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How is foam sclerotherapy different from other sclerotherapy procedures?

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Video Overview

How is foam sclerotherapy different from other sclerotherapy? Foam sclerotherapy consists of injecting foam of a varicose vein. Either one of the two FDA approved drugs currently on the market, Polidocanol or Sotradecol, can be turned into foam by agitating the solution with a gas. Usually, the solution is placed into one syringe and the gas which is either a room air or a combination of oxygen and carbon dioxide connected through a three-way stop cock. The two syringes are agitated 10-12 times and this results in the formation of a thick foam which is then injected into a varicose vein using ultrasound guidance. Upon immediate contact of the foam with the vein wall, there is destruction of the endothelial cells that lead to the formation of a chemical phlebitis and a soft thrombus. The treated leg is then elevated and multi-layered compression is placed on the leg. This compression remains in place for several days and at a week's time or two weeks thereafter, the vein is checked on ultrasound and usually found to be closed. Over the course of several months, this vein undergoes fibrosis and the varicose vein is thus eliminated without the need for surgical removal.

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