in Flebologia - SIF

6 - Varici reticolari e telangectasie
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6.4 - Scleroterapia con trans-illuminazione:
tecnica ed approccio razionale.
ABSTRACT:
Atelli P. F., Goffredi L., Della Rocca M. D.,
Furino E., Quarto G., Apperti M.
The actual experience come out from a practical need which has been made
evident during sclerosing therapy of reticular veins and of the spider veins (or
telangectasias): looking at blood vessel in a more evident way, in order to use
the needle in a more precise and safe way.
The idea of using instruments which should allow to have a better vision than
eyesight or magnifying glass, come out from the need to see “more and better”.
In fact the technique of trans-illumination has been using for ten years.
For this purpose different instruments have been used, which only in part met
our needs: a first instrument (figment of our testing!) had a strong luminous
intensity, but a wavelength which didn’t detect in a more clear way the blood
vessel to be sclerosed; in addiction, manipulation was still not ergonomic. A
second tool used, worked with a complex system of infrared rays with digital
elaboration of pictures which made usage not pratical; however this instrument
was too much expensive. A third instrument used a led light and was very easy
for the usage, but had a wavelength and a luminous intensity still not perfect.
A fourth instrument lighted up blood vessels in a more evident way; basing on
this, one, it was considered perfect for introducing the needle with more precision,
but the particular shape obstructed a complete view of veins picture, made
of reticular veins and telangectasias.
Therefore, the need to find a system, which should overcame the difficulties,
brought us day by day to create a new instrument, the VISIOVEN®, which is,
in our opinion, the most efficient and suitable for our goals. These characteristics
are mainly due to:
6.4 - Scleroterapia con trans-illuminazione: tecnica ed approccio razionale
• the particular wavelength of laser light, which easier passes into subcutaneous
tissue and then glance also versus the surface, like a mirror;
• the extreme manageability of handling, which allowed us to have a
complete view of the system of reticular varices and of telangectasias,
sometimes a wonderful vision!
However, during our experience, we found that the trans-illumination could be
used not only as an instrument for more precise detectability of an high number
of veins, within the scope to proceed “from big to little”, from up versus down,
first “mother vein”, then telangectasias. This procedure, of course, is correct,
but could be changed into a sort of sclerosing therapy “a la demand” , pricking
what is possible and visible, based mainly on morphologic interpretations,
without understanding why sclerosing some blood vessel or others.
Otherwise there are not many studies which help us to understand the flows
and refluxes of vein system, which remains often not visible also at ultrasonography.
This thinking pushed us to begin a speculative way which could bring to give an
hemodynamic meaning to telangiectasias and the reticular system too. First
results are very encouraging and, if they will be confirmed by testing experience
of the involved colleagues, this could represent an unexpected success.
We believe that the pictures have a more strength than speculative reflections
into showing our idea and the results of an easy technique for the execution of
a technique of irreplaceable helpfulness during our clinical practice.
Not only for see more, but for see better!
Not only for see, but mainly for understand!
OBIETTIVI:
Il nostro lavoro nasce dall’esigenza di rendere più agevole e più razionale la
scleroterapia delle varici di piccolo calibro, in particolare Teleangectasie e
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