LEV 12. Small-Diameter Recanalization of the Great Saphenous Vein after Ultrasound-Guided Foam Sclerotherapy: Three-Year Follow-up

The objective of this study was to assess the anatomic outcome of small-diameter (≤3 mm) above-knee great saphenous vein (GSV) recanalization. Patients treated by ultrasound-guided foam sclerotherapy for GSV incompetence (1-10 years) and presenting with a recanalization of the GSV trunk with a diameter of 3 mm at most were enrolled in a prospective study. The primary outcome was the diameter of the recanalized GSV trunk measured at 15 cm below the saphenofemoral junction. The secondary outcome was the identification of factors that might affect GSV recanalization. The study included 110 (73% female, 27% male) patients. Average age was 57.3 years (median, 59 years; range, 35-80 years) Most of patients were C1 and asymptomatic patients. Average Venous Clinical Severity Score was 1.6 ± 1.3 (median, 2; range, 0-6). Average diameter was 1.9 ± 0.5 mm (median, 1.8 mm; range, 1.0-2.9 mm). The GSV had been treated 4.1 ± 2.6 years ago. At 3-year follow-up, average diameter was 2.2 ± 0.8 mm (median, 2.0 mm; range, 1.2-4.4 mm). A significant increase was reported (P = .0005) in 23.6%: reduction or identical, 44.5% of patients; increase of 0.1 to 0.5 mm, 15.6%; increase of >0.5 mm, 40%. No risk factors for progression were identified in multivariate analyses. No clinical changes were reported. At 3-year follow-up, no significant increase of the recanalization diameter was observed in >50% of patients. These findings indicate that a small recanalization after ultrasound-guided foam sclerotherapy should not always be considered a failure of treatment. There is a need to question the requirement for re-treating the GSV trunk as soon as a small-diameter recanalization has been identified through duplex ultrasound examination.