Comparative study of ambulatory phlebectomy and foam sclerotherapy in the treatment of primary non-axial varicose veins

Perforators are those which connect the superficial and deep venous system either directly to main 
veins or indirectl through the muscular and soleal venous plexus. The emergence of minimally 
invasive techniques like ambulator phlebectomy (AP) and foam sclerotherapy (FS) has led to 
increasing interest about the appropriate therapy for the treatment of isolated perforator incompetence. 
There have been no studies which have compared the effectiveness of these in-office procedures in 
isolated perforator incompetence due to the low prevalence of cases. Aim of the work is to compare 
the clinical parameters (return to normal activity, primary symptomrelief), functional parameters 
(procedure time, change in disease severity, course of venous ulcer), and duplex parameters 
(recurrence in treated veins, complete occlusion of treated veins) in the management of leg 
varicosities having isolated primary perforator incompetence by ambulatory phlebectomy and duplex 
guided foam sclerotherapy. Though the procedure time was shorter with FS than AP, the other 
parameters of primary symptom relief such as change in disease severity, faster healing of venous 
ulcer, complete occlusion of treated veins in follow-up duplex examination, and lower recurrence of 
treated veins are better with AP than FS. Conclusion, the interruption of perforators is effective in 
decreasing the symptoms of chronic venous insufficiency and for the rapid healing of ulcers.The 
interruption of the incompetent perforating veins appears to be essential to decrease ambulatory 
venous hypertension.It is apparent from this study that ambulatory phlebectomy stands distinct with 
enormous benefits and serves as a superior alternative to foam sclerotherapy in treating patients with 
isolated perforator incompetence.