An Introduction to Ultrasound- Guided FOAM Sclerotherapy (UGFS)

Ultrasound guided FOAM sclerotherapy(UGFS) is the latest development in the sclerotherapy field. The principle is the same as conventional sclerotherapy. The sclerosant is used to obliterate varicose veins.The new points in this technique are that the liquid sclerosant is agitated to produce a foam-like mixture which is basically air that is mixed with sclerosant, the use of foam appears to maximise the effect of the injection. Foam becomes less diluted than liquid when injected into the vein allowing more high-strength solution to come into contact with the vein wall, The result is that less solution has to be injected in order to get the same effect, and the success rate is higher.

Watch a video of FOAM sclerotherapy: www.youtube.com/watch?v=8uHEy1gu7xg

In essence, UGFS is a safe and highly effective out-patient procedure which eliminates the deeper diseased veins hidden from view that have traditionally required surgical removal. Here is a brief explanation of this important advance in the treatment of varicose veins. Until recently, sclerotherapy was thought to be effective only for spider veins and small varicose veins that remain after surgery. But since 1990, the use of duplex ultrasound (DUS) has enabled the precise anatomic location of abnormal "saphenous" veins and their tributaries, so that injections of powerful sclerosing agents directly into these veins can be accurately delivered for effective and durable results. DUS thus serves both to provide a diagnostic functional map, and to guide the actual injection process. The patient benefits by avoiding Xray contrast studies (venography), while eliminating the targeted saphenous veins without the disadvantages of surgery (higher risks and costs, recuperation time, and scars).

Duplex ultrasound is the key to the success of this procedure. First, it locates the diseased "saphenous" vein(s) hidden from view that cause the more obvious bulging surface varicosities. Next, DUS guides both the placement and number of injections according to individual response. Later, follow-up DUS examinations confirm success, and guide additional treatment when necessary.

The success of both surgery and sclerotherapy depends on accurate control of all reflux (backward flow) points. Due to recent advances, both methods now share a similarly high success rate when performed by experienced practitioners who accurately target the diseased veins using DUS. However, published studies show that most patients prefer sclerotherapy if given the choice.

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