Sclerotherapy in Venous Ulcers: The Sooner the Better


Sclerotherapy is the most widely used endovenous procedure as an alternative to surgery in patients with venous ulcers. As it is a minimally invasive technique, with excellent results and few complications, it is of great interest to our usually elderly patients with comorbidities. I had previously dedicated a post to this technique: “Sclerotherapy wins against venous ulcer recurrence”. Subsequently, in the post “5 recent publications on the treatment and prevention of venous ulcers” I commented on the results of the recently published EVRA study, which points to the benefit of endovenous techniques, not only to prevent recurrences but also to accelerate wound healing.

This sounds very hopeful, but the reality is that most of our patients do not have quick access to the specialists who perform this technique. We are sure that many venous ulcer patients can benefit from sclerotherapy and that proper diagnosis and early treatment are essential in wound healing and quality of life. Therefore, we have established a partnership with the Angiology and Vascular Department of the Central Hospital Central de la Cruz Roja in Madrid, a leading team in phlebology. The formalization of this collaboration would not have been possible without the enthusiasm, motivation and effort of Dr. Lourdes Reina, head of Service and Secretary of the Capítulo Español of Phlebology and Lymphology of the Spanish Society of Angiology and Vascular Surgery (among other positions and titles). Lourdes Reina clearly states that the continuous training of professionals is the essential pillar to achieve a successful treatment in our patients. I couldn’t agree more: NO TRAINING, NO CHOICE!

The EVF How Plus Sclerotherapy took place on the 21st and 22nd of March at the Hospital Central de la Cruz Roja in Madrid.  The EVF (European Venous Forum) is an international scientific society very involved in the training and dissemination of knowledge among phlebologists. Lourdes Reina tells us with words and images how these conferences were developed:

“46 ultrasound-guided sclerotherapy treatments were carried out. All complex cases, many of them varicose veins, pelvic varicose veins and advanced stages of chronic venous disease. Several cases of patients with healed or active ulcers were treated. Seven expert teachers and 12 students came from all over the world (South Africa, Turkey, Venezuela, Brazil, Serbia). All of them are physicians dedicated to Phlebology, with interest in expanding their knowledge in Sclerotherapy.   Theoretical lectures were given on technical aspects, complications, C1, varicose vein recurrence and of course an update on the treatment of venous ulcers. I gave a talk on venous ulcer treatment. I stressed the importance of carrying out a venous echoDoppler as soon as possible to look for the presence of superficial venous reflux and rule out the existence of extensive deep venous disease, in order to apply endoluminal therapy in the first two weeks of the ulcer ocurrence, with the aim of eliminating superficial venous reflux. I discussed the advantages of endoluminal therapy versus stripping surgery in patients with wounds and the advantages of sclerotherapy versus other endoluminal techniques. I also commented on the trend in the indication of endothermal techniques or sclerotherapy depending on the patient profile according to the experts.

Dear Lourdes, it is a great pleasure that our teams can work together to improve the lives of people with venous leg ulcers!



Definitive program EVF HOW Plus Course Sclerotherapy Madrid 21-22 March 2019

Also available in: Español (Spanish)



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