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How is sclerotherapy different than foam sclerotherapy?

This question was asked in Philadelphia, Pennsylvania and has 7 answer(s) as of 06/18/2013.
I want to know more about sclerotherapy to treat varicose veins. I know that sclerotherapy is a chemical injection into the skin. What is the chemical? And under what symptoms do you recommend foam sclerotherapy? What's the difference with the foam treatment? Is one cheaper.


Doctors Answers (7)

Sclerotherapy is the injection of a sterile chemical sclerosant, usually a liquid medical-grade detergent such as Sotradecol (sodium tetradecyl sulfate) or polidocanol into a vein. This causes an inflammatory destruction of the internal lining of a vein resulting in closure of the vein and re-absorption by the body. Foaming of the liquid increases the potency of the sclerosant by about 3 fold by increasing the contact time with the internal vein wall and is typically used on larger veins. The cost may be the same or more for treating superficial surface veins and would cost more if used with a guided procedure such as ultrasound guided injections of deeper larger varicose veins.

Foam Sclerotherapy basically means you are mixing the medication that is injected with either room air or CO2 to make it bubbly. This is very effective for closing down the varicose veins. The medication that is injected may vary between vein practices. I generally use either Asclera or sodium tetradecyl sulfate (STS). In my practice it is not more expensive when we foam the solution. We either treat bulging varicose veins with sclerotherapy or phlebectomy. A phlebectomy is the removal of the varicose veins through tiny micro punctures in the skin that leave minimal to no scarring. Of course it is most important to treat the underlying problem that is causing the varicose vein first which will yield the best results.

Sclerotherapy is the treatment of varicose viens by injecting a liquid sclerosant (medication) into the vein that needs treatment. There are different types of sclerosant available. Detergent sclerosants, sodium tetradecyl sulfate and polidocanol are the medications that are used to make "foam." Liquid sclerotherapy is different from foam sclerotherapy due to the addition of air or a mixture of air and carbon dioxide added to the sclerosant. Foam is typically used for the treatment of larger varicose veins. However, it can be used in smaller veins as well. It is injected into varicose veins under ultrasound guidance or with visual guidance. It looks like shaving cream and can been seen inside the veins with ultrasound imaging after injection. It displaces the blood and fills varicosities where as the liquid form is diluted with blood and may not be as effective for treating larger veins. It is a very effective method of treating large varicose veins.

Foam sclerotherapy is different from regular or liquid sclerotherapy because it is more potent. The foam bubbles prolong and intensify the effect of the sclerosant. In modern sclerotherapy, the foam and the liquid are usually one of two medications: sotradecol or polidocanol. Sclerotherapy can be used for any vein related symptoms. The price for foam and regular sclerotherapy are usually the same.

Both procedures are called sclerotherapy. Ultrasound guided "Foam" sclerotherapy is done to treat medium size varicose veins (3mm-6mm). This latter procedure requires ultrasound guidance, and the former are simple injections using the naked eye.

Sclero therapy is the injection of a chemical into the veins which causes an inflammatory reaction resulting in permanent vein closure. Currently, the 2 FDA approved sclerosants are sodium teyradrcyl and polidocanol. Foam sclero therapy is the mixture of the sclerosant with air. This causes the sclerosant to become more diluted and therefore a higher volume can be injected. Foam sclerosant is also easier to visualize under ultrasound. There should be no difference in price between regular sclero therapy and foam sclero therapy.

Both foam sclerosant and liquid agents are directly injected into veins, not the dermis (skin). Both work by sclerosing or denuding the inner lining of the vein. The foam solution is just the liquid agent that is mixed with air bubbles, enhancing the sclerosing effect. The only drug used at my office is Polidocanol (Asclera).

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