Foam sclerotherapy treats varicose veins

Ultrasound-guided foam sclerotherapy is safe and effective for the treatment of varicose veins, a study shows. The technique safely achieves complete occlusion in 91 percent of legs with varicose veins, doctors report in the British Journal of Surgery.

Still, longer follow-up is needed to determine if the benefits are lasting, they warn.

Established sclerotherapy techniques use liquid injections to treat varicose veins. Ultrasound-guided foam sclerotherapy is a variation that uses a sclerosant solution that has been transformed into foam by being forcibly mixed with air.

A study reported in 1944 provided the first evidence that adding air to liquid "sclerosants" enhanced their efficacy in treating varicose veins. However, this concept received little attention until about a decade ago when researchers showed that sclerotherapy with foam was more effective than with liquid sclerosants, particularly under ultrasound guidance.

In their report, Dr. S. G. Darke and S. J. A. Baker, from the Royal Bournemouth Hospital in the UK describe 192 patients referred for varicose vein treatment over a 15-month period. Eleven of these patients selected surgery, while the remainder chose ultrasound-guided foam sclerotherapy.

Of the 220 legs treated with ultrasound-guided foam sclerotherapy, 163 were successfully treated, showing complete occlusion of varicosities after one intervention. With a second treatment, 32 additional legs achieved complete occlusion and with a third, 1 more responded. Thus, overall rate of complete occlusion was 91 percent.

Ultrasound-guided foam sclerotherapy was generally well tolerated and was not associated with any serious complications. Several patients experienced phlebitis and pigmentation, which could have cosmetic implications, but further follow-up is needed, the authors note.

While encouraging, "the results reported here are very early," the researchers point out. "It remains uncertain whether these early results will translate into similarly satisfactory longer-term outcomes, even if further injections are necessary."

SOURCE: British Journal of Surgery August 2006.