C. Hamel-Desnos

Hôpital Paris Saint-Joseph

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P. Desnos

Société Française de Médecine Vasculaire

François‐André Allaert

Laboratoire d'étude de l'apprentissage et du développement

Jean-Luc Gillet

Université de Caen Normandie

P. Ouvry

Centre Hospitalier Universitaire de Grenoble

Philippe Kern

Société d'Étude de l'Environnement (Switzerland)

Eberhard Rabe

University Hospital Bonn

P. Carpentier

Université Grenoble Alpes

O. Pichot

Groupe Hospitalier Mutualiste de Grenoble

P. Quéhé

Université de Bretagne Occidentale

L Tessari

Intel (United Kingdom)

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101

Société Française de Médecine Vasculaire

Assistance Publique – Hôpitaux de Paris

Université Paris Cité

Sorbonne Université

Centre National de la Recherche Scientifique

Société Française de Cardiologie

French Clinical Research Infrastructure Network

Centre Hospitalier Universitaire de Grenoble

Hôpital Européen Georges-Pompidou

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European guidelines for sclerotherapy in chronic venous disorders

Phlebology The Journal of Venous Disease (2013)

Eberhard Rabe F. X. Breu Attilio Cavezzi P Coleridge Smith Alessandro Frullini

Sclerotherapy is the targeted chemical ablation of varicose veins by intravenous injection of a liquid or foamed sclerosing drug. The treated veins may be intradermal, subcutaneous, and/or transfascial as well as superficial and deep in venous malformations. The aim of this guideline is to give evidence-based recommendations for liquid and foam sclerotherapy.This guideline was drafted on behalf of 23 European Phlebological Societies during a Guideline Conference on 7-10 May 2012 in Mainz. The conference was organized by the German Society of Phlebology. These guidelines review the present state of knowledge as reflected in published medical literature. The regulatory situation of sclerosant drugs differs from country to country but this has not been considered in this document. The recommendations of this guideline are graded according to the American College of Chest Physicians Task Force recommendations on Grading Strength of Recommendations and Quality of Evidence in Clinical Guidelines.This guideline focuses on the two sclerosing drugs which are licensed in the majority of the European countries, polidocanol and sodium tetradecyl sulphate. Other sclerosants are not discussed in detail. The guideline gives recommendations concerning indications, contraindications, side-effects, concentrations, volumes, technique and efficacy of liquid and foam sclerotherapy of varicose veins and venous malformations.

Guideline

Polidocanol

Quality of evidence

10.1177/0268355513483280

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Citations (276)

Great Saphenous Vein Diameters in Phlebological Practice in France: A Report of the DIAGRAVES Study by the French Society of Phlebology

European Journal of Vascular and Endovascular Surgery (2018)

C. Hamel-Desnos Marianne De Maeseneer Matthieu Josnin Jean-Luc Gillet François‐André Allaert

Great saphenous vein

10.1016/j.ejvs.2018.09.011

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Citations (15)

Recommandations de la Société française de médecine vasculaire concernant la sécurité et l’environnement en médecine vasculaire. Généralités

Journal des Maladies Vasculaires (2014)

P. Carpentier P. Desnos Jean-Antoine Gérard P. Giordana C. Hamel-Desnos

10.1016/j.jmv.2014.07.048

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Le diamètre de la grande veine saphène est-il un critère pour le choix de traitement des varices ? Le pour

Journal des Maladies Vasculaires (2015)

C. Hamel-Desnos

10.1016/j.jmv.2014.12.127

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Thermal ablation of saphenous veins is feasible and safe in patients older than 75 years: A prospective study (EVTA study)

Phlebology The Journal of Venous Disease (2014)

