Objective: We assessed the use of ultrasound guided foam sclerotherapy (UGFS) to treat bilateral varicose veins either as synchronous or interval procedures. We specifically assessed total foam volume usage and its influence on early outcome and complications.Methods: We reviewed our prospectively compiled computerised database of patients with bilateral varicose veins who have undergone UGFS. Duplex findings, foam volumes used and clinical outcome were assessed.Results: One hundred and twelve patients had undergone UGFS for bilateral varicose veins. Sixty-one had bilateral UGFS (122 legs) and 51 had interval UGFS (102 legs). Seventy-eight percent bilateral and 60% interval procedures were for single trunk disease. Median foam volumes per treatment episode were: 17.5 mls bilateral, and 10 mls interval FS. At two weeks 81% of legs had complete occlusion after bilateral UGFS compared to 70% after interval UGFS. One patient in the bilateral UGFS developed transient visual disturbance. There was no systemic complications in the interval UGFS.Conclusions: Bilateral foam sclerotherapy treatment did not adversly affect vein occlusion rates and there was no significant difference in complication rates between the two groups. Bilateral UGFS can be safely performed in selected patient presenting with bilateral varicose veins.

Objectives: Botulinum toxin injection effectively treats axillary hyperhidrosis. Durability estimates of 3-14 months, based on self re-referral may overestimate duration. Our objective was to determine treatment durability by active follow-up of patients.Design: Audit of current practice.Materials and methods: Patients presenting with severe primary axillary hyperhidrosis were actively followed up for 24 months after intradermal injections of Botulinum Toxin A (Dysport (TM) 120 units/axilla). A 10-point Likert Scale (1 = worst imaginable symptoms, 10 = absolute resolution) and the Hyperhidrosis Disease Severity Score (HDSS) were used at 1 day and 3, 6, 12 and 24 months. We offered re-treatment when symptoms returned to the pre-intervention state.Results: We treated 45 patients with a mean age of 29 (15-49) years of whom 36 (78%) were women. The median pre-treatment Likert score (i.q.r.) of 3 (2-3) improved to 10 (10-10) on day 1. Scores at 3 (n = 44), 6 (n = 43) and 12 (n = 39) months were 10 (10-10), 8 (7.5-10), and 7 (5-8) respectively. The median 24-month score was 3 (3-6) for 35 patients, including 11 patients with scores >= 6 who have not required re-treatment. HDSS scores followed a similar pattern.Conclusions: Axillary botulinum toxin treatment is durable. Patients experience gradual return of symptoms between 6 and 24 months. A minority do not require re-treatment at this time. (c) 2009 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

Restricted accessAbstractFirst published online August 1, 2008Spring meeting of the Venous Forum at The Royal Society of Medicine, 3–4 April 2008Volume 23, Issue 4https://doi.org/10.1258/phleb.2008.081001