Abstract：Objective This study aimed to explore the curative effect of foam sclerotherapy for pathological perforator veins in the treatment of variceal ulcer of lower extremities (VULE) under ultrasound guidance. Methods A cross-sectional study was conducted. Sixty patients (65 sides) with VULE caused by pathological perforator veins who were admitted to the First Affiliated Hospital of Bengbu Medical University from January 2017 to January 2021 were included in this study. Among them, 38 were males and 22 were females, with an average age of 46-77(56.3±11.4) years. The clinical-etiological-anatomical-pathological-physiological classification was grade C6. The patients were treated with foam sclerotherapy for pathological perforator veins under ultrasound guidance. The operation time, postoperative hospital stay, ulcer healing, perforator vein reflux, and postoperative complications (such as local induration formation, skin necrosis, deep vein thrombosis, pulmonary embolism, stroke, and transient visual impairment) were observed. Results All surgeries of the 60 patients were successfully completed without any complications such as sclerosant leakage, bleeding, or soft tissue swelling. The operation time was 23.0-80.0(46.6±12.2) min, and the postoperative hospital stay was 1.0-10.0(5.6±1.7) days. Two patients developed local induration on the 7th day after surgery, but they recovered after appropriate treatment. All 60 patients were followed up for 6-12(10.8±2.7) months. During the follow-up period, two patients experienced recurrence of minor ulcers around 2 months after surgery, with ultrasound examination revealing partial reperfusion of the previously closed perforator veins. They were treated with foam sclerotherapy under ultrasound guidance, and their ulcers healed without further recurrence after 3 months of follow-up. The ulcers on the affected limbs of all 65 sides in the 60 patients healed within 1-3 months, and follow-up ultrasound examinations showed no pathological perforator vein reflux around the original ulcer site. During the follow-up period, symptoms such as itching, pain, and pigmentation on the affected lower limbs significantly improved, and there were no complications such as skin necrosis, deep vein thrombosis, pulmonary embolism, stroke, or transient visual impairment. Conclusion Using foam sclerotherapy under ultrasound guidance to treat pathological perforator veins in VULE is safe and effective. It features easy operation and the ability to be repeatedly used in case of postoperative recurrence. Therefore, it is worth promoting and applying clinically.
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