C. Hamel-Desnos P. Desnos François‐André Allaert Philippe Kern

Objectives To investigate the tolerance and safety of thermal ablation (TA), consisting of radiofrequency or endovenous laser (EVLA) of saphenous veins (SV) in elderly (group 1 ≥75 years), compared with a control group (group 2 <75 years). Method An Observational multicenter-prospective study was conducted, under the aegis of the French and Swiss Societies of Phlebology (18 centers). Ninety patients were included in group 1, 617 in group 2 (mean age 80 years and 53 years; 69% women in both groups), representing 863 SV. Mean trunk diameters were similar in both groups (small SV: 6 mm; great SV: 7 mm). In group 1, comorbidities were more frequent, particularly cardiac insufficiency, diabetes, history of thrombosis, and CEAP clinical class was significantly higher. Results EVLA was used in 86% of cases. Settings used were similar in both groups for each technique. Only 6% of TA was performed in an operating room for group 1 (14% group 2). Tumescent local anaesthesia (TLA) alone was used in 91% of cases in group 1 (85% group 2). The mean pain score was only 1.6 for the procedure itself (VASP 0–10; 10 max.) and 1.4 for the 10 days following the procedure. Side effects were few, but rate of paraesthesia was higher when general anaesthesia was used (11.8%) compared with TLA alone (2.2%). At three months, 100% of SV was occluded in group 1 (99.5% group 2), with high satisfaction score (9.3/10). Conclusion TA is safe and effective in elderly; it should be performed strictly under TLA to minimize side effects.

Great saphenous vein

10.1177/0268355514540882

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Citations (12)

La problématique du greffon veineux saphène en chirurgie cardiaque et vasculaire : revue de la littérature

Journal des Maladies Vasculaires (2015)

F.-X. Himpens P. Lemasle C. Hamel-Desnos

10.1016/j.jmv.2014.12.140

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French sclerotherapy and compression: Practice patterns

Phlebology The Journal of Venous Disease (2014)

V. Tripey J-M Monsallier Rémy Morello C. Hamel-Desnos

Based on the recommendations of experts, and supported by a low level of proof, compression after sclerotherapy is applied all over the world. Objective: Investigating the practice of French vascular physicians for sclerotherapy and the use of post-sclerotherapy compression. Methods: A questionnaire concerning their practices was sent to French vascular physicians through their regional vascular medicine professional development associations. Results: A total of 366 vascular physicians replied to the questionnaire, of whom 63% (229/366) were in private practice, 6% (21/366) in hospitals and 31% (115/366) had a mixed private–hospital practice. Sclerotherapy was practised by 88% (323/366) of them. Two-thirds of the vascular physicians used sclerosing foam and practised sclerotherapy using ultrasound guidance. Less than one-third of the vascular physicians regularly applied compression after sclerotherapy. When compression was applied, it was usually after treatment of saphenous or accessory saphenous veins and, in most cases, medical compression stockings of 15–20 mm Hg were used. With respect to the period recommended for wearing compression, this ranged from 48 h to 1 week for 65% (193/299) of the vascular physicians questioned. Conclusion: The great majority of vascular physicians who answered the questionnaire employ ultrasound guidance to perform sclerotherapy and use sclerosing foam. Compression after sclerotherapy is diversely applied in France and does not comply with the recommendations of the French Health Authorities who recommend wearing a stocking of 15–20 or 20–36 mm Hg for a period of 4–6 weeks. Thus, less than one-third of the vascular physicians regularly used elastic compression and when they did, it was usually a medical compression stocking of 15–20 mm Hg, for 1 week or less.

10.1177/0268355514554024

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Citations (7)

Foam Sclerotherapy of the Saphenous Veins: Randomised Controlled Trial with or without Compression

European Journal of Vascular and Endovascular Surgery (2010)

C. Hamel-Desnos B. Guias P. Desnos A. Mesgard

Great saphenous vein

10.1016/j.ejvs.2009.11.027

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Citations (125)

Anticoagulant therapy for symptomatic calf deep vein thrombosis (CACTUS): a randomised, double-blind, placebo-controlled trial

The Lancet Haematology (2016)