How is varicose bleeding treated in venous insufficiency?

Updated: Oct 22, 2018
  • Author: Robert Weiss, MD; Chief Editor: William D James, MD  more...
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Answer

Patients with varicose bleeding usually present to an emergency department (ED), where the traditional management is to oversew the involved vessel. Patients who have had significant blood loss may be admitted to the hospital, particularly if the bleeding varicosity is large and if the overlying tissue is friable. Oversewing a vessel almost always results in short-term control, but it can also cause short-term recurrence of hemorrhage because the procedure does nothing to ablate the dilated, superficial, thin-walled vessel that has ruptured.

Variceal hemorrhage is best managed by means of primary sclerotherapy with sodium tetradecyl sulfate. Tretbar reported a series of cases that were successfully treated by means of primary compression sclerotherapy over a 3-year period. [33]


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