Warren B. Seiler III, MD
John Di Saia, MD
Beatriz H. Porras, MD
Shervin Naderi, MD, FACS
Edward Zimmerman MD
Paula Di Marco Young, BS RN
Seth A. Yellin, MD FACS
Dr. Kevin D. Light
Stephen Weber MD PhD
Brian K. Sidella
Sabine Zenker, MD
Daniel Kaufman MD
Brian Howard MD FACS
Mickey A. Couvertier
Lila Bratani MD
Alex Denes MD FACP
5 CommentsFoam-Sclerotherapy Study: Over 90% complete occlusion.
The study, reported in the August issue of the British Journal of Surgery, suggests that ultrasound-guided foam sclerotherapy safely achieves complete occlusion in 91 percent of varicose-vein cases.
192 patients were referred for varicose vein treatment over a 15-month period. Eleven of these patients selected surgery, while the remainder opted for ultrasound-guided foam sclerotherapy. The latter treatment involved the use of polidocanol in a 1:3 mixture with air. Under ultrasound guidance, 1 percent foam was injected into superficial veins, while 3 percent was used for saphenous trunks.
Of the 220 legs treated with ultrasound-guided foam sclerotherapy, 163 showed complete occlusion of varicosities after one treatment. With a second treatment, 32 additional legs achieved complete occlusion, and one more responded positively after a third treatment. According to the study the overall rate of complete occlusion was 91 percent.
The study goes on to say that the ultrasound-guided foam sclerotherapy was generally well tolerated and that there were no serious complications. The study noted that several patients did experience phlebitis and pigmentation, which could have cosmetic implications. They conclude that further research is needed.
Reader Comments (5)
Varicose veins - reticular and spider veins. I want to offer veins but only small reticular/spider veins. I have a number of questions and any advice would help.
I am advised u have to use a NdYag for leg veins but u can use an IPL for face - why??
Has anyone bough the training DVD and any specific recommendations?
I am trying to get hold of a veinlite LED but having some issues in Canada. Any suggestions?
David
My Experience with Foam Sclerotherapy<
I have been using foam sclerotherapy on regular basis since early 2004 and have treated hundreds of patients since then. Although foam sclerotherapy may often replace surgery, especially for branch varicose veins of medium to large size, it is not the best choice when the saphenous veins need closure. In my Los Angeles Vein Clinic, I use the Vnus Closure procedure for the treatment of the great saphenous vein, and later apply foam sclerotherapy for the remaining branch veins. As to the rate of success and patient satisfaction, the results are really impressive. Of course I am referring to the of branch veins.
Nd:Yag will penetrate deeper than IPL. Leg telangieectasia are deeper from the surface than those on the face. IPL does not penetrate deeper structures as well. That said, you can still use IPL on leg veins with experience. You would have to use an IPL device whose parameters are independently controllable.
That said if you're just beginning I'd probably stick to facial veins. Your patient satisfaction is likely to be very good. Unless you're absolutely sure that a patient does not have chronic venous insufficiency in the legs treating leg telangiectasia with surface laser before treating the underlying CVI will lead to high patient dissatisfