Phlebology > Volume 24, Number 3 > Pp. 114-119

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Original Articles

Transient adverse events positively associated with patent foramen ovale after ultrasound-guided foam sclerotherapy

Pauline Raymond-Martimbeau 

Dallas Non-Invasive Vascular Laboratory, Dallas, TX, USA

Correspondence: Pauline Raymond-Martimbeau MD FACPh, 5439 Glen Lakes Dr., Dallas, TX 75231, USA. Email: pmartimbo{at}aol.com

Objectives: To prospectively study the association between patent foramen ovale (PFO) detected by contrast transcranial Doppler (cTCD) and adverse events (AEs) reported by patients after ultrasound-guided foam sclerotherapy (UGFS) for the treatment of varicose veins.

Methods: All patients reporting AEs after UGFS were studied using cTCD directed at the middle cerebral artery to determine the Spencer grading score by counting high-intensity transient signals. Agitated saline was used as the contrast medium. The Spencer grading score determined the presence or absence of PFO. All patients undergoing UGFS received follow-up phone calls within 24 hours and again two weeks after the procedure.

Results: Of the 3259 patients who underwent UGFS, AEs were reported by seven (0.21%) patients at their first session. These included visual disturbance, migraine and chest discomfort. Five (71.4%) of these seven patients tested positive for PFO by cTCD. The two-week follow-up confirmed no permanent symptoms.

Published studies show high sensitivity and specificity for cTCD when compared with contrast transesophageal echocardiography (cTEE).

Conclusions: The overall rate of AEs reported is consistent with published results. The presence of a PFO was detected in most patients reporting AEs after undergoing UGFS. While PFO screening with high sensitivity and specificity can be performed efficiently in the clinic setting, based on the literature, further investigation is warranted.

Key Words: chronic venous disorders • patent foramen ovale • right-to-left shunt • contrast transcranial Doppler • ultrasound-guided foam sclerotherapy

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