Sunday, October 28, 2012

Foam Sclerotherapy and Stroke: The Facts

In a clinical audit in the United Kingdom of 7,027 patients who had undergone 11,537 foam sclerotherapy procedures, no cases of stroke were reported.

· In France alone, 1.5 million sessions of sclerotherapy are performed each year. Around the world, it is quite likely that millions of sclerotherapy treatments are performed each 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 being performed around the world each day. Some involved liquid sclerotherapy (4 cases), not just foam (9 cases). The majority (10 out of 13) made a complete recovery. Of the 3 cases of stroke after sclerotherapy that did not make a complete recovery, 2 occurred after liquid sclerotherapy.

· Stroke is a much greater risk after any operation under general anaesthetic including surgical vein stripping than after 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 the removal of varicose veins.

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 to treat varicose veins that was previously only treatable by surgery. These are the use of ultrasound to guide the injection and the preparation of the chemical as foam. Over the last 10 years or so, the use of foam injection was spread widely in France, Spain and Italy and more recently the technique is being used in the USA. The treatment can be performed as a "walk in, walk out" or "lunch hour procedure".

What is foam Sclerotherapy?

The solutions that are injected are exactly the same as those which are already used to treat varicose veins. These are mixed with air to create foam, which looks a little like hair mousse, or shaving foam. 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 vein reflux and varicose veins.

Who is suitable for Foam Sclerotherapy?

Most people with small or moderate sized varicose veins can be treated in this way. People with severe vein reflux are usually best treated by Laser or VNUS Closure FAST to obtain a more rapid improvement. People with large varicose veins lying close to the skin are also better treated by Microphlebectomy to avoid the brown discolouration of the skin which may occur after foam Sclerotherapy.

Key features

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

· There is no need for an operation under general anaesthetic

· The treatment involves injections under local anaesthetic

· A treatment session is complete in about 45 minutes

· The treatment is carefully monitored using ultrasound

· A firm compression bandage must be worn for a week afterwards

· The cost of treatment are much lower than for surgical methods

· Minimal or no time off work

How does the foam work?

After injection, the foam pushes the blood out of the way and completely fills the vein. The lining of the vein is instantly removed by the foam (this doesn't hurt) and the vein responds by shrinking and the vein walls stick together. The channel 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

Treatment is performed in a treatment room and not an operating theatre. The patient rests comfortably on an examination couch. A small amount of local anaesthetic is used to numb the skin of the leg and a small needle is inserted into the refluxing vein that is feeding the varicose veins. The position of the needle is carefully monitored using ultrasound so that feeder veins are closed. Foam is then injected and its progress into the feeder veins and varicose veins is care-fully monitored with ultrasound. The whole treatment usually takes no more than 45 minutes. Finally a firm bandage is applied to the leg. The aim of this is to keep the veins compressed so that they do not fill with blood when the patient stands up. The bandage is usually worn for a week followed by an elastic compression stocking for a further week. When the bandages are removed at the follow-up appointment it is usual to find that all the varicose veins have been sealed. The leg may be a little bruised at this stage, although this is usually fairly minor. If any varicose veins have not been completely treated in the first session, they are injected and bandaged to complete removal of all veins. If varicose veins are present in both legs, the treatment is given to one leg at a time with an interval of 1 to 2 weeks.

Dr Gajraj is the founder and director of The VeinCare Centre. He was an NHS consultant vascular surgeon in Somerset. He was trained at St George's Hospital and St Thomas's Hospital in London and has treated patients with vein conditions for over 20 years. He has published scientific research on varicose veins and other vein problems. He is a member of the Vascular Society of Great Britain and Ireland, a member of the Venous Forum of the Royal Society of Medicine and Fellow of the Royal College of Surgeons.

The VeinCare Centre was founded to provide the public and referring doctors with the best advice on all aspects of vein treatment. All our staff are highly qualified and have a particular interest in varicose veins and the treatment of related conditions such as spider veins and thread veins.

For more information about Foam Sclerotherapy Treatment please visit If you're worried about your veins or if you are wondering whether ultrasound guided foam sclerotherapy would be suitable for you, please do get in touch on 0800 698 3467 or email We are happy to offer simple advice by telephone and email for free and without obligation.

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