YOU ARE NOW CONNECTED TO THE TOXLINE (1981 FORWARD, NON-ROYALTY) FILE. ==VARICOSE VEINS== 3 AUTHOR Callam MJ TITLE Epidemiology of varicose veins. SOURCE Br J Surg; VOL 81, ISS 2, 1994, P167-73 (REF: 70) ABSTRACT Assessment and treatment of varicose veins comprises a significant part of the surgical workload. In the UK, National Health Service waiting lists suggest that there is still considerable unmet need. This review analyses all published data on the epidemiology of varicose veins, paying particular regard to the differing epidemiological terminology, populations sampled, assessment methods and varicose vein definitions, which account for much of the variation in literature reports. Half of the adult population have minor stigmata of venous disease (women 50-55 per cent; men 40-50 per cent) but fewer than half of these will have visible varicose veins (women 20-25 per cent; men 10-15 per cent). The data suggest that female sex, increased age, pregnancy, geographical site and race are risk factors for varicose veins; there is no hard evidence that family history or occupation are factors. Obesity does not appear to carry any excess risk. Accurate prevalence data allow provision of appropriate resources or at least aid rational debate if demand is greater than the resources available. 4 AUTHOR Green D TITLE Sclerotherapy for varicose and telangiectatic veins. SOURCE Am Fam Physician; VOL 46, ISS 3, 1992, P827-37 (REF: 25) ABSTRACT Varicose veins of the lower extremities are present in approximately 20 percent of adults. They are often symptomatic and may contribute to the development of cutaneous changes of venous insufficiency. Sclerotherapy is a nonsurgical procedure to eradicate varicosities. It can be performed in the office and is more cost-effective than traditional surgical vein stripping, which requires hospitalization and a recuperation period. Sclerotherapy is relatively safe and effective and may be used to treat both varicose veins and telangiectatic "spider" veins of the lower extremities. 13 AUTHOR Bodian EL TITLE Sclerotherapy: a personal appraisal. SOURCE J Dermatol Surg Oncol; VOL 15, ISS 2, 1989, P156-61 (REF: 20) ABSTRACT Sclerotherapy is still an excellent procedure for treatment of sunburst venous blemishes. The technique is basic, as described previously. Points to remember are: 1. Use a syringe suited to the size of your hand. The disposable 3-cc syringe fits most hands, and does not require a reload after injection of 1 cc of sclerosant. The TBC syringe may be too long, and holds only 1 cc of sclerosant. 2. Be sure your needle is sharp. Change your needle as often as needed. It is surprising what a difference this can make. 3. Magnify your work! 4. Once you are in the vein, keep your eye on target (the needle point). A fractional deviation can cause you to perforate the tiny blood vessel. 5. Don't aim your needle under the vein; go parallel to it. 6. Inject a small bolus of air before the sclerosant solution. This ensures that you are in the venule and reduces chances of local side effects. Therefore, the syringe and needle must be tilted up, or else the bolus of air is behind the solution. 7. Remember to always store your hypertonic saline separately from all other injectables.