Phlebology > Volume 24, Number 4 > Pp. 176-182

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Original Articles

Sclerotherapy of varicose veins in patients with documented thrombophilia: a prospective controlled randomized study of 105 cases

C M Hamel-Desnos ^* , J-L Gillet , P R Desnos  and F A Allaert 

^* Saint Martin Private Hospital, Vascular Medicine, Caen; Private Practice, Vascular Medicine, Bourgoin Jallieu; Private Surgery, Vascular Medicine, 2 avenue de Bagatelle, Caen, France; Mc Gill University, Epidemiology, Biostatistics and Occupational Medicine, Montreal, Canada

Correspondence: C Hamel-Desnos MD, Saint Martin Private Hospital, 18 rue des Roquemonts, 14050 Caen, France Email: claudine{at}desnos.eu

Objectives: The aim of this study was to assess thrombotic complications following sclerotherapy in thrombophilic patients in combination with thromboprophylaxis, in two randomized arms using low molecular weight heparin (LMWH) or warfarin.

Patients and methods: This study received approval from the Ethics Committee. A total of 105 patients (81 females, 24 males) ranging in age from 20 to 82 years (mean 50) were selected: 75 with Factor V Leiden mutation, 18 with prothrombin 20210A mutation, 7 with high level of Factor VIII, 5 combinations of these. After randomization, 51 and 54 patients received warfarin and LMWH, respectively. A total of 199 sclerotherapy sessions were performed. Foam was used in 160 treatments.

Results: No episodes of symptomatic deep vein thrombosis (DVT) or pulmonary embolism (PE) occurred; no instances of DVT were revealed by ultrasound-monitoring.

Conclusions: This study suggests that in the three most common forms of thrombophilia, sclerotherapy, in combination with thromboprophylaxis, can be performed safely. Prophylaxis with LMWH is easier to use than warfarin.

Key Words: factor V Leiden mutation • thrombosis • prophylaxis • varicose veins • foam sclerotherapy

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