Application of thermal imaging diagnostics in assessment of inflammatory response after sclerotherapy in patients with lower limb daricose disease

Background and Objectives: Sclerotherapy of the lower extremities veins refers to one of the promising methods of treating patients with varicose veins. However, at present, there are no effective methods for assessing the condition of sclerotic veins during sclerotherapy. Known instrumental methods for diagnosing varicose veins cannot be used for such an assessment, since the absence of blood flow and the presence of intravascular inclusions in a sclerotic vein more closely resembles the picture of thrombophlebitis and does not allow us to judge the degree of success of the surgery. Since an important sign of postinjection thrombophlebitis is a local increase in temperature, it is of interest to study the possibility of using thermal imaging diagnostics to assess the condition of a sclerosed vein. Materials and Methods: To obtain temperature data, the ThermaCamSC 3000 camera from FlirSystems company was used, with a sensitivity of $0.02^{\circ}C$ and a resolution of the IR matrix of $320\times 240$ pixels. The thermogram analysis was performed using ThemaCamResearcher software and Mathcad software. The dimensions of the hyperthermia area were estimated by the ratio of the number of pixels, the value of which exceeded the average between the maximum and minimum temperature in the analyzed area to the total number of pixels in the analysis area. Results: Using thermal imaging diagnostics, it was found that for the patients who did not suffer an inflammatory reaction after sclerotherapy, the temperature difference with the surrounding tissues was $1.4 \pm 0.7^{\circ}C$, and the size of the hyperthermia area decreased by $63 \pm 3\%$. For the patients who were diagnosed with post-injection thrombophlebitis, the temperature difference with the surrounding tissues was $2.4 \pm 0.8^{\circ}C$, and the size of the hyperthermia area decreased only by $25 \pm 6\%$. Conclusion: Thermal imaging diagnostics after sclerotherapy can serve as a diagnostic method for assessing the need for conservative treatment of the area of chemical destruction of varicose vein endothelium.