Ultrasound-Guided Foam Sclerotherapy

Foam sclerotherapy closes varicose veins by injecting medicated foam under ultrasound guidance. It requires no incisions or general anaesthetic, and it is especially useful for veins that are too twisted, too short, or too close to the skin for a catheter.

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How it works

The foam is made by mixing a sclerosant medicine with air. When injected into the vein, it displaces the blood and irritates the vein lining, causing the walls to stick together and close the vein. Over the following weeks and months, the body gradually absorbs the closed vein, and blood flows through the healthy deep veins instead.

Ultrasound lets us see the foam travel along the vein in real time, so it reaches exactly the segment that needs treating, including veins that cannot be seen from the surface.

 

When foam is the right choice

Foam sclerotherapy may be recommended:

• for tortuous (twisted) veins a catheter cannot pass along

• for varicose veins that have come back after previous surgery or ablation

• for branch veins left after EVLA or radiofrequency ablation, often in the same session

• where an alternative to thermal ablation is preferred

NICE recommends thermal ablation first where it is suitable, and foam where it is not. Your duplex scan shows which applies to your leg.

 

The treatment

1. The veins to be treated are mapped with ultrasound.

2. A fine needle or small cannula is placed in the vein.

3. We prepare the foam and inject it under ultrasound, watching it fill the target vein.

4. The leg is bandaged, and a compression stocking is applied.

5. You walk around straight away and go home the same day.

Treatment takes 15 to 60 minutes, depending on how many veins are treated.

 

After foam sclerotherapy

Compression and regular walking are the key to a good result. You will be given written instructions on how long to wear the stocking. Firm, tender lumps along the treated vein are common in the first weeks as the vein is absorbed; occasionally we release trapped blood from a lump with a fine needle in clinic, which brings immediate relief.

In around 1 in 8 treated veins, foam does not close the vein fully at the first attempt and a further session is needed. This is checked at your follow-up scan.

 

Side effects and risks

• Skin staining — a brownish line along the treated vein in 10 to 30 in 100 cases, fading over 6 to 12 months; a faint mark persists in a few.

• Matting — a blush of very fine red vessels in about 1 in 5, usually fading within a year.

• Visual disturbance — flashing lights or a brief blind spot in around 1 to 2 in 100, more often in people with migraine; it resolves within the hour. Please tell us if you have migraine with aura.

• Deep vein thrombosis — 1 to 3 in 100, most often a small clot found on the routine follow-up scan.

• Stroke or TIA — a very rare complication of foam.

We go through the risks that apply to you, and the alternatives, before you decide.

 

Book a consultation

Mr Prionidis sees patients at Springfield Hospital and Phoenix Hospital in Chelmsford, St Edmunds Hospital in Bury St Edmunds, and Weymouth Street Hospital in London.

No GP referral is needed, and we welcome both self-pay and insured patients.

Call 01245 241 340 or email info@avclinic.co.uk.