الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Background: Venous leg ulcers are a considerable health problem because of their high incidence, slow healing, high recurrence rate and high cost of treatment. Minimally invasive treatments such as endovenous thermal ablation and foam sclerotherapy proved to be safe and effective. However, there is paucity in studies focusing on management of postphlebitic venous ulcers using endovenous thermal ablation of superficial system in combination with foam sclerotherapy. Objectives: The aim of our study was to assess the healing time, procedure related complications and recurrence rate in patients having a post phlebitic venous leg ulcer after being treated with EVLA associated with ultrasound guided foam sclerotherapy to incompetent perforators with compression therapy. Subjects and Methods: This is a prospective observational study, conducted at Ain Shams University Hospitals and Nasser institute hospital in Cairo on 20 patients presented with postphlebitic venous leg ulcers. Results: After six months 80% of cases had a totally healed ulcers, 10% with ulcer decrease in size of more than 50% and recurrence rate 10%. The adverse events of this procedure were DVT (5%), hematoma (5%), ecchymosis 65%), thrombophlebitis (10%), and pain (55%). There was significant improvement of the VCSS as regard pain, edema, inflammation, ulcer size, and number. There was highly significant (p<0.0001) improvement in the mean (SD) VCSS (preoperative 18 (2.808) vs postoperative 6.367 (2.3449)). Conclusion: Patients with totally recanalized deep venous system post deep venous thrombosis, presenting with non-healing venous leg ulcers, may benefit from thermal ablation of superficial varicose veins combined with ultrasound guided foam sclerotherapy. This combined approach is a feasible, safe, and effective modality in terms of improved healing rate, low recurrence rate, low complications, and significant improvement in quality of life.