Often, Sclerotherapy will be safer than endovenous ablation to remove veins that are close to nerves or that are very close to the surface of the skin.

Published on Jul 11, 2012

EVLT is the standard of care at this time and in experienced hands there is little risk. There is a foam sclerotherapy device on the market but it has limited history, results and complications. There can be an increased risk of DVT and stroke if not performed by an experienced surgeon. USGS without this device would be less effective and higher risk. I would recommend finding a vascular trained surgeon who had done many EVLTs, speak to some paitents and ask a lot of questions.

Published on Jul 11, 2012

Foam sclerotherapy is a fantastic way to treat varicose veins. If the veins are on the surface you don't need ultrasound. If the veins are under the surface of the skin and you can't see them with the naked eye then you always need ultrasound guidance to be sure the foam injection is going directly into the abnormal vein that needs treatment. We usually treat any straight subsurface veins (the great and small saphenous veins) with EVLT (endogenous laser treatment) because it has a better long term success rate. EVLT and ultrasound guided foam sclerotherapy both have side effects, and those should be discussed at length with the patient before deciding which modality works best for their veins. We usually use a combination of EVLT, ambulatory phleboctomy, and ultrasound guided sclerotherapy.

Published on Jul 11, 2012

Foam Sclerotherapy is not as effective as thermal ablation for larger veins like the Greater or Smaller Saphenous veins.

Published on Jul 11, 2012

Foam Sclerotherapy can be used on larger varicose veins and the saphenous veins but it may require multiple treatments and the long term results are not as good as laser. Foam sclerotherapy for the saphenous should be done under ultrasound guidance. There is very little chance of nerve injury with closure techniques. No procedure is without risk and each procedure has its own possible complications.

Published on Jul 11, 2012

In my 6 years experience of with foam sclerotherapy, foam sclerotherapy is effective on small and larger varicose veins, provided it is administered correctly by targeting only the varicosity without causing damage to deep and healthy veins. Please note, the key is proper use of foam sclerotherapy which should be done under ultrasound guidance and based on detailed mapping of superfical veins system and reflux sources. In my opinion, the treating physician must have proper training and experience with sclerotherapy of varicose veins.

Foam sclerotherapy has different side effects than an EVLT. Foam Sclerotherapy is less likely to cause nerve damage but has a very small risk of embolism to a distant part of the body which EVLT doesnt have. Both EVLT and foam sclerotherapy have a low risk of complications. The choice between the two procedures should also take in consideration the effectiveness of the treatment and EVLT seldom has to be repeated whereas Foam Sclerotherapy often has to be repeated. Dr Wright will discuss the risk and benefits of any treatment with you prior to embarking on any treatment.

Published on Jul 11, 2012

It is difficult to generalize. Most of the time the very large varicose veins are treated with ambulatory phlebectomy. The great and lesser saphenous veins are treated with laser (EVLT). Tributaries veins, perforator veins, reticulars and spiders are treated with sclerotherapy, with or without ultrasound guidance. However there are some variations and the same type of vein problem can be treated with two or three different modalities and will depend on the individual patient and the experience of the physician which one chooses.

Published on Jul 11, 2012

In my experience of 8 years with foam sclerotherapy, yes foam sclerotherapy is effective on small and larger varicose veins, provided it is administered correctly by targeting only the varicosity without causing damage to deep and healthy veins. Please note, the key is proper use of foam sclerotherapy which should be based on detailed mapping of superfical veins system and reflux sources. In my opinion, the treating physician must have proper training and experience with sclerotherapy of varicose veins, and must either do the ultrasound himself or be present in the room while the ultrasonographer is mapping the varicose veins and healthy veins. The study should cover areas beyond standard evaluation of deep vein and short and long saphenous veins. Anatomical variations is the rule rather than rare when it comes to superficial vein system of the legs. Furthermore, in subsequent visits, legs veins must be re-studied and re-mapped again and again. Of course it is not fair to charge the patient for repeat ultrasound studies. In subsequent visits, I am not surprised to find one or more sources of reflux that were not seen on the first vein mapping session. So if the treating doctor is relying on a piece of text report coming from an ultrasound tech, to plan multiple treatment sessions, the odds are some important sources of reflux will be missed. Of course we need ultrasonographers and they are very valuable to any practice, but the doctor must be there and be part of search for reflux sources and looking for anatomical variations.

Published on Jul 11, 2012

Foam sclerotherapy is not safer than EVLT. Endovenous Laser Ablation ("EVLA" or "EVLT") closes down the leaking vein that causes varicose veins in over 90% of patients with one procedure. Foam sclerotherapy, although useful, frequently requires several procedures. Foam sclerotherapy to treat the underlying cause of varicose veins is done under ultrasound. As for treating the actual varicose veins, there are two options. Sclerotherapy vs. microphlebectomy. The advantage of microphlebectomy is that it is done in one setting vs. potentially several for sclerotherapy.

Published on Jul 11, 2012

Foam sclerotherapy is a good alternative to EVLT, but I find laser ablation more complete, the over ninety nine percent closure rate. I also find it to be less painful then foam procedures, especially when using the newer laser frequencies such as the 1470, and vnus closure fast. Nerve injury would be very rare complication of EVLT. The only nerve injury w3e have ever encountered is a temporary superficial numbness. This usually resolves in a few weeks, and again is very rare. I find the laser the best way to close the large saphenous vein, and the foam procedures best to close the connecting trunk veins. So a combination of the two procedures is ideal. This avoids all surgery.

Published on Jul 11, 2012