Venous Pressure Monitoring in Patients Undergoing Foam Sclerotherapy

ISRCTN ISRCTN00165319
DOI https://doi.org/10.1186/ISRCTN00165319
Secondary identifying numbers 645/09
Submission date
22/09/2010
Registration date
29/09/2010
Last edited
16/11/2017
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Circulatory System
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English summary of protocol

Not provided at time of registration

Contact information

Mr Tarig Barakat
Scientific

Queen Elizabeth Hospital
Gateshead
NE9 6SX
United Kingdom

Study information

Study designMulticentre observational cohort trial
Primary study designObservational
Secondary study designCohort study
Study setting(s)Hospital
Study typeTreatment
Participant information sheet Not available in web format, please use contact details below to request a patient information sheet
Scientific titleContinuous Ambulatory Venous Pressure Monitoring and the Results of Foam Sclerotherapy in the Lower Limb
Study objectives1. Primary: To quantify and assess the venous pressure-lowering effect of Foam Sclerotherapy in patients with lower limb superficial venous reflux and to compare the venous pressures with patients' activity profiles.
2. Secondary: To assess changes in quality of life associated with foam sclerotherapy treatments
Ethics approval(s)Newcastle and North Tyneside 1 Research Ethics Committee (REC) – submission pending (ref:10/H0906/37)
Health condition(s) or problem(s) studiedVaricose veins
Intervention1. Recruitment:
Patients will be recruited from outpatient clinics held at the Queen Elizabeth Hospital and Freeman Hospital. Three patient groups, determined by the anatomical site of venous reflux will be identified for the study:
1.1. Varicose veins with truncal long saphenous (LSV) incompetence
1.2. Varicose veins with truncal short saphenous (SSV) incompetence
1.3. Varicose veins with combined truncal LSV and SSV incompetence

Patients from the out patient clinic who have been listed for foam sclerotherapy as treatment for their varicose veins, and who fulfil the inclusion criteria will be invited to take part in the study.
These patients will have had a duplex scan as part of their normal work up for varicose vein treatment, and this will determine the sites of venous reflux. Those patients taking part in the study will be invited to attend at a separate visit in order to do venous pressure and activity measurements.
Patients who have agreed to take part in the study and who fulfil the inclusion criteria will be asked to attend the hospital (Freeman or Queen Elizabeth Hospital) for investigations prior to their foam sclerotherapy treatment and again following treatment.

2. Monitoring:
At each of these visits the following will be performed:
2.1. Continuous Ambulatory Venous Pressure Monitoring (CAVPM)
Local anaesthetic will be injected into the skin or emla cream applied at the site of proposed cannula insertion. A 20- gauge PTFE venflon cannula will be inserted into the LSV at the level of the ankle. This will be connected to a pressure transducer and pressure monitoring kit (Novatrans MX860 and MX8004 respectively) and the transducer will be attached to the leg at a predetermined height above the lateral malleolus. Patency of the cannula will be maintained by a continuous heparinised saline flush (concentration 10 units/ml) infused by a syringe driver (MS 16A, Sims Graseby Ltd). The transducer will then be attached to the CAVPM system, which will consist of a palm to Psion organiser II data logger and sf12 software (digitron instrumentation). Attached to the data logger via a cable will be a signal amplifier. The SF12 software processes signals from the amplifier, it drives the data logger and connects the data logger to the Psion Organiser II where data will be stored.

2.1.1. The venous pressure will then be measured during the following activities:
2.1.1.2. Lying, sitting, and standing
2.1.1.3. During and after 10 tiptoe exercises
2.1.1.4. Continuously during walking at a steady pace on a treadmill for a period of up to 20-30 minutes, depending on the patient's capacity for walking.

2.1.2. From these measurements the following data will be obtained:
2.1.2.1. Mean pressure supine, sitting and standing
2.1.2.2. Mean minimum lower limb venous pressure achieved during walking
2.1.2.3. Mean lower limb venous pressure achieved during walking
2.1.2.4. Rates of change of pressure (RCP) with change in posture

2.2. Activity Monitoring (Newcastle Medical Activity Monitor System [NUMACT])
A (non-invasive) NUMACT device will be used. This entails attaching a position sensor to the chest and accelerometer sensor to the lateral aspect of the lower limb being studied. These sensors are connected to a Psion 3 series palmtop computer via an interface module, which the signals from the sensors and provides a high-speed serial data link to the palmtop. The patient can wear this equipment around their waist. The patients will leave the hospital wearing these sensors and will be asked to go about their normal daily activities to permit recordings to be taken over a period of 24 hours. After this they will be reviewed in hospital to remove the recording devices.
The following will be recorded by this method:
2.2.1. Activity profiles during the 24 hour period
2.2.2. The time spent in various positions (supine, sitting, standing)
2.2.3. The time spent performing activities and the step amplitude.

The patient will have a duplex scan before and 6 weeks after the foam sclerotherapy as part of the clinical work up. The CAVPM and NUMACT measurements will performed before and after the foam sclerotherapy.
Intervention typeDevice
Pharmaceutical study type(s)
Phase
Drug / device / biological / vaccine name(s)
Primary outcome measureTo quantify and assess the venous pressure-lowering effect of Foam Sclerotherapy in patients with lower limb superficial venous reflux and to compare the venous pressures with patients' activity profiles. These measurements will be performed using a Continuous Ambulatory Venous Pressure Monitoring device and a NUMACT system
Secondary outcome measuresTo assess changes in quality of life associated with foam sclerotherapy treatments using the Aberdeen Varicose Vein Questionnaire.
Overall study start date15/10/2010
Completion date14/10/2012

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participants36
Key inclusion criteria1. Patients with long or short saphenous venous reflux
2. Patients with varicose veins belonging to any of the clinical classes of Clinical, Etiologic, Anatomic and Pathophysiologic (CEAP) classification C2, C3, C4, C5 and C6
3. Patients with a full range of movement of the joints in both their lower limbs
4. Patients who are freely mobile with no mechanical aid assisting their movement
5. Aged 18 - 75
Key exclusion criteria1. Patients belonging to CEAP Ec, Po and Po & R or with past history of Deep Vein Thrombosis (DVT) or pulmonary embolism
2. A history suggestive of deep venous obstruction
3. Peripheral arterial disease
4. Anticoagulation therapy
5. Serious systemic diseases such as angina, myocardial infarction, asthma, COAD, CCF, hepatic failure and renal failure
6. Pregnancy
7. Any patent with heparin allergy
8. Patients unable to give consent
Date of first enrolment15/10/2010
Date of final enrolment14/10/2012

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

Queen Elizabeth Hospital
Gateshead
NE9 6SX
United Kingdom

Sponsor information

Gateshead Health NHS Foundation Trust (UK)
Hospital/treatment centre

Queen Elizabeth Hospital
Gateshead
NE9 6SX
England
United Kingdom

ROR logo "ROR" https://ror.org/01aye5y64

Funders

Funder type

Government

Gateshead Health NHS Foundation Trust (UK)

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Editorial Notes

16/11/2017: No publications found, study status unverified.