Abstract
Genel popülasyonda ileri yaşla birlikte daha sık bulgulanan alt ekstremite varisleri adölesan dönemde nadir gözlenmekte ve tedavi yaklaşımı da özellik arz edebilmektedir. Adölesan dönem kendine has problemleri de içeren son derece hassas bir periyottur. Kliniğimizde 2013 yılının son altı aylık peryodu içerisinde alt ekstremite varislerine yönelik skleroterapi yöntemiyle tedavi görmüş olan erken ve geç adölesan hastaları retrospektif olarak değerlendirerek sunmayı amaçladık. Haziran-Aralık 2013 tarihleri arasında polikliniğimizde skleroterapi işlemi uygulanmış olan 13-21 yaş arası toplam yirmiiki hasta çalışmaya dahil edildi. Hastaların daha objektif değerlendirilebilmesi açısından 13-18 yaş arası hastalar erken genç adölesan, 19-21 yaş arası hastalar ise geç erişkin adölesan olarak gruplandırıldı. Çalışmaya alınan hastaların 5 tanesi erkek 4 genç adölesan, 1 erişkin adölesan ve 17 tanesi kadındı 6 genç adölesan, 11 erişkin adölesan . Bu hastaların demografik ve radyolojik özellikleri belgelendi. Yaygın olarak kabul görmüş olan CEAP sınıflandırmasına göre ekstremitelerin dağılımı işlem öncesi gerçekleştirildi. Çalışmaya alınan bütün hastalara poliklinik şartlarında damar çapına uygun olarak 26, 30 veya 32 G enjektör uçları ile saf veya köpük şeklinde Na-tetradecyl sulphate ile skleroterapi yapıldı. Anerjik-allerjik reaksiyon riski minimal subkütan doz uygulaması yapılarak 2. ve 24. saatlerde kontrol edildi. Na-tetradecyl sulphate, farklı konsantrasyon seçenekleri nedeni ile sklerozan ajan olarak tercih edildi. Uygulanan seans sayısına bakıldığında 12 hastada tek seans skleroterapi uygulaması yeterli olurken, 5 hastada iki, 2 hastada üç ve 3 hastada dört seans uygulama gerçekleştirilmiştir Kliniğimizde her bir seansta ortalama 5 ile 15 ayrı enjeksiyon uygulanmaktadır . Sonuç: Venöz hastalıkların takip ve tedavisi hakkında çok sayıda literatür bilgisi bulunmasına karşın, özellik arz eden adölesan dönem hakkında yeterli bilgi bulunmamaktadır. Çalışmamızın, adölesan dönem üzerindeki tetkik ve tedaviler hakkında farklı bir bakış açısı oluşturacağını düşünmekteyiz. Ayrıca özellikle genç olgularda skleroterapinin ciddi bir komplikasyon oluşturmadan, varikozitelerin ortadan
Keywords
References
- ) Vasilenko SA, Ram N, Lefkowitz ES. Body image and Şrst sexual intercourse in late adolescence. 2011;34: 327–35. of
- Adolescence 2) Murray KM, Byrne DG, Rieger E. Investigating adolescent stres and body image. Journal of Adolescence 2011;34: 269– 78.
- ) Darvall KAL, Bate GR, Sam RC, Adam DJ, Silverman SH, Bradbury AW. Patients’ Expectations before and Satisfaction after Ultrasound Guided Foam Sclerotherapy for VaricoseVeins. Eur J Vasc Endovasc Surg 2009;38:642-7.
- ) Mlosek RK, Wozniak W, Malinowska S, Migda B, Serafin-Król M, MilekT. The Removal of Post-sclerotherapy Pigmentation following Sclerotherapy Aloneor in Combination with Crossectomy. Eur J Vasc Endovasc Surg 2012;43:100-5.
- ) Kulkarni SR, Messenger DE, Slim FJA, Emerson LG, Bulbulia RA, Whyman MR, Poskitt characterization of deep vein thrombosis following
- sclerotherapy in 1000 legs with superficial venous reflux. J Vasc Surg& Venous and Lym Dis 2013;1:231-8. incidence and ultrasound-guided foam 6) Rasmussen L, Lawaetz M, Serup J, Bjoern L, Vennits B, Blemings A, Eklof B. Randomized
- endovenous laser ablation, radiofrequency ablation, foam sclerotherapy, and surgical stripping for great saphenous varicose veins with 3-year follow-up.J VascSurg& Venous and Lym Dis 2013;1:349-56.
- comparing 7) Blaise S, Charavin-Cocuzza M, Riom H, Brix M, Seinturier C, Diamand JM, Gachet G, Carpentier PH. Treatment of Low-flow Vascular Malformations by Ultrasound-guided Sclerotherapy with Polidocanol Foam: 24 Cases and Literature Review. Eur J Vasc Endovasc Surg 2011;41:412-7.
