Foam sclerotherapy

Varicose veins occur when the one way valves in the veins in the leg fail allowing blood under pressure to flow the wrong way. The veins are not designed to cope with this increased pressure so they enlarge and become prominent and more visible. Venous disease is largely inherited. It affects men and women equally but starts earlier in women often beginning in pregnancy. It is not caused by standing for long periods but the symptoms may be increased. They are not related to weight, blood pressure or smoking, nor are they caused by crossing the legs.

Injections to close off the veins have been used to treat varicose veins for decades, but poor long term results meant that the technique fell out of favour. We now know that if the fluid is mixed with a gas such as air to form foam, the results of treatment are much improved. This treatment is performed as an out-patient procedure so avoiding the inconvenience, discomfort and expense of an admission to hospital. It is painless and you can drive home and return to normal activities immediately afterwards.

Doppler Ultra Sound Scanning For Veins

In order to determine if any venous abnormalities are present, we recommend that you undergo a Doppler Ultrasound Scan before any specific treatment programme can be provided.

It is worthy of note that thread veins can actually be caused as a result of larger reticular veins under pressure which then feed blood into smaller veins. If these larger veins remain untreated then the thread veins can get worse. In fact they can undergo “matting”, where the thread veins not only extend, but form a mass of very fine vessels which are impossible to treat. This is a disaster that can now be avoided with the introduction of ultra sound scanning at Court House Clinics.

Reticular veins are flat, usually visible vessels up to 4mm in diameter with a one way valve at the upper end where they join the deep vein system. It is the failure of this valve which allows blood to flow under pressure the wrong way down the leg. Now this flow can be detected using a hand held Doppler machine. The technology was created by Christian Doppler, a nineteenth century Austrian mathematician.

The Doppler machine emits high frequency ultrasound which bounces off the blood corpuscles and the reflected sound frequency depends on the direction of blood flow enabling incompetent veins to be identified with ease. This prevents misdiagnosis and ensures veins are treated in the correct way.

Prices from £80 for the Doppler Scanner

Frequently asked questions

Who gets varicose veins?

Venous disease is largely inherited. It affects men and women equally but starts earlier in women often beginning in pregnancy. It is not caused by standing for long periods, but the symptoms may be worse. It is not related to weight, blood pressure or smoking nor is it caused by crossing the legs.

What is Foam Sclerotherapy?

Injections to close off the veins have been used to treat varicose veins for over 50 years. We now know that if the fluid is mixed with a gas to form a foam the results of treatment are much improved.

It is performed as an out-patient procedure so avoiding the inconvenience and expense of an admission to hospital.

It is painless and you can drive home and return to normal activities immediately afterwards.

How is Foam Sclerotherapy performed?

The cause of the varicose veins is identified by ultrasound. A cannula is inserted into the main, truncal vein and a small volume of foam injected. This may need to be done at three or four sites to completely fill all the veins. The foam damages the lining of the vein wall. A firm stocking keeps the vein compressed while the walls stick to each other so closing the vein.

The stocking must be worn continuously for at least a week and the ultrasound examination repeated to ensure the vein remains closed.

What happens afterwards?

You will be able to drive home or back to work immediately. Painkillers are almost always unnecessary. The leg will be bandaged and a stocking applied.

You will be asked to return for a follow up appointment when an ultrasound will be repeated to assess your progress. Further ultrasound checks are made at intervals to ensure that the vein remains closed.

Are there any complications?

No procedure is complication free but they are less than with surgery. In particular, bruising is less and Foam Sclerotherapy is virtually pain free so you can return to normal activities immediately. Skin staining over the treated vein can occur in about 20% of legs which will fade over the year but a mark may be permanent. Foam sclerotherapy is successful in 70 to 90% on the first treatment and may need to be repeated to obtain the desired result.

Is Sclerotherapy safe?

Yes. The solution has been used for years and as a foam, only a very small amount is needed. Allergy is very rare occurring in about 1 in 100,000 people.

What are the alternatives?

Conventional surgery or Endovenous Laser therapy are also effective methods of treating incompetence of the main vein. However, both these techniques are more invasive and have more complications although they are usually minor.

Will the veins come back?

With surgery recurrence occurs in about 20% of legs over 5 years. Foam Sclerotherapy is likely to be about the same.

Is Foam Sclerotherapy successful?

Yes. The vein is closed off within 2 weeks in more than 90% of people. If not, the injections are repeated. The results at 5 years are about the same as for other treatments for varicose veins.

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Before and after

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