الفهرس 
o Anatomic consideration of the venous systemOnly 14 pages are availabe for public view
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Abstract
Summary
Varicose veins are veins that have become enlarged and tortuous, affecting around 25% of adults. VVS are most common in the superficial veins of the legs, which are subject to high pressure when standing. Besides being a cosmetic problem, VVS can be painful, especially when standing. Severe long-standing VVS can lead to leg swelling, venous eczema, lipodermatosclerosis and ulceration.
Sclerotherapy is a well-tolerated and highly efficacious treatment for varicose and telangiectatic leg veins. Sclerosing solutions act by inducing endothelial damage (endosclerosis), which eventually leads to endofibrosis of the treated vessels. Sclerosing solutions can be placed into three broad categories based on their mechanisms for producing endothelial injury: detergent, osmotic, or chemical irritant solutions. The two most widely used sclerosing solutions worldwide are STS and POL. These detergent based sclerosing agents have a well-documented history of safety and efficacy spanning 40 to 50 years. In our study we used POL (Aethoxisclerol 1%).
IPL systems are high-intensity light sources, which emit polychromatic light with noncoherent broad wavelength spectrum of 515–1,200 nm. The basic principle of IPL devices is a more or less selective thermal damage of the target. The combination of prescribed wavelengths, fluences, pulse durations, and pulse intervals facilitates the treatment of a wide spectrum of skin conditions. With the aid of convertible cut-off filters, IPLs can be easily adapted to the desired wavelength range.
The aim of our study was to perform clinical comparison between injection sclerotherapy with POL1%versus injection sclerotherapy with POL1% plus IPL in the treatment of lower limb varicosities and to asses if the addition of IPL sessions would increase the patient and physician satisfactions or not.
30 female patients with bilateral primary small varicosities subjected to general and local examination and venous duplex to exclude SFJ, SPJ or any perforator incompetence. Then the patients were categorized into two groups, group (A) performed injection sclerotherapy with POL1% and group (B) performed injection sclerotherapy with POL1% followed by 4sessions of IPL on residual small telangiectasias that couldn’t be injected. Photographic records were obtained pretreatment, after every session and after the end of the treatment. Side effects of the treatment assessed at each follow up visit. We compared between patients and physician satisfactions with injection alone versus their satisfaction with injection plus 1PL.
The present study results showed that there was no statistically significant difference between the two groups as regarding the patient and physician satisfaction with p-value >0.05. However, there were no statistically significant difference between the two groups as regarding age, number of pregnancies, duration of varicosities, size of varicosities, occupation, family history and complaint.
In addition we found that there was a statistically significant negative relation between mean physician’s satisfaction with age and duration of varicosities with p-value >0.05, and significant positive relation between mean size of varicosities and both patients and physician satisfaction percentage with p-value >0.05
In conclusion, the injection sclerotherapy for minute varicosities remain the treatment of choice. However, laser and flash-lamp light source as a treatment of lower extremity telangiectasia remains an exciting new area of phlebology research, as the alternatives for treating vessels that are noncannulizable with standard sclerotherapy needles.