Compression Foam Sclerotherapy

Compression foam sclerotherapy is not only a powerful device in the treatment of varicose veins, but it is also more effective than the use of the original liquid sclerosant [15]. The first prospective randomized study compared foam sclerotherapy using the DSS with conventional fluid sclerotherapy in 88 patients with long saphenous vein insufficiency. A single injection of 2–2.5 ml of foam or 3% polidocanol solution demonstrated a 2-year occlusion rate of 84% in the foam group versus 40% in the fluid group [17].Although the results of foam sclerotherapy are clearly seen by the untrained eye, the components of the foam are not simplistic. Presently, there is no “foam sclerotherapy school” because the procedure itself is not sufficiently well established.Various techniques of preparation, treatment regimens, indications, etc., exist without a widely accepted “state of the art.” Sclerosing foam is defined as a nonequilibrium dispersion of gas bubbles in a sclerosing solution where the gas fraction is equal to or greater than 0.52 [liquid-to-gas ratio of 1 : 5 (1+4)] [15]. The foam is composed of a tensioactive sclerosing agent (usually a detergent sclerosant) and air and is considered more powerful than the original sclerosing solution because of the high concentration of sclerosing agent on the surface of the small air bubbles (micelles). The characterization of the sclerosing foam is dependent upon variables such as the type and concentration of the tensioactive sclerosing agent, type of gas, ratio of liquid to gas, method of preparation, time between processing and use, and bubble size [15, 18]. The characteristics and properties of sclerosing foams account for their action, efficacy, safety, and potency.