FAILURES of SCLEROTHERAPY of the GREAT SAPHENOUS VEIN: CLINICAL and SUBCLINICAL RECURRENCIES

Ann : In a former analysis we have shown that only half of all Duplex-proven failures develop into a clinical recurrency; the aim of this work is to determine which conditions enhance this tendency. Introduction : Subclinical recurrences show just a reflux at Duplex-examination, while clinical recurrences are obvious. The time-lap between first reflux and clinical appearance is the preclinical interval. Method : 1 000 sapheno-femoral junctions measuring between 5 and 18 mm (at 3 cm below the junction) have been treated in one session applying Sigg's method. The Duplex-controls were done at 2-4-6-8-10 years. Persistent reflux at Duplex-examination meant therapeutic failure. All recurrancies, clinical and subclinical, were divided into two groups. Group alpha had a reduction of the initial diameter of less than 30 To, group beta of more of 30%. Results : We had 116 clinical recurrencies and 230 subclinical recurrences. Successful cases (clinically and at Duplex-examination) showed a decrease in diameter of more than 70 %. Clinical recurrencies had a reduction of less than 30 % subclinical recurrences had a reduction between 30 and 70 %. Conclusion : A reduction of diameter at the sapheno-femoral junction of less than 30 % could be a predictive sign of clinical recurrency. We think that this could be the limit above which a recurrency could keep its subclinical status. A reduction of less than 30 % would be insufficient to prevent the varicous veins to reappear.