Foam Sclerotherapy Effective for Varicose Veins

Ultrasound-guided foam sclerotherapy safely achieves complete occlusion in 91% of legs with varicose veins, according to a new study.

Researchers from the Royal Bournemouth Hospital (UK) assessed a total of 192 consecutive patients referred for varicose vein treatment over a 15-month period. Eleven of these patients selected surgery, while the remainder chose ultrasound-guided foam sclerotherapy, using polidocanol in a 1:3 mixture with air. Under ultrasound guidance, 1% foam was injected into superficial veins, while 3% was used for saphenous trunks. The maximum permitted foam volume was 14 ml. Of the 220 legs treated with ultrasound-guided foam sclerotherapy, 163 showed complete occlusion of varicosities after one intervention. With a second treatment, 32 additional legs achieved complete occlusion and with a third, one more responded. Thus, the overall rate of complete occlusion was 91%.

With the exception of two legs with great saphenous vein incompetence that failed ultrasound-guided foam sclerotherapy, the remaining legs without complete occlusion did achieve partial blockage. The presence of small saphenous vein varicosities rather than great saphenous vein incompetence predicted treatment success after one session. Ultrasound-guided foam sclerotherapy was generally well tolerated and was not associated with any serious complications. Several patients experienced phlebitis and pigmentation that could have cosmetic implications. The findings were reported in the August 2006 issue of the British Journal of Surgery.

"The results reported here are very early,” concluded the authors Dr. S. G. Darke and Dr. S. J. Baker, of the vascular surgery department at Royal Bournemouth Hospital. "It remains uncertain whether these early results will translate into similarly satisfactory longer-term outcomes, even if further injections are necessary.”

Foam sclerotherapy uses a technique that converts the liquid sclerosing solution to a foam that has a greater surface area, so much more of the vein comes in contact with the sclerosing agent. Added ultrasound guidance allows visualization of the inserted needle in deeper veins.



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