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Anke H Scultetus

Publications and source records attributed to Anke H Scultetus.

4 recordsLinked to original sources
PubMed2003

Microthrombectomy reduces postsclerotherapy pigmentation: multicenter randomized trial.

OBJECTIVE: Postsclerotherapy pigmentation occurs in nearly 30% of patients. Hemosiderin, from degradation of the venous thrombus, is the possible cause. The hypothesis that early removal of the thrombus may eliminate or decrease the incidence of pigmentation has not been proved or documented. The objective of this study was to investigate the effects of early microthrombectomy on incidence of postsclerotherapy pigmentation. MATERIAL AND METHODS: This multicenter, randomized, controlled study involved 101 patients with varicose veins (100 women, 1 man; mean age, 46 years [range, 25-68 years]). Patients were divided into two groups, with veins 1 mm or less in diameter (group 1, n = 50) or veins 3 mm or less in diameter (group 2, n = 51). Group 1 was treated with Sotradecol (STD) 0.25%, and group 2 with STD 0.50%. In each patient, an area of varicosities was selected and divided into halves. One half was randomized to microthrombectomy and the other half served as control. Microthrombectomy was performed 1 to 3 weeks after treatment in the randomized half. Standard photographs were obtained before and 16 weeks after treatment, and were evaluated by three independent reviewers who were blinded to treatment assignments. Each reviewer received an identical set of pretreatment and posttreatment 10 x 15-cm color photographs of the study area, and completed a scoring sheet. Average of the scores was used to evaluate primary (pigmentation) and secondary (overall clinical improvement) end points. The paired t test and chi-square test were used for statistical analysis. RESULTS: In group 1, microthrombectomized areas had statistically significant less pigmentation (P =.0047) and better overall clinical improvement scores (P =.0002) compared with the control side. In group 2 there was no significant difference between the two areas, but patients reported significant relief of pain and inflammation associated with postsclerotherapy thrombophlebitis. CONCLUSION: In veins 1 mm or smaller, microthrombectomy reduced pigmentation and improved overall clinical results. In veins 3 mm or smaller, statistical significance was not achieved, but thrombectomy resulted in faster resolution of the postsclerotherapy pain and inflammation. On the basis of these results, microthrombectomy after sclerotherapy is recommended.

Adult↗
PubMed2002

The pelvic venous syndromes: analysis of our experience with 57 patients.

BACKGROUND: The pelvic venous syndromes comprise a group of poorly understood disorders of the pelvic and gonadal venous circulation. The objective of this paper was to review our experience with the pelvic venous syndromes and, in the light of the current literature, make management recommendations. MATERIALS AND METHODS: Fifty-seven female patients (age range, 24 to 48 years; mean, 34 years) with symptoms of pelvic pain, dysuria, dysmenorrhea, dyspareunia, and the presence of vulval and pelvic varices were studied. Diagnosis included physical examination, Doppler scan, duplex ultrasound scan, computed tomography, magnetic resonance imaging, and retrograde cinevideoangiography. The symptoms were classified as: 1, mild (n = 15); 2, moderately severe (n = 19); and 3, severe (n = 23). Group 1 was treated with sclerotherapy/local excision of vulval varices. Group 2 had gonadal vein resection (GVR; n = 12) and sclerotherapy or gonadal vein coil embolization (GVE; n = 7) and sclerotherapy. Only the incompetent side was treated. Patients in group 3 with isolated hypogastric vein tributary reflux were treated either with hypogastric vein tributaries division (HVTD) or with embolization (HVTE) as the only procedure. Those with combined gonadal and hypogastric vein reflux were treated with HVTE followed by GVR. The follow-up period ranged from 2.5 to 24 years (mean GVR/HVTD, 12.4 years; mean GVE/HVTE, 2.3 years). Pain improvement was assessed with a visual analog scale and through mailed questionnaires (response rate, 100%). Patient results were classified as excellent (asymptomatic), moderate (mild discomfort), or no improvement. RESULTS: In group 1, 12 patients had excellent results and three had moderate results. In group 2, 10 patients treated with GVR had excellent results, one had moderate results, and one had no improvement. Three patients treated with GVE were asymptomatic, and four had no improvement. In group 3, three patients treated with HVTD were asymptomatic and two had no improvement. Five patients treated with HVTE were asymptomatic, and one had no improvement. Of the 12 patients treated with HVTE and GVR, 10 were asymptomatic, one had moderate results, and one had no improvement. CONCLUSION: Local excision of vulval varices and sclerotherapy were sufficient in patients with mild symptoms. Gonadal vein excision produced better results than GVE. In patients with isolated hypogastric vein reflux, embolization was a better option than surgical treatment. GVR preceded by embolization of the incompetent tributaries of the internal iliac vein was indicated in patients with combined reflux and severe symptoms. Supplemental sclerotherapy of vulval varices is recommended after control of the intrapelvic reflux.

Adult↗