Transthoracic Echocardiogram and Transcranial Doppler Detection of Emboli After Foam Sclerotherapy of Leg Veins
Authors: Hansen, Kristin; Morrison, Nick; Neuhardt, Diana L.; Salles-Cunha, Sergio X.
Source: Journal for Vascular Ultrasound, Volume 31, Number 4, December 2007 , pp. 213-216(4)
Publisher: Society for Vascular Ultrasound
Key:
- Free Content
- New Content
- Subscribed Content
- Free Trial Content
Abstract:
Purpose.—Patients with chronic venous insufficiency have been successfully treated with foam sclerotherapy. Reports of cerebral and respiratory symptoms after the foam procedure have been related to an open foramen ovale (PFO) between the right and left sides of the heart. This work evaluated the value of ultrasonography to demonstrate that bubbles may traverse a PFO and may be detected at the middle cerebral artery.Methods.—Patients describing cerebral or respiratory symptoms or suspected of having a PFO entered this study. Cerebral symptoms included visual disturbance, lightheadedness, dizziness and migraine. Respiratory problems included cough. A total of 20 patients had transthoracic echocardiography (TTE), and 12 had transcranial Doppler (TCD) of the middle cerebral artery.Results.—TTE detected bubbles in the left heart in 13 (65%) of 20 patients. The 12 TCDs were performed in nine patients with positive and three with negative TTE evaluation; five TCDs were positive for emboli at the middle cerebral artery. All five patients had positive transthoracic echocardiography.Conclusions.—This single-institution evaluation for quality control demonstrated that 1) patients with cerebral or respiratory symptoms after foam sclerotherapy may have PFO; and 2) patients with patent PFO may embolize the gas particles to the brain. Therefore, patients with known PFO must be evaluated before foam injection, and patients that are candidates for this treatment may have to be screened for PFO.Document Type: Research article
Key:
- Free Content
- New Content
- Subscribed Content
- Free Trial Content

Click here for Page Help