A survey of current attitudes of British and Irish vascular surgeons to venous sclerotherapy

Aim: To determine current practice amongst vascular surgeons regarding venous sclerotherapy. Method: A postal questionnaire was sent to 350 members of the Vascular Surgical Society of Great Britain and Ireland. Results: There were 218 replies (62%). Forty surgeons (18.3%) never injected varicose veins (VV) although six injected venous flares. Most surgeons (n = 168, 77.1%) reserved sclerotherapy for residual VV postoperatively. Primary varicose veins without proximal incompetence were injected by 152 (69.7%) and recurrent VV without proximal incompetence by 141 (64.7%). Sixteen surgeons only injected residual postoperative VV. Few surgeons injected VV in the presence of proximal incompetence. Where specified, 46% of respondents were injecting fewer VVs than in previous years. Only 5% were injecting more. By contrast, 44% were injecting more venous flares than previously (p<0.001). Eight different sclerosants were used, the commonest being STD (146 surgeons) and Sclerovein (33). The median number of patients treated with sclerotherapy was 11-50 per year compared with 51-150 per year who were operated upon. The median time advised for compression was 2 weeks (range - a fc-cu minutes - 2 months). Treatment was repeated at a median of 4 weeks (0-6 months). Thirty-two surgeons obtained written consent. All but eight respondents discussed potential complications, the commonest being staining and ulceration. Forty-six surgeons had patients who had experienced serious complications, the commonest being ulceration. There runs one reported death from a pulmonary embolus. Conclusion: Sclerotherapy is being used less frequently for VV. Most surgeons use if for residual VV and for those without proximal incompetence.