Foam sclerotherapy

Injection treatments for varicose vein removal have been used for many years to treat varicose veins. Two recent developments now allow us to use an injection technique to treat varicose veins that were previously only treatable by surgery. These are the use of ultrasound to guide the injections and the preparation of the chemical as a foam.

Over the last 10 years or so, the use of foam injections has spread widely in France, Spain and Italy and more recently the technique is being used in the USA. The treatment can be performed as a “walk in, walk out” or “lunch hour” procedure.

Key features

  • There is no need for an operation under general anaesthetic
  • The treatment involves injections under local anaesthetic
  • A treatment session is complete in about 45 minutes
  • The treatment is carefully monitored using ultrasound
  • A firm compression bandage must be worn for a week afterwards
  • The costs of treatment are much lower than for surgical methods
  • No time off work

What is foam?

The solutions that are injected are exactly the same as those which are already used to treat varicose veins. These are mixed with air to create a foam which looks a little like hair mousse or shaving foam. Many scientific studies have shown that this foam is perfectly safe to inject into veins. The air is rapidly absorbed from the veins leaving the solution to treat the veins.

What does the foam do?

Foam pushes the blood out of the way and completely fills the vein. The lining of the vein is removed by the foam and the treatment starts a healing process. The vein walls stick together and the channel is closed off. With time the vein is completely absorbed by the body.

The treatment

Treatment is performed in a treatment room and not an operating theatre. The patient rests comfortably on an examination couch. A small amount of local anaesthetic is used to numb the skin of the leg and a small needle is inserted into the refluxing vein that is feeding the varicose veins. The position of the needle is carefully monitored using ultrasound so that the feeder veins are closed.

Foam is then injected and its progress into the feeder veins and varicose veins is carefully monitored with ultrasound. The whole treatment usually takes no more than 45 minutes.

Finally a firm bandage is applied to the leg. The aim of this is to keep the veins compressed so that they do not fill with blood when the patient stands up. The bandage is usually worn for a week followed by an elastic compression stocking for a further week.

When the bandages are removed at the follow-up appointment it is usual to find that all the varicose veins have been sealed. The leg may be a little bruised at this stage, although this is usually fairly minor. If any varicose veins have not been completely treated in the first session, they are injected and bandaged to complete removal of all veins.

If varicose veins are present in both legs, the treatment is given to one leg at a time with an interval of 1 or 2 weeks.

Who is suitable for foam sclerotherapy?

Most people with small or moderate size varicose veins can be treated in this way and feeder veins associated with thread veins and spider veins can also be treated by foam sclerotherapy. People with very extensive large varicose veins are usually best treated by a combination of foam sclerotherapy and phlebectomy to obtain rapid results with the best cosmetic appearance. In many cases combination therapy is recommended and very often foam sclerotherapy is combined with VNUS Closure as well as phlebectomy.