Polidocanol sclerotherapy for venous insufficiency in patients with recalcitrant leg ulcers: More treatment is better

In this study, Shao and colleagues have prospectively evaluated the results of a strategy employing 1% polidocanol microfoam to address source of venous insufficiency in patients with chronic nonhealing leg ulcers. 1 Shao M.Y. Harlin S. Chan B. et al. VIEW-VLU observational study of the effect of Varithena on wound healing in the treatment of venous leg ulcers. J Vasc Surg Venous Lymphat Disord. 2023; 11: 692-699 Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar Previously the Effect of Surgery and Compression on Healing and Recurrence (ESCHAR) trial found that stripping the superficial veins resulted in a lower incidence of venous ulcer recurrence after healing compared to compression alone. 2 Barwell J.R. Davies C.E. Deacon J. et al. Comparison of surgery and compression with compression alone in chronic venous ulceration (ESCHAR study): randomised controlled trial. Lancet. 2004; 363: 1854-1859 Abstract Full Text Full Text PDF PubMed Scopus (498) Google Scholar The Early Venous Reflux Ablation (EVRA) trial informed us that early superficial venous ablation resulted in more rapid ulcer healing than a strategy of compression followed by ablation after ulcer healing. 3 Gohel M.S. Heatley F. Liu X. et al. A randomized trial of early endovenous ablation in venous ulceration. N Engl J Med. 2018; 378: 2105-2114 Crossref PubMed Scopus (221) Google Scholar In the EVRA trial, investigators were able to select their preferred method of percutaneous superficial ablation, including endothermal ablation, mechanicochemical ablation, or foam sclerotherapy. VIEW-VLU observational study of the effect of Varithena on wound healing in the treatment of venous leg ulcersJournal of Vascular Surgery: Venous and Lymphatic DisordersVol. 11Issue 4PreviewChronic venous hypertension, triggered by venous reflux and/or obstruction, leads to skin changes and venous leg ulcers (VLUs). Compression therapy is the standard of care, but many wounds remain unhealed. The objectives of this study were to observe the effects of endovenous chemical ablation with commercially available 1% polidocanol injectable microfoam on VLU healing and recurrence rates. Full-Text PDF Open Access