Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

Relazione medici di base sulla schiuma sclerosante

1,491 views

Published on

relazione ai Medici di base

Published in: Healthcare
  • DOWNLOAD THIS BOOKS INTO AVAILABLE FORMAT (2019 Update) ......................................................................................................................... ......................................................................................................................... Download Full PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download Full EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download Full doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... ......................................................................................................................... ................................................................................................................................... eBook is an electronic version of a traditional print book THIS can be read by using a personal computer or by using an eBook reader. (An eBook reader can be a software application for use on a computer such as Microsoft's free Reader application, or a book-sized computer THIS is used solely as a reading device such as Nuvomedia's Rocket eBook.) Users can purchase an eBook on diskette or CD, but the most popular method of getting an eBook is to purchase a downloadable file of the eBook (or other reading material) from a Web site (such as Barnes and Noble) to be read from the user's computer or reading device. Generally, an eBook can be downloaded in five minutes or less ......................................................................................................................... .............. Browse by Genre Available eBooks .............................................................................................................................. Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, ......................................................................................................................... ......................................................................................................................... .....BEST SELLER FOR EBOOK RECOMMEND............................................................. ......................................................................................................................... Blowout: Corrupted Democracy, Rogue State Russia, and the Richest, Most Destructive Industry on Earth,-- The Ride of a Lifetime: Lessons Learned from 15 Years as CEO of the Walt Disney Company,-- Call Sign Chaos: Learning to Lead,-- StrengthsFinder 2.0,-- Stillness Is the Key,-- She Said: Breaking the Sexual Harassment Story THIS Helped Ignite a Movement,-- Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones,-- Everything Is Figureoutable,-- What It Takes: Lessons in the Pursuit of Excellence,-- Rich Dad Poor Dad: What the Rich Teach Their Kids About Money THIS the Poor and Middle Class Do Not!,-- The Total Money Makeover: Classic Edition: A Proven Plan for Financial Fitness,-- Shut Up and Listen!: Hard Business Truths THIS Will Help You Succeed, ......................................................................................................................... .........................................................................................................................
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • DOWNLOAD THIS BOOKS INTO AVAILABLE FORMAT (2019 Update) ......................................................................................................................... ......................................................................................................................... Download Full PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download Full EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download Full doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... ......................................................................................................................... ................................................................................................................................... eBook is an electronic version of a traditional print book THIS can be read by using a personal computer or by using an eBook reader. (An eBook reader can be a software application for use on a computer such as Microsoft's free Reader application, or a book-sized computer THIS is used solely as a reading device such as Nuvomedia's Rocket eBook.) Users can purchase an eBook on diskette or CD, but the most popular method of getting an eBook is to purchase a downloadable file of the eBook (or other reading material) from a Web site (such as Barnes and Noble) to be read from the user's computer or reading device. Generally, an eBook can be downloaded in five minutes or less ......................................................................................................................... .............. Browse by Genre Available eBooks .............................................................................................................................. Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, ......................................................................................................................... ......................................................................................................................... .....BEST SELLER FOR EBOOK RECOMMEND............................................................. ......................................................................................................................... Blowout: Corrupted Democracy, Rogue State Russia, and the Richest, Most Destructive Industry on Earth,-- The Ride of a Lifetime: Lessons Learned from 15 Years as CEO of the Walt Disney Company,-- Call Sign Chaos: Learning to Lead,-- StrengthsFinder 2.0,-- Stillness Is the Key,-- She Said: Breaking the Sexual Harassment Story THIS Helped Ignite a Movement,-- Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones,-- Everything Is Figureoutable,-- What It Takes: Lessons in the Pursuit of Excellence,-- Rich Dad Poor Dad: What the Rich Teach Their Kids About Money THIS the Poor and Middle Class Do Not!,-- The Total Money Makeover: Classic Edition: A Proven Plan for Financial Fitness,-- Shut Up and Listen!: Hard Business Truths THIS Will Help You Succeed, ......................................................................................................................... .........................................................................................................................
