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Ultrasound Guided Foam Sclerotherapy

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There is little doubt that the integration of ultrasound technology with traditional sclerotherapy has made varicose vein treatment both safer and more precise. Ultrasound guided foam sclerotherapy, sometimes called endovenous chemical ablation, is a type of varicose vein treatment that combines the use of ultrasound imaging and foam sclerotherapy. Ultrasound guided foam sclerotherapy is a useful alternative to vascular surgery for a large number of patients with varicose veins. The ultrasound enables the physician to see and treat veins below the skin.

A traditional sclerotherapy agent is a liquid medication. Its chemical effect irritates the lining of the targeted vein such that the entire vein seals off completely. After the blood vessel is no longer functional, it is eventually reabsorbed by surrounding body tissue. In general, sclerotherapy aims to remove spider veins and varicose veins. These veins may be unattractive and/or cause symptoms such as leg heaviness, cramping, fatigue or swelling. In addition, varicose veins can lead to nutritional compromise of the skin, resulting in skin darkening, inflammation or open sores called ulceration.

The liquid agent used in regular sclerotherapy is effective but can be diluted and rendered less effective if there is a lot of blood in the targeted varicose vein. The dilution occurs before the liquid agent has a chance to work properly inside the varicose vein. This is particularly true when treating larger varicose veins that contain a high amount of blood.

Foam sclerotherapy, a variation of sclerotherapy with liquid agents, can be used to reduce the issue of blood diluting the sclerosant. Foam is created by taking certain types of liquid sclerosants and mixing or agitating them with a gas such as air or carbon dioxide. Researchers have lauded the benefits of the foam agent’s thicker consistency in yielding increased success in eliminating varicose veins.

The thicker solution used in foam sclerotherapy displaces the blood and thus does not tend to get diluted. As a result the medication tends to stay in contact with the vein wall for a longer period of time than was ever possible with liquid sclerotherapy agents.

Another benefit of foam sclerotherapy over traditional sclerotherapy is that the foam used actually shows up more clearly on an ultrasound machine than would a liquid agent. This means that the physician can track which veins have been treated as well as the initial impact of the treatment. When ultrasound is used to track foam treatment of varicose veins, the procedure is called ultrasound guided foam sclerotherapy. Using the ultrasound to deliver foam sclerotherapy is a way to improve precision, accuracy and effectiveness of the treatment.

Instructions after treatment with ultrasound guided foam sclerotherapy often include wearing compression stockings for one to two weeks, walking on a daily basis and avoiding hot baths, heavy lifting and long travel for one week or so after the procedure. Although ultrasound guided foam sclerotherapy is generally very well tolerated, complications are possible, just as with any medical procedure. It is important that an experienced physician perform treatment with ultrasound guided foam sclerotherapy in order to maximize success and minimize risk.

Utilize DoctorQA’s vein specialist database if you want to know if ultrasound guided foam sclerotherapy may benefit your vein condition.


Reviewed by Steven E. Zimmet, MD, RVT, FACPh
Editor of Phlebology
President, Zimmet Vein & Dermatology
Past-President, American College of Phlebology

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