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FOAM Sclerotherapy


Ultrasound guided FOAM sclerotherapy is a variation of liquid sclerotherapy that can be used instead of surgery to treat varicose veins.

Foam sclerotherapy is performed as an out-patient procedure and takes about 30 minutes.

Using an ultrasound scanner a very small plastic tube called a cannula is inserted into the varicose vein or vein feeding into the varicose vein. This is usually either the ‘long saphenous vein’ on the inside of the thigh or the ‘short saphenous vein’ on the back of the calf and their main branches. Using the ultrasound scanner allows a surgeon to see the needle enter the vein requiring treatment.

The foam is freshly prepared and injected into the Varicose vein via the plastic tube. Once the foam enters the varicose veins it is massaged along the varicose veins in the leg. The FOAM can be easily seen using the ultrasound as it is full of bubbles that show up clearly on ultrasound. Doing this allows us to ensure that the veins are filled with the sclerosant. Typically I inject 8-12 ml of foam at each treatment session. If any FOAM is seen close to the deep venous system then pressure can be applied to keep this to a minimum. This is why the ultrasound is used to guide the FOAM sclerotherapy.

The injection causes no pain in the leg, although sometimes some a mild ache can be felt as the sclerosant starts to take effect.

In about 85% of patients, only one foam treatment session is required; about 15% of patients require two sessions and 1-2% require three sessions. The larger and more extensive, the more likely it is that more than one session will be required.

Following the procedure class 2 compression stockings are applied. These are to be worn for two weeks to keep the veins compressed with the aim for comfort and greater success by wearing them.

Advantages

  • Outpatient procedure
  • No General anaesthetic
  • No Cuts
  • No nerve damage
  • Earlier return to work
  • Cost


Disadvantages

  • The skin over the treated varicose vein can turn brown. This can take a few months (sometimes up to year) to disappear and may, unusually, be permanent
  • In order to keep the treated VV empty of blood while they seal off, it is necessary to wear compression for several weeks after each treatment
  • Lumpiness: It is normal, especially in patients with large veins, to be able to still feel some lumpiness beneath the skin. Depending on the size of vein this disappears over a few months and in most patients is gone by 6-12 months
  • Overall treatment can take a little longer as very occasionally multiple treatments are needed

A patient information leaflet for FOAM sclerotherapy is available here


FOAM sclerotherapy of varicose veins has been recognised by the National Institute of Clinical Excellence (NICE) who has also published guidance on FOAM sclerotherapy.

FOAM sclerotherapy NICE Guidance