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • DOWNLOAD THIS BOOKS INTO AVAILABLE FORMAT (2019 Update) ......................................................................................................................... ......................................................................................................................... Download Full PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download Full EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download Full doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... ......................................................................................................................... ................................................................................................................................... eBook is an electronic version of a traditional print book THIS can be read by using a personal computer or by using an eBook reader. (An eBook reader can be a software application for use on a computer such as Microsoft's free Reader application, or a book-sized computer THIS is used solely as a reading device such as Nuvomedia's Rocket eBook.) Users can purchase an eBook on diskette or CD, but the most popular method of getting an eBook is to purchase a downloadable file of the eBook (or other reading material) from a Web site (such as Barnes and Noble) to be read from the user's computer or reading device. Generally, an eBook can be downloaded in five minutes or less ......................................................................................................................... .............. Browse by Genre Available eBooks .............................................................................................................................. Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, ......................................................................................................................... ......................................................................................................................... .....BEST SELLER FOR EBOOK RECOMMEND............................................................. ......................................................................................................................... Blowout: Corrupted Democracy, Rogue State Russia, and the Richest, Most Destructive Industry on Earth,-- The Ride of a Lifetime: Lessons Learned from 15 Years as CEO of the Walt Disney Company,-- Call Sign Chaos: Learning to Lead,-- StrengthsFinder 2.0,-- Stillness Is the Key,-- She Said: Breaking the Sexual Harassment Story THIS Helped Ignite a Movement,-- Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones,-- Everything Is Figureoutable,-- What It Takes: Lessons in the Pursuit of Excellence,-- Rich Dad Poor Dad: What the Rich Teach Their Kids About Money THIS the Poor and Middle Class Do Not!,-- The Total Money Makeover: Classic Edition: A Proven Plan for Financial Fitness,-- Shut Up and Listen!: Hard Business Truths THIS Will Help You Succeed, ......................................................................................................................... .........................................................................................................................
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • DOWNLOAD THIS BOOKS INTO AVAILABLE FORMAT (2019 Update) ......................................................................................................................... ......................................................................................................................... Download Full PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download Full EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download Full doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... ......................................................................................................................... ................................................................................................................................... eBook is an electronic version of a traditional print book THIS can be read by using a personal computer or by using an eBook reader. (An eBook reader can be a software application for use on a computer such as Microsoft's free Reader application, or a book-sized computer THIS is used solely as a reading device such as Nuvomedia's Rocket eBook.) Users can purchase an eBook on diskette or CD, but the most popular method of getting an eBook is to purchase a downloadable file of the eBook (or other reading material) from a Web site (such as Barnes and Noble) to be read from the user's computer or reading device. Generally, an eBook can be downloaded in five minutes or less ......................................................................................................................... .............. Browse by Genre Available eBooks .............................................................................................................................. Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, ......................................................................................................................... ......................................................................................................................... .....BEST SELLER FOR EBOOK RECOMMEND............................................................. ......................................................................................................................... Blowout: Corrupted Democracy, Rogue State Russia, and the Richest, Most Destructive Industry on Earth,-- The Ride of a Lifetime: Lessons Learned from 15 Years as CEO of the Walt Disney Company,-- Call Sign Chaos: Learning to Lead,-- StrengthsFinder 2.0,-- Stillness Is the Key,-- She Said: Breaking the Sexual Harassment Story THIS Helped Ignite a Movement,-- Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones,-- Everything Is Figureoutable,-- What It Takes: Lessons in the Pursuit of Excellence,-- Rich Dad Poor Dad: What the Rich Teach Their Kids About Money THIS the Poor and Middle Class Do Not!,-- The Total Money Makeover: Classic Edition: A Proven Plan for Financial Fitness,-- Shut Up and Listen!: Hard Business Truths THIS Will Help You Succeed, ......................................................................................................................... .........................................................................................................................
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • DOWNLOAD THAT BOOKS INTO AVAILABLE FORMAT (2019 Update) ......................................................................................................................... ......................................................................................................................... Download Full PDF EBOOK here { http://shorturl.at/mzUV6 } ......................................................................................................................... Download Full EPUB Ebook here { http://shorturl.at/mzUV6 } ......................................................................................................................... Download Full doc Ebook here { http://shorturl.at/mzUV6 } ......................................................................................................................... Download PDF EBOOK here { http://shorturl.at/mzUV6 } ......................................................................................................................... Download EPUB Ebook here { http://shorturl.at/mzUV6 } ......................................................................................................................... Download doc Ebook here { http://shorturl.at/mzUV6 } ......................................................................................................................... ......................................................................................................................... ................................................................................................................................... eBook is an electronic version of a traditional print book that can be read by using a personal computer or by using an eBook reader. (An eBook reader can be a software application for use on a computer such as Microsoft's free Reader application, or a book-sized computer that is used solely as a reading device such as Nuvomedia's Rocket eBook.) Users can purchase an eBook on diskette or CD, but the most popular method of getting an eBook is to purchase a downloadable file of the eBook (or other reading material) from a Web site (such as Barnes and Noble) to be read from the user's computer or reading device. Generally, an eBook can be downloaded in five minutes or less ......................................................................................................................... .............. Browse by Genre Available eBooks .............................................................................................................................. Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, ......................................................................................................................... ......................................................................................................................... .....BEST SELLER FOR EBOOK RECOMMEND............................................................. ......................................................................................................................... Blowout: Corrupted Democracy, Rogue State Russia, and the Richest, Most Destructive Industry on Earth,-- The Ride of a Lifetime: Lessons Learned from 15 Years as CEO of the Walt Disney Company,-- Call Sign Chaos: Learning to Lead,-- StrengthsFinder 2.0,-- Stillness Is the Key,-- She Said: Breaking the Sexual Harassment Story That Helped Ignite a Movement,-- Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones,-- Everything Is Figureoutable,-- What It Takes: Lessons in the Pursuit of Excellence,-- Rich Dad Poor Dad: What the Rich Teach Their Kids About Money That the Poor and Middle Class Do Not!,-- The Total Money Makeover: Classic Edition: A Proven Plan for Financial Fitness,-- Shut Up and Listen!: Hard Business Truths that Will Help You Succeed, ......................................................................................................................... .........................................................................................................................
