Why does foam-sclerotherapy work better than liquid-sclerotherapy for medium & large varicose veins?

With traditional liquid sclerotherapy, once the sclerosing liquid is injected in a vein, it quickly dilutes with blood, resulting in decreased concentration of sclerosing agent within the lumen of the target vein. Therefore, an effective concentration of sclerosant is not staying in touch with the inner surface of the vein for a sufficient amount of time in many cases. While foam displaces the blood away and remains in contact with the inner layer of injected veins for a longer and more effective period. This makes foam sclerotherapy a much more effective treatment than liquid sclerotherapy. Furthermore, with foam there is much less post treatment local pain, discomfort, and pigmentation of the overlying skin. In summary, foam is much more effective and associated with fewer side effects in the treatment of varicose veins. Nowadays, many European pioneers of foam-sclerotherapy prefer foam over surgery, as presented at the latest World Congress on Vein Disease in San Diego in the summer of 2003. Obviously, physicians who lack experience in liquid-sclerotherapy and are not trained in foam-sclerotherapy should not perform sclerotherapy

What are the different treatment methods available for larger varicose vein conditions?

First, it should be emphasized that there is no single treatment that is suitable for all different varicose vein types and conditions. A vein specialist would first evaluate and map your particular condition by identifying the locations of incompetent valves. Then he/she would suggest one or more treatment modalities that fit your individual condition.

The old treatment for large varicose veins is ligation & stripping surgery of great saphenous veins, which requires general anesthesia and involves multiple incisions and a long recovery period. In addition, many patients with varicose veins do not have a problem with the great saphenous veins to begin with. Phlebectomy, which consists of pulling out of small segments of varicose veins through micropunctures, is another treatment that is suitable for some. Thanks to modern phlebology, most patients may be successfully treated using other effective non-surgical treatment methods: Use of radiofrequency energy to close varicose veins, VNUS Closure is one of the new treatments. Dr. Fattahi is the first physician in Northern California to use VNUS Closure procedure. Echo-sclerotherapy, in which injection of the sclerotherapy solution is guided under ultrasonography, is another great treatment modality for incompetent perforating veins.