Foam is suitable for certain varicose vein cases

Obliteration, or in medical terms "sclerotherapy" of veins, is a very old technique. Here, materials are injected into the vessels which irritate and consciously damage the walls of these veins. As a consequence, the veins become closed, either by way of local blood coagulation ("thrombus formation"), or directly through "adhesion" of the vessel walls, especially in vessels with a narrow calibre.

For several years now, the obstruction of varicose veins has no longer been practised through the injection of a liquid sclerosing agent, but ever more frequently through the application of a foam or "microfoam". Here, the alcoholic sclerosing agent is, through a special, very simple technique, injected back and forth between two hypodermic syringes until a very fine "microfoam" has formed that is stable for a few minutes.

Instead of injecting a liquid sclerosing agent, the foam is now injected into the vein being treated.

Foam sclerosation has several advantages:

• The sclerosant foam or microfoam clearly has a stronger effect than the original liquid sclerosing agent which has served as a basis
• The foam generally remains in the vessel being treated for several minutes, while the liquid sclerosing agent, as a rule, is washed away very quickly: this intensifies the desired damaging effect on the vascular wall
• The sclerosant foam or microfoam automatically spreads further along the course of the vein through its own tendency to expand
• In larger veins, the distribution of the injected microfoam can also be observed with ultrasound.
• With this procedure, the side branches of larger veins can be closed very well - vessels which are still open, for instance, after vein surgery or a radiofrequency treatment. Also, the application of microfoam is suitable for the primary closure of such veins, without any further preceding treatment.

After the vein treatment, as with the classic vein sclerotherapy, medical compression stockings must be worn for three to 21 days.

 

The use of sclerosant foam is not well suited for the following situations:

• Intended occlusion of very large veins or truncal veins (like the great saphenous vein)
• Sclerosation of very fine veins (like very narrow spider veins)

 

Explanation:

• Foam sclerotherapy of the large truncal veins frequently leads to the flow of microfoam into the deep venous system, where it might trigger the development of a dangerous deep vein or pelvic vein thrombosis
• In dynamic magnetic resonance imaging, the sclerosant foam can already be observed within a matter of seconds even in the circulatory system of the brain: Therefore, it goes without saying that the injection of such large quantities as would be required for the foam sclerosation of truncal veins is not practised
• The application of sclerosant foam ("microfoam") in spider veins, in the same way as conventional vein sclerotherapy using a liquid active agent, frequently leads to the lasting development of unsightly brown spots on the skin. Here, a laser therapy with a special Nd:YAG laser, as used by us, is clearly an advantage.

 

Summary:

We have used microfoam or sclerosant foam for many years as a welcome supplement to the other gentle and scientifically well-documented therapeutic procedures, like radiofrequency therapy (VNUS Closure®, CELON®, RFITT®) or the vein laser or steam vein sclerosis technique.

We use foam sclerotherapy preferably in the course of follow-up vein treatment, to close side branches which might possibly still remain and which are too large to be treated using the Nd:Yag laser.

Foam sclerotherapy, however - for the aforementioned reasons, still offers no replacement for the current techniques involving the reconstruction of the truncal veins through the use of a surgical procedure:

Particularly so, since there is the more gentle and effective alternative of radiofrequency surgery as compared to the traditional (and relatively rough) stripping.