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • Be the first to like this

Relazione medici di base sulla schiuma sclerosante

  1. 1. Le vene varicose oggi Dr. Maurizio Ronconi
  2. 2. Epidemiologia malattia varicosa > 6 milioni persone costi superiori a $ 2,5 miliardi 2 milioni di giornate lavorative perse anno anno 1-2% della popolazione costo per NHS £ 400-600 milioni 3% tot. investito per la salute nel mondo industrializato 1% costo totale per la salute
  3. 3. Varicose veins today J. L. O’Hare and J. J. Earnshaw Department of Vascular Surgery, Gloucestershire Royal Hospital, Gloucester GL1 3NN, UK The past few years have witnessed an explosion in types of minimally invasive treatment technique and this has made decisions about varicose vein treatment more difficult . These techniques include thermal ablation in the form of endovenous laser ablation or radiofrequency ablation, and foam sclerotherapy. As it can be concluded already that all of the techniques addressed in this article improve quality of life. British Journal of Surgery 2009; 96: 1229 – 1230
  4. 4. Tecniche odierne di cura delle varici Chirurgiche - Safenectomia radicale - Radiofrequenza (RF) - Laserterapia (EVLT) Non chirurgiche approccio mini-invasivo alla crosse e al tronco safenico, senza eseguire la crossectomia - Sclerosi (ECO-endosclerosi con mousse)
  5. 5. Safenectomia radicale Tecnica stripping lungo, stripping corto,flebectomia Anestesia: generale, peridurale, locale, Incisione inguinale (polite) e sezione della connessione safeno-femorale (safeno-poplitea). Sezione della safena al malleolo (stripping lungo) o al ginocchio (stripping corto) e suo incanulamento mediante stripper. Sezione, legatura delle collaterali e di eventuali perforanti Strippng della safena Outcome Dimissione dall’ospedale il giorno dopo (o giorno stesso) l’intervento. Ripresa normale attività dopo 7 giorni Complicanze Cicatrice chirurgica Linforrea Lesioni nervose
  6. 6. Radiofrequenza Tecnica Anestesia locale al ginocchio. Inserimento di un ago che dalla cute entra direttamente nella vena. Attraverso l’ago viene fatto passare un catetere per radiofrequenza Il catetere trasmette enegia termica fornita dalla radiofrequaenza alla parete della vena facendola collassare e saldare Outcome Dopo la procedura i pazienti vengono bendati, vengono invitati a camminare e generalmente possono riprendere il lavoro entro pochi giorni Complicanze ustioni della cute disestesie/parestesie cutanne da lesioni dei nervi sensitivi superficiali
  7. 7. Radiofrequenza
  8. 8. Laser Tecnica Anestesia locale al ginocchio. Inserimento di un ago che dalla cute entra direttamente nella vena. Attraverso l’ago viene fatto passare una piccola fibra laser Il catetere trasmette enegia termica fornita dalla luce pulsata alla parete della vena facendola collassare e saldare Outcome Dopo la procedura i pazienti vengono bendati, vengono invitati a camminare e generalmente possono riprendere il lavoro entro pochi giorni Complicanze ustioni della cute disestesie/parestesie cutanne da lesioni dei nervi sensitivi superficiali
  9. 9. Laser
  10. 10. ECO-endosclerosi con mousse Tecnica Visualizzazione della vena da trattare mediante ECO-colordoppler Puntura della vena sotto guida ECO Iniezione di schiuma scelrosante Non necessita di alcuna anestesia Complicanze tromboflebite chimica pigmentazione della cute Outcome Immediata rispresa della deambulazione Ripresa dell’attivtà lavorativa dal giorno seguente
