BENEFIT OF TREATMENT WITH INTRAVENOUS SCLEROSIS IN A PATIENT WITH PERIPHERAL ARTERY DISEASE – A CASE REPORT
Keywords:
peripheral arterial disease, venous sclerosis, claudicationAbstract
Peripheral arterial disease (PAD) is a complex process. Prevention of major amputations should always be the cornerstone of treatment. PAD affects the peripheral vasculature and can cause gangrene, intermittent claudication, ischemic rest discomfort, ischemic ulcers, and functional impairment. There is a fine line between the peripheral arterial system and the peripheral superficial venous system, and therefore these two systems can be considered as one system, especially in patients with proven superficial venous insufficiency.
Objective: To protect patients with PAD and simultaneously with venous insufficiency from future unwanted complications, we provided a case where superficial venous sclerosis provides better peripheral arterial circulation, proven by examining arterial flow before and after the intervention.
Case report: A 75-year-old man presented to the doctor because of pain in the lower extremities when walking. Doppler of the lower extremities was performed, where a biphasic Doppler signal of the AFS with PSV 83 sm/sec was noted, absent Doppler signal of the A.popliteal in the P2 segment. On the trend mill test before the intervention, on a treadmill with a speed of 3.7 m/sec and an elevation of 0%, the patient walked 50 meters until claudication occurred. Venous sclerosis of the saphenous vein magna and saphenous vein parva was performed. Two hours after the intervention, the patient underwent another trend mill test, where at a speed of 3.7 m/sec and with 0% elevation, the patient walked 400 meters until claudication occurred. One month after the intervention, a control Doppler of the lower extremities was performed on the patient, where a biphasic Doppler signal of the AFS with PSV 65 sm/sec as well as a biphasic Doppler signal of the A.popliteal with PSV 55 sm/sec was noted. On the trend mill test, on a treadmill with a speed of 3.7 m/s and an elevation of 0%, the patient did not experience claudication during the test.
Conclusion: From our case report, we concluded that the flow in the arterial bed improved immediately after the venous sclerotherapy. This contributes to the reduction of future unwanted complications in patients with peripheral arterial disease, as well as to the improvement of clinical symptoms.
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