in Flebologia - SIF

4 - La recidiva varicosa
7. Zummo M. Sclérose versus chirurgie de la saphène interne. Critères selon le reflux au
doppler. Phlébologie 89, A. Davy, R.Stemmer, éds. John Libbey. Eurotext Ltd 89: 791-
3
8. Bernbach H.R., Ferrara F. Die Sklerosierung der sapheno-femoralen Krosse mit Duplex
kontrolle. European congress of the UIP. 26/09-01/10/99 Bremen/Germany.Vasomed,
Supplement 1/1999: 21.
70
ABSTRACT:
4.2 - Le recidive post-trattamento ESEC
4.2 - Le recidive post-trattamento ESEC
Castagnoli S., Bernardini E.
INTRODUCTION: Recanalization post-sclerotherapy of the veins has
always been considered an undesirable development, a failure, then a relapse.
Distinguished Authors have published, several times, several items about
(Wallois, Ouvry, Schadeck), but it underscored a total discrepancy between the
clinical outcome, positive up to 95% of cases, and the instrumental one, usually
negative for the ultrasonographic evidence.
ESEC TECHNIQUE: With the ESEC, recanalization is not a recurrence,
but one of the main purposes of the method, representing the beginning of a
series of events that will lead to a reduction of the vessel caliber, reduced flow
and, in cases where it made valve realignment tube (up to 56%), also the total
functional recovery during walking. The occurrence of retrograde flow does not
necessarily mean that there is a reflux. Often the hemodynamic study showes
a persistence of retrograde flow through one or more perforators without valve
jump, or with a jump of a valve but without symptoms or varicose shooting
events. Let us keep in mind that the varicose disease does not restore, primitive
varicose being constitutional, chronic and progressive.
DISCUSSION: We talk about relapse in general when, after the apparent
success of a treatment, reappears in all, or in part, the previous pathological
picture.
The ESEC therapy aims, preserving the heritage saphenous pattern with its
drainage, to the disappearance of symptoms, to a significant reduction of
varicose veins with aesthetic improvement, to the evolution of the hemodynamic
initial picture to a more stable and more easily retractable one: in summary, to
the suppression of stasis and of CVI framework, without suppressing the veins.
The treatment protocols require 2-6 sessions of ESEC in the first year, and
there after 1-2 controls, with time to time necessary shooting sclerotherapy
71