Foam Sclerotherapy or Endovenous Laser Ablation for Varicose Veins: A Side-by-Side Look

Updated on: January 7, 2020

Foam sclerotherapy (also called ultrasound guided foam sclerotherapy) and endovenous laser ablation (also called endovenous laser treatment or EVLT) are two of the most common treatments available at most vein clinics across the country. Both are minimally-invasive treatments for varicose veins.

While the general idea behind both treatments is to collapse problem veins, the way the procedures are performed differs.

    How the procedures are performed

    Sclerotherapy is performed by injecting a liquid irritant (a sclerosant) into problem veins, this then causes the vein to collapse and blood flow to be rerouted to a health vein while the collapsed vein is reabsorbed by the body. Sclerotherapy is the treatment of choice for spider veins and smaller veins.

    The foam sclerotherapy procedure is similar to the liquid variety, though in foam sclerotherapy the chemical solution is mixed with gas. Adding gas to the solution creates bubbles which displace blood in the veins thereby allowing the chemical to reach the vein walls without becoming diluted by the blood. This increases the efficacy of the treatment, making it a suitable treatment for the larger veins such as varicose veins. The bubbles also make the procedure easier to view through ultrasound technology.

    Endovenous laser ablation on the other hand is performed by inserting a laser fiber into the problem vein. The fiber is slowly heated using low energy, which causes the vein to heat and collapse. Both procedures require a topical anesthetic to ensure patient comfort throughout treatment.

    These are minimally-invasive treatments that leave no scarring. While the general idea behind both treatments is to collapse problem veins, the way the procedures are performed differs.

    What you can expect in recovery

    The recovery from each procedure is fairly similar. Neither procedure requires you to miss work, with many able to return to work or resume other normal daily activities after the procedure.

    Compression stockings may be used following each procedure to aid in recovery and to promote healthy blood flow. You will be given specific recovery instructions from your doctor, and you're encouraged to follow their directions to ensure a safe recovery.

    A follow up visit may be scheduled in many cases to check the progress of treatment. Both treatments are also similar in that one session is sometimes all that is needed to reach optimal results, but not always. Multiple treatments may be required. While both foam sclerotherapy and endovenous ablation permanently remove the veins they treat, people with varicose veins tend to be genetically disposed to the condition and for that reason it is likely that at some point new veins will appear.1 Many people who have varicose veins removed go back for "touch ups" after some time.

    Citations:

    1. Dr. Sales, C. (2012). Are Varicose Vein Treatments Permanent? Retrieved from the Vein Institute of New Jersey website: https://www.veininstitutenj.com/are-varicose-vein-treatments-permanent/

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