{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:41:40Z","timestamp":1790775700658,"version":"4.1.0"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T00:00:00Z","timestamp":1768867200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study aimed to evaluate the efficacy and safety of Controlled Venospasm-Assisted Foam Sclerotherapy (CVAFS) combined with high ligation (HL) for treating primary great saphenous vein (GSV) varicosities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>A retrospective cohort of 127 patients with primary GSV varicosities underwent CVAFS with high ligation between 1 Jan 2023 and 1 October 2023. Venospasm was induced by rotational mechanical stimulation of the catheter combined with external compression, resulting in a transient reduction of vessel diameter by 50%\u201370%, followed by DSA (Digital subtraction angiography)-guided foam injection (1:4 liquid-to-gas ratio). Technical success was defined as complete procedural execution under imaging guidance. Primary endpoints included 1-year GSV occlusion rate (assessed by duplex ultrasound) and reduction in Venous Clinical Severity Score (VCSS). Complications were recorded and managed conservatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Technical success was achieved in 100% of limbs (145\/145). Among 127 enrolled patients, 109 patients (125 limbs) completed the 12-month follow-up, yielding a follow-up rate of 85.8% (109\/127). At 12 months, 93.6% of great saphenous veins (117\/125 limbs) maintained complete occlusion. The Venous Clinical Severity Score (VCSS) significantly decreased from 6.18\u2009\u00b1\u20093.90 preoperatively to 0.86\u2009\u00b1\u20090.90 postoperatively (\n                      <jats:italic>V<\/jats:italic>\n                      \u2009=\u20097,875,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). Thrombophlebitis observed in 9.6% of limbs (12\/125), all cases resolved spontaneously within 2 weeks with conservative management (warm compression and NSAIDs). Saphenous Junction Pain occurred in 32.8% of limbs (41\/125), with complete resolution within 2 weeks without intervention. No deep venous thrombosis (DVT), pulmonary embolism, skin necrosis, or neurological injuries were documented.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CVAFS leverages controlled venospasm to enhance foam-endothelium contact, significantly improving occlusion rates and symptom relief with acceptable safety. This approach offers a promising minimally invasive alternative for GSV varicosities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2025.1730329","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T06:34:45Z","timestamp":1768890885000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Controlled venospasm-assisted foam sclerotherapy combined with high ligation\u2014a novel minimally invasive approach for primary great saphenous vein varicosities"],"prefix":"10.3389","volume":"12","author":[{"given":"Chen","family":"Ya","sequence":"first","affiliation":[{"name":"Department of Interventional Radiology, Jingzhou Hospital Affiliated to Yangtze University","place":["Jingzhou, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liu","family":"Zechao","sequence":"additional","affiliation":[{"name":"Department of Interventional Radiology, Lianshui County People\u2019s Hospital","place":["Lianshui, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhu","family":"Xuchang","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Lianshui County People\u2019s Hospital","place":["Lianshui, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Boyu","sequence":"additional","affiliation":[{"name":"Department of Interventional Radiology, Lianshui County People\u2019s Hospital","place":["Lianshui, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liu","family":"Zhengli","sequence":"additional","affiliation":[{"name":"Department of Interventional Radiology, Nanjing First Hospital, Nanjing Medical University","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kong","family":"Jie","sequence":"additional","affiliation":[{"name":"Department of Interventional Radiology, Nanjing First Hospital, Nanjing Medical University","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1016\/j.jvsv.2022.09.004","article-title":"The 2022 society for vascular surgery, American venous forum, and American vein and lymphatic society clinical practice guidelines for the management of varicose veins of the lower extremities. 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