  11. 11. Scleroterapia: definizione “Iniezione nel lume vasale di una sostanza estranea all’organismo” “Agisce provocando un danno endoteliale (endosclerosi) che innesca un processo infiammatorio e quindi la fibrosi del vaso” “Lo sclerosante ideale è indolore, senza effetti collaterali, specifico per danneggiare la parete venosa” M.P. Goldman 2002
  12. 12. Preliminary experience with a new sclerosing foam in the treatment of varicose veins Lorenzo Tessari, MD, * Attilio Cavezzi, MD, † and Alessandro Frullini, MD, FACP ‡ * Glauco Bassi Foundation, Trieste, Italy, † Vascular Unit, "Stella Maris" Clinic, S. Benedetto del Tronto, Italy, and ‡ Studio Flebologico, Incisa Valdarno, Florence, Italy Dermatol Surg 27:1: january 2001
  13. 13. 2nd European Consensus Meeting on Foam Sclerotherapy - Tegernsee, Germany
  14. 14. Objectives To revise and update the results of the 1st European Consensus Meeting and to include new, important topics in the development of Foam Sclerotherapy. To provide practical information for less experienced colleagues. Methodology The 29 participants were sent a comprehensive questionnaire in advance covering all the relevant aspects of Foam Sclerotherapy. Until early 2006, 184.000 patients had been treated with Foam Sclerotherapy by the invited experts
  15. 15. F. X. Breu et al., Supplement 71, February 2008, 3 VASA 2008; S/71: 3–29
  16. 16. Results Foam Sclerotherapy has become an established treatment option for varicosis and has undoubtedly im- proved the management of varicose veins. F. X. Breu et al., Supplement 71, February 2008, 3 VASA 2008; S/71: 3–29
  17. 17. Chronic venous disease treated by ultrasound guided foam sclerotherapy P. Coleridge Smith UCL Medical School, London, UK GSV 363 318 (88%) 45 GSV > 5 mm dia 160 130 (81%) 30 GSV <¼ 5 mm dia 203 189 (93%) 15 GSV treated POL 39 33 (80%) 6 GSV treated STD 324 285 (88%) 39 GSV primary 257 220 (86%) 37 GSV recurrent 106 98 (92%) 8 25 14 11 4 21 SSV 141 116 (82%) 48 (77%) 68 (86%) 11 (73%) 105 (84%) Eur J Vasc Endovasc Surg Vol 32, November 2006 SSV > 5 mm dia 62 SSV <¼ 5 mm dia 79 SSV treated POL 15 SSV treated STD 126 SSV primary 135 24 111 (82%) Totale esaminati Stato della vena a 11 mesi dal trattamento 808 occlusa insufficiente
  18. 18.  Surgery for varicose veins is widely used in the UK but recurrence may be expected in 25-50% of patients at 5 years  Surgery leaves scars and may result in damage to adjacent structures including nerves, lymphatics, major arteries and veins. Deep vein thrombosis and pulmonary embolism occur Conclusions. This technique is useful in the management of chronic venous disease as an alternative to surgery Eur J Vasc Endovasc Surg Vol 32, November 2006
  19. 19. Outcome of ultrasound-guided sclerotherapy for varicose veins: medium-term results assessed by ultrasound surveillance K.A. Myers,1* D. Jolley,2 A. Clough1 and J. Kirwan1 1Melbourne Vascular Ultrasound, Epworth Hospital, and 2Monash Institute of Health Services Research, Melbourne, Australia 3 percent. successi 100 80 60 40 20 0 1 2 anni dopo la schiuma successo secondario successo primario Eur J Vasc Endovasc Surg, Vol 33 January 2007
  20. 20. Efficacy and Safety of Great Saphenous Vein Sclerotherapy Using Standardised Polidocanol Foam (ESAF): A Randomised Controlled Multicentre Clinical Trial E. Rabe,1*,a J. Otto,2 D. Schliephake2 and F. Pannier1,a 1Department of Dermatology, University of Bonn, Germany, and 2Chemische Fabrik Kreussler & Co. GmbH, Wiesbaden, Germany Europ J vasc Endovasc Surg: Vol 35, February 2008
