Summary
Since October 2009, the use of Athoxysklerol® foam has been approved in Germany as an option for treating varicose veins. According to the current guidelines, foam sclerotherapy can be used for all types of varicose veins. It has proved itself particularly useful for treating branch varicose veins and perforators, and as a non-surgical alternative for trunk varicose veins.
Apart from the history and clinical examination, the prerequisites for planning and carrying out foam sclerotherapy include mapping the veins by means of careful duplex ultrasound scanning of the standing patient. Once a decision for sclerotherapy has been made, patients must be fully informed about the treatment and give their consent in writing.
For the venepuncture, patients should be standing or sitting down. If the varicose veins are clearly visible or the venepuncture is performed under ultrasound guidance, the patient can be recumbent. The foam should always be applied with the patient lying down. The Tessari and DSS systems are well-established methods of producing foam. After injection of the foam, compression should be applied at the injection site, a local compression bandage applied, and finally a medical compression stocking put on top.
The adverse effects of foam sclerotherapy do not differ substantially from those of liquid sclerotherapy. Duplex ultrasonography is appropriate for monitoring therapeutic success.
Keywords
Foam sclerotherapy - Polidocanol - indication - contraindication
