Department of Teaching and Learning

Objectives.  To determine peri-procedural incidence of side effects following treatment of lower extremity superficial veins with carbon dioxide-oxygen (CO2-O2) foam sclerotherapy, and to compare results with historical controls using CO2- or air-based foams. 
Design. Prospective data collection, quality-assurance program, private clinical setting.
Materials. The clinical population consisted of one hundred patients, 95% women, 52±13 (SD) years-old, CEAP class C2EpAsPr.
Methods.  Patients underwent ultrasound-guided foam sclerotherapy following thermal ablation; 1-3 % polidocanol and 70% CO2-30%O2 gas were mixed in a 1:4 proportion. Volume injected averaged 22±11 (range: 2-48) ml.  Vital signs were monitored for 1 hour; side effects were recorded up to 24 hours post procedure. Incidence of side effects was compared to CO2- and air-based foam data. 
Results. Heart rated decreased from 73±11 at the start to 68±9 bpm (p<.001 by paired t-test) following the procedure.  Systolic and diastolic pressures, 127/75 ±18/14 mmHg, respiratory rate, 15±4 rpm, and pO2, 98±2 %, did not change significantly.  Itching (n=7) or localized leg pain (n=24) reporting was similar to that for air-based foam (P>.05).  No reporting of dry cough or nausea was superior to the air foam experience (P<.05).  Reporting of chest tightness (n=1) or dizziness (n=1) was less than that for air-based foam (P=.002).  Incidence of visual disturbance (n=2), although less than that for CO2 (3%) or air (8%), was not significantly different (P>.05). 
Conclusions.  Lower or similar incidence of side effects was documented following CO2-O2 when compared to CO2 or air-based foam sclerotherapy.