  21. 21. Recovery after ultrasound-guided foam sclerotherapy (UGFS) compared with conventional surgery for varicose veins K. A. L. Darvall, G. R. Bate, D. J. Adam and A. W. Bradbury Department of Vascular Surgery, Birmingham University, Heart of England NHS Trust, Birmingham, UK This questionnaire study showed that, when compared with conventional varicose vein surgery, UGFS was associated with significantly less pain and time off work and driving. British Journal of Surgery 2009; 96: 1262 – 1267
  22. 22. Recovery after ultrasound-guided foam sclerotherapy (UGFS) compared with conventional surgery for varicose veins K. A. L. Darvall, G. R. Bate, D. J. Adam and A. W. Bradbury Department of Vascular Surgery, Birmingham University, Heart of England NHS Trust, Birmingham, UK dolore nulla poco tanto chirurgia % p a z i e n t i 100 0 5% foam 17% P = 0,001 % p a z i e n t i 100 0 foam chirurgia T trascorso prima ripresa lavoro 2 settimane 1 -2 settimane 2 -7 giorni entro le 24 ore
  23. 23. La scleromousse: indicazioni  Vena Grande safena (GSV),  Vena Piccola Safena (SSV),  Tributarie (Trib),  Vene varicose ricorrenti (RecVV),  Vene perforanti (PerfV),  Vene reticolari (RetV),  Telangiectasie (Tel),  Malformazioni vascolari venose (VVM)  Altre indicazioni (emorroidi, cisti di Baker, varicocele)
  24. 24. Nostra esperienza pre-procedura  Accurata raccolta anamnestica  Esame clinico ed eco-color doppler  Consegna e spiegazione consenso informato
  25. 25. Nostra esperienza Tecnica  ecografo 7,5 -10 mhz (trasversale o longitudinale)  visualizzazione della crosse  puntura della vena a distanza dalla crosse (4-10 cm)  eventuale catetere intravenoso  concentrazione : TDS 1-3% POL 1-3%  quantità: 0,5 – 1 – 2 fino ad 8 cc  dimensioni vena safena < 12mm
  26. 26. Nostra esperienza post-trattamento  Controllo immediato ECO-colordoppler  Calza elastica  Mobilizzazione immediata  Precise indicazioni di comportamento  Terapia domiciliare
  27. 27. Terapia domiciliare Bioflavonoidi  scoperti da Albert Szent-Gyorgyi (premio Nobel nel 1937)  effetto sinergico antiossidante con la vitamina C  aumentano la resistenza dei capillari e regolano la loro permeabilità  proteggono dalle emorragie e dalle rotture dei capillari 450-900 mg/die
  28. 28. Nostra esperienza Follow-up  7 giorni: esame clinico + eco-colordoppler  30 giorni: eco-colordoppler  6 mesi eco-colordoppler  1 anno esame clinico + eco-colordoppler
  29. 29. Nostra esperienza  Età 30- 84 anni  Dimensioni vene trattate da 0,6 a 1,8 cm  DTS e POL a concentrazioni 1% o 3%  Quantità massima 8 cc (media 4cc)  3 pz in TAO 155 procedure 85 pazienti Casistica
  30. 30. Nostra esperienza Risultati Obliterazione totale 82% (70 pz) Recidiva parziale 14% (12 pz) Completa ricanalizzaizone 4% (3 pz) Follow-up medio 24 mesi
  31. 31. Complicanze in Letteratura  dolore locale  Complicanze ecchimosi maggiori  flebite chimica(3,5-17%)  disestesie  ematoma sede puntura TVP (0,8-2%) EP (0%) Stroke (1 caso) Complicanze minori  cefalea  scotomi amaurosi  teleangectasie  iperpigmentazione  prurito
  32. 32. Nostra esperienza: complicanze Dolore locale lungo la vena trattata 28 28 Iperpigmentazione Iperpigmentazione temporanea temporanea 15 15 Eritema da bendaggio elasto adesivo 6 Edema 1 Cefalea 1 Infezioni 0 TVP/ TEP 0 Ematoma sede puntura 0 Disturbi visivi 0
  33. 33. Novembre 2009
  34. 34. Febbraio 2010
  35. 35. 24/10/2007
  36. 36. 02/03/2010
  37. 37. Varicose veins today J. L. O’Hare and J. J. Earnshaw Department of Vascular Surgery, Gloucestershire Royal Hospital, Gloucester GL1 3NN, UK Today, clinicians should be able to offer at least one alternative to conventional surgery British Journal of Surgery 2009; 96: 1229 – 1230
  38. 38. Grazie per la cortese attenzione

×