Abstract:
This article presents a comprehensive analysis of the effects of sclerotherapy on deep veins, specifically investigating the phenomena of deep vein sclerosis (DVS) as distinct from deep vein thrombosis (DVT). The research highlights how sclerosants used in procedures to treat varicose veins, such as endovenous laser ablation (EVLA) and foam ultrasound-guided sclerotherapy, can sometimes inadvertently affect deep veins, leading to sclerosis rather than thrombosis.
A key aspect of the study was the use of D-dimer levels and ultrasound to differentiate DVS from DVT. The results indicated that DVS, characterized by fibrosclerosis, is a relatively benign condition that does not require anticoagulation. The study tracked the outcomes of 9143 procedures, finding a 2.83% incidence of deep vein occlusions, with the majority being DVS. The analysis also demonstrated that D-dimer levels could effectively help distinguish between DVS and DVT, with D-dimer values less than 0.5 µg/mL excluding DVT.
The article emphasizes that while DVS may develop following sclerotherapy, it is largely self-resolving, and most patients regain vein patency and competence over time. The study concludes that DVS does not present the same clinical risks as DVT and does not necessitate anticoagulation therapy.
Discussion:
This article is a valuable contribution to understanding the differences between DVS and DVT, particularly in the context of treatments for varicose veins. The use of D-dimer as a diagnostic tool provides clinicians with a method to minimize unnecessary anticoagulation, which is critical in avoiding complications such as bleeding.
For further academic writing based on this article, the analysis could delve deeper into the practical applications of these findings, particularly how they might influence treatment protocols for varicose veins and the prevention of post-sclerotherapy complications.
Article Reference:
Kurosh Parsi, Brydon Panozzo, Alison Bull, Anes Yang, Mina Kang, Yana Parsi, & David E. Connor. (2020). Deep vein sclerosis following sclerotherapy: Ultrasonic and d-dimer criteria. Phlebology, 26. https://journals.sagepub.com/doi/10.1177/0268355519873534