Foam Sclerotherapy - Pros & cons

The advantages and disadvantages of ultrasound guided foam sclerotherapy (UGFS)

When used optimally, ultrasound guided foam sclerotherapy (UGFS) is used in veins that cannot be treated by any other technique. As such it is hard to compare ultrasound guided foam sclerotherapy (UGFS) with other techniques.
 
In patients who have stripping or other endovenous treatments, ultrasound guided foam sclerotherapy (UGFS) may be needed as an additional procedure to improve the results or to reduce recurrence in the future.
 
Over the last decade, there has been a trend for some companies and doctors to try to replace stripping, endovenous laser ablation (EVLA) and radiofrequency ablation (RFA) with ultrasound guided foam sclerotherapy (UGFS). In such practices, the great saphenous vein (GSV) and small saphenous vein (SSV) as well as other refluxing veins (anterior accessory saphenous vein, perforating veins etc) are treated with ultrasound guided foam sclerotherapy (UGFS) and the leg is bound.
 
Although some studies have suggested that ultrasound guided foam sclerotherapy (UGFS) is as effective as stripping in such patients, this becomes much less important or interesting when we remember how poor the results of stripping are when compared to the new endovenous techniques performed by experts. In patients with true venous reflux, many of the veins are greater than 6 mm in diameter and therefore ultrasound guided foam sclerotherapy (UGFS) may have a role as an additional procedure, but to get the best results will not be the only technique or even the main technique used.
 
For completeness, those that do advocate ultrasound guided foam sclerotherapy (UGFS) for the treatment of such varicose veins would suggest that the advantages are reduced cost, a walk-in walk-out procedure that can be performed in a simple clinic room and only a very small amount of local anaesthetic is required.
 
However the disadvantages of ultrasound guided foam sclerotherapy (UGFS) when used alone in such cases, are a very high recanalisation rate of the veins that are larger than five or 6 mm in diameter, often necessitating a second treatment within six months to get any notable effect. In addition, the long-term results in these larger veins are considerably worse than the endovenous laser ablation (EVLA) and radiofrequency ablation (RFA) when performed properly. There is also much higher risk of phlebitis (painful lumps in the legs in the healing period) and brown staining of the skin.
 

Conclusion:

Ultrasound guided foam sclerotherapy (UGFS) is an essential technique in the treatment of varicose veins and venous problems. The foam should never be made with air. Ultrasound guided foam sclerotherapy (UGFS) is invaluable to treat a great many difficult veins including recurrent varicose veins, but is rarely sufficient to be used by itself as a single procedure. Ultrasound guided foam sclerotherapy (UGFS) is optimally used as an additional procedure to other techniques and therefore as part of a combination approach to get the best results.
 
 
This website was last updated on 11/10/16.

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