- ) Lattimer CR, Azzam M, Kalodiki E, Shawish E, Trueman P, Geroulakos G. Cost and Effectiveness of Laser with Phlebectomies Compared with Foam Sclerotherapy in Superficial
- Resultsof a Randomised Controlled Trial. Eur J Vasc Endovasc Surg 2012; 43:594-600.
Abstract
Lower extremity varicosities are more commonly observed with aging in general population. Although it is rare in adolescence, treatment in adolescent term has specific issues. Adolescence is a very sensitive period with its very own problems. We aimed to represent retrospective examination of young and mature adolescent patients treated with sclerotherapy in last six months of 2013. Twenty two adolescent patients ages between 13 and 21 , treated with sclerotherapy between June and December 2013 were included in this study. For obtaining more objective point of view, patients were divided into two groups: patients between ages 13 and 18 as young adolescent group and patients between 19 and 21 as mature adolescent group. Five of the patients were male 4 in young adolescent group and 1 in mature adolescent group and seventeen were female 6 in young adolescent group and 11 in mature adolescent group . Demographic and radiologic specifications of these patients were achieved. Extremities’ distribution according to widely accepted CEAP classification was performed before treatment. We treated all patients with Na-tetradecyl sulphate liquid or foam sclerotherapy by using 26 G, 30 G or 32 G cannulas appropriately selected for vein diameter in our outpatient clinic. For reducing anergic-allergic reaction risk, after injection of minimal subcutaneous dose, patient was checked at 2nd and 24th hours. Na-tetradecyl sulphate is preferred as sclerosant agent because of its various concentrations in the market. If we consider session counts; twelve patients were treated in single session, five patients in two sessions, two patients in three sessions and three patients were treated in four sessions in our clinical practice five to fifteen injections are performed in a session . There are numerous studies about treatment and follow-up of venousdiseases, but there is not enough data about adolescent term which has its specific issues. We believe that, our study will provide a different point of view for diagnostic and treatment procedures of adolescent term. Sclerotherapy may be preferred in treatment of varicosities in young patients without serious complication and with better cost effectiveness. Also, sclerotherapy hast the best cosmetic results without restricting daily activities of these patients
Keywords
References
- ) Vasilenko SA, Ram N, Lefkowitz ES. Body image and Şrst sexual intercourse in late adolescence. 2011;34: 327–35. of
- Adolescence 2) Murray KM, Byrne DG, Rieger E. Investigating adolescent stres and body image. Journal of Adolescence 2011;34: 269– 78.
- ) Darvall KAL, Bate GR, Sam RC, Adam DJ, Silverman SH, Bradbury AW. Patients’ Expectations before and Satisfaction after Ultrasound Guided Foam Sclerotherapy for VaricoseVeins. Eur J Vasc Endovasc Surg 2009;38:642-7.
- ) Mlosek RK, Wozniak W, Malinowska S, Migda B, Serafin-Król M, MilekT. The Removal of Post-sclerotherapy Pigmentation following Sclerotherapy Aloneor in Combination with Crossectomy. Eur J Vasc Endovasc Surg 2012;43:100-5.
- ) Kulkarni SR, Messenger DE, Slim FJA, Emerson LG, Bulbulia RA, Whyman MR, Poskitt characterization of deep vein thrombosis following
- sclerotherapy in 1000 legs with superficial venous reflux. J Vasc Surg& Venous and Lym Dis 2013;1:231-8. incidence and ultrasound-guided foam 6) Rasmussen L, Lawaetz M, Serup J, Bjoern L, Vennits B, Blemings A, Eklof B. Randomized
- endovenous laser ablation, radiofrequency ablation, foam sclerotherapy, and surgical stripping for great saphenous varicose veins with 3-year follow-up.J VascSurg& Venous and Lym Dis 2013;1:349-56.
- comparing 7) Blaise S, Charavin-Cocuzza M, Riom H, Brix M, Seinturier C, Diamand JM, Gachet G, Carpentier PH. Treatment of Low-flow Vascular Malformations by Ultrasound-guided Sclerotherapy with Polidocanol Foam: 24 Cases and Literature Review. Eur J Vasc Endovasc Surg 2011;41:412-7.
- ) Lattimer CR, Azzam M, Kalodiki E, Shawish E, Trueman P, Geroulakos G. Cost and Effectiveness of Laser with Phlebectomies Compared with Foam Sclerotherapy in Superficial
- Resultsof a Randomised Controlled Trial. Eur J Vasc Endovasc Surg 2012; 43:594-600.
Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Research Article |
| Authors | |
| Publication Date | March 1, 2014 |
| Published in Issue | Year 2014 Volume: 18 Issue: 1 |