Font Size: Increase | Decrease

What is foam sclerotherapy and how does it work?

I was researching treatments for varicose veins and I found that foam sclerotherapy is a viable treatment. How exactly does foam sclerotherapy work and are there any negative side effects associated with it?

ENTER YOUR ZIP CODE TO GET HELP NOW FROM DOCTORS

Doctors Answers (9)

Foam sclerotherapy involves mixing air with the sclerosing liquid to achieve better results. This foamed solution is then injected into bigger veins to achieve the excellent results of closing veins. Sometimes, we will use ultrasound to gain access to bigger veins and inject the foamed solution into these veins.

Foam is made from one of two detergent sclerosants mixed usually with air or some other inert gas. The foamed sclerosant increases surface area of sclerosant that is in contact with the vein and provides a more uniform coating to the inside of the vein. This allows the use of lower volumes and concentrations with better results for larger veins. It is unnecessary and inadvisable to use foam on smaller (spider) veins. There is a slightly higher risk of side effects with foam sclerotherapy versus liquid. They include visual disturbances, headache, chest pain, or numbness immediately after foam sclerotherapy; 99.9% have full spontaneous recovery within 15-30 minutes.

Sclerotherapy is the injection into a vein, usually of a medical grade detergent that will remove or destroy the thin inner coating of the vein (endothelial lining). This lining can be replaced by the body, allowing the vein to be maintained, but if it is kept closed after the sclerotherapy by wearing compression hose and avoiding exposure to hot water, then the closed veins are reabsorbed by the body and new normal veins will grow when they are needed. Mixing the detergent sclerosant liquid with a gas produces a temporary foam that is more potent, because it is able to stay in contact with the inner vein wall much longer than the liquid. Foam sclerotherapy is useful for treating medium to larger veins, including some varicose veins. It does produce trapping of blood in the closed vein (as does sclerotherapy), which may require aspiration on a follow-up exam. If the vein is large and directly below the skin, it can produce some soreness and staining of the skin (iron stain). For treating larger varicose veins and saphenous trunks, other techniques should be considered, including endovenous ablation and phlebectomy.

Foam sclerotherapy works very well. I prefer this method above all other treatments. However, laser and radiofrequency have their place in the treatment of varicose veins as well. All methods have similar risk and are relatively rare.

Foam sclerotherapy has a place in the treatment of smaller varicose vein. The sclerosing solution is mixed with medical CO2 to make a thick foam. When injected into a vein, it expands to ensure the solution makes good contact with the vein wall and keeps the solution in the vein longer than a liquid would stay. However, the underlying cause of the varicose below is typically venous insufficiency to the saphenous vein. This must be treated first to ensure success of the surface treatments. I, as a board certified surgeon, prefer to remove larger varicose vein through tiny punctures called microphlebectomy. One visit and they are gone, whereas sclerotherapy entails multiple visits to inject and/or remove a blood clot out of the veins.

Foam sclerotherapy is described on the internet. You can try checking Wikipedia for further information. Foam sclerotherapy has not yet been approved by the FDA for varicose veins.

Foam is made from one of two sclerosants and provides a more uniform coating to the inside of the vein. This allows the use of lower volumes and concentrations with better results for larger veins. It is unnecessary and unadvisable to use foam on smaller (spider) veins. Approximately 10-15% of patients experience visual disturbances, headache, chest pain, or numbness immediately after foam sclerotherapy; 99.9% have full spontaneous recovery within 15-30 minutes. Extremely rare stroke-like symptoms have persisted for a day or two, usually (but not always) in patients with a persistent patent foramen ovale (small opening in the heart septum).

Foam Sclerotherapy is when the sclerosant that is being injected into the vein is made foamy by mixing it with CO2 and/or O2. This is more powerful and effective when treating larger caliber veins. Negative side effects can include migraines and there is a risk of neurological complications, particularly in patients with a PFO, which is an opening in the heart. This is normally prevented by lying flat during the treatment and afterwards for 15 minutes.

Sclerotherapy is a treatment for small veins such as spider veins and reticular veins (blue veins under the skin). The sclerotherapy medication is injected into the vein and destroys the vein by contacting the inner vein wall. Foam sclerotherapy is using the same medication but mixing it with a gas to produce a foam. The foam, when injected into the vein, displaces the blood instead of mixing with it. The result is more of the medication touches the vein wall so you will get better results from your treatment. I typically do not use foam sclerotherapy on varicose veins because it will cause phlebitis, which can be quite uncomfortable, brown staining, and take many months for the vein to disappear. When used in the right situation, it is very effective in eliminating veins and very safe with the most common side effects being mild phlebitis.

Disclaimer: The information found on this website is intended to be general medical information; it is not a medical diagnosis or medical advice. Specific medical advice can only be given with full knowledge of all of the facts and circumstances of your health situation. You should seek consultation with a doctor familiar with your medical condition. Posting a question on this website does not create a doctor-patient relationship. All questions you post will be available to the public; do not include confidential information in your question.