Foam Sclerotherapy and Stroke: The Facts

In a UK clinical audit of 7,027 patients undergoing 11,537 foam sclerotherapy procedures, no stroke was reported.

· In France alone, 1.5 million sclerotherapy sessions are performed every year. Worldwide, millions of sclerotherapy treatments are very likely to be performed every month.

In a prospective registry of 12,713 sclerotherapy procedures in France, no cases of stroke were reported.

Only 13 cases of stroke after sclerotherapy have been published in the world despite the huge number of these procedures performed every day around the world. Some involved liquid sclerotherapy (4 cases), not just foam (9 cases). The majority (10 out of 13) made a full recovery. Of the 3 cases of stroke after sclerotherapy that did not make a full recovery, 2 occurred after liquid sclerotherapy.

Stroke is a much greater risk after any operation under general anesthesia, including surgical stripping of the veins compared to foam sclerotherapy.

In my opinion, foam sclerotherapy is very safe. In fact, I believe it is much safer than traditional operations under GA such as stripping which are usually recommended by most vascular surgeons for varicose vein removal.

Ultrasound-guided foam sclerotherapy

Injection treatments have been used for many years to treat varicose veins. Two recent developments now allow us to use an injection technique for the treatment of varicose veins that was previously only curable surgically. These are the use of ultrasound to guide the injection and preparation of the chemical as a foam. In the last 10 years or so, the use of foam injection has spread widely in France, Spain and Italy, and more recently the technique is used in the United States. The treatment can be performed as an “entry, exit procedure” or “lunch time procedure”.

What is foam sclerotherapy?

The solutions that are injected are exactly the same as those already used for the treatment of varicose veins. These are mixed with air to create Sclerotherapy
a lather, which looks a bit like hair mousse or shaving cream. Many medical and scientific studies have confirmed that Foam Sclerotherapy has an excellent safety record and that it produces excellent results in the treatment of venous reflux and varicose veins.

Who is suitable for foam sclerotherapy?

Most people with small to medium sized varicose veins can be treated this way. People with severe venous reflux are generally best treated with Laser or VNUS Closure FAST to achieve faster improvement. People with large varicose veins that are close to the skin are also best treated with microflebectomy to avoid the brown discoloration of the skin that can occur after foam sclerotherapy.

Main features

Ultrasound-guided sclerotherapy is a new method of treating varicose veins

· An operation under general anesthesia is not necessary

Treatment involves injections under local anesthesia

· A treatment session is complete in approximately 45 minutes

Treatment is carefully monitored by ultrasound

A rigid compression bandage should be worn for one week afterwards

The cost of treatment is much lower than that of surgical methods

· Little or no time off work

How does the foam work?

After the injection, the foam pushes the blood away and completely fills the vein. The vein lining is immediately removed from the foam (this doesn’t hurt) and the vein responds by shrinking and the walls of the vein come together. The canal through the vein is sealed and over the course of a few months the vein is completely absorbed by the body’s healing processes.

The treatment

The treatment is performed in a treatment room and not in an operating room. The patient rests comfortably on an examination table. A small amount of local anesthetic is used to numb the skin on the leg, and a small needle is inserted into the reflux vein that feeds the varicose veins. The position of the needle is carefully monitored by ultrasound so that the supply veins are closed. The foam is then injected and its advancement in the feeding veins and varicose veins is carefully monitored with ultrasound. The entire treatment usually takes no more than 45 minutes. Finally, a firm bandage is applied to the leg. The purpose of this is to keep the veins compressed so that they do not fill with blood when the patient stands up. The bandage usually comes i…