. Phlebology 1991; 6: 37-39.
  • 89 Stücker M, Reich S, Hermes N. et al. Safety and efficiency of perilesional sclerotherapy in leg ulcer patients with postthrombotic syndrome and/or oral anticoagulation with Phenprocoumon. JDDG 2006; 4,9: 734-738.
  • 90 Tazelaar DJ, Neumann HAM, de Roos KP. Long cotton wool rolls as compression enhancers in macro sclerotherapy for varicose veins. Dermatol Surg 1999; 25,1: 38-40.
  • 91 Tessari L, Cavezzi A, Frullini A. Preliminary experience with anew sclerosing foam in the treatment of varicose veins. DermatolSurg 2001; 27: 58-60.
  • 92 Vander Plas JPL, Lambers JC, van Wersch JW, Koehler PJ. Reversible ischaemic neurological deficit after sclerotherapy of varicose veins. Lancet 1994; 343: 428.
  • 93 Villavicencio J, Pfeifer J, Lohr J, Goldman M, Cranley R, Spence R. Sclerotherapy for varicose veins: Practice guidelines and sclerotherapy procedures. In: Glovicki P, Yao J. (Eds). Handbook of venous disorders. London:: Chapmann & Hall Medical; 1996: 337-354.
  • 94 Vin F. Principes de la sclérothéraphiedes troncs saphènes internes. Phlebologie 1997; 50,2: 229-234.
  • 95 Wagdi P. Migräne und offenes Foramen Ovale: nur ein vorübergehender Hoffnungsschimmer?. Kardiovasc Med 2006; 9: 32-36.
  • 96 Weiss RA, Sadick NS, Goldman MP, Weiss MA. Post-sclerotherapy compression: controlled comparative study of duration of compression and its effects on clinical outcome. Dermatol Surg 1999; 25: 105-108.
  • 97 Weiss RA, Weiss MA. Incidence of side effects in the treatment of telangiectasias by compression sclerotherapy: Hypertonics saline vs. polidocanol. J Dermatol Surg Oncol 1990; 16: 800-804.
  • 98 Wildenhues B. Endovenöse kathetergestützte Schaumsklerosierung. Phlebologie 2005; 34: 165-170.
  • 99 Wollmann JC. Schaum –zwischen Vergangenheit und Zukunft. Vasomed 2002; 16 (01) 34-38.
  • 100 Wollmann JC. The history of sclerosing foams. Dermatol Surg 2004; 30: 694-703.
  • 101 Wright D, Gobin JP, Bradbury AW, Coleridge-Smith P, Spoelstra H, Berridge D, Wittens CHA, Sommer A, Nelzen O, Chanter D. Varisolve European Phase III Investigators Group. Varisolve® 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: 180-190.
  • 102 Yamaki T, Nozaki M, Iwasaka S. Comparative study of duplex-guided foam sclerotherapy and duplex-guided liquid sclerotherapy for the treatment of superficial venous insufficiency. Dermatol Surg 2004; 30,5: 718-722.
  • 103 Yamaki T, Nozaki M, Sasaki K. Color duplex-guideds clerotherapy for the treatment of venous malformations. Dermatol Surg 2000; 26,4: 323-328.
  • 104 Zipper SG. Nervus peronäus-Schaden nachVarizensklerosierung mit Aethoxysklerol. Versicherungsmedizin 2000; 4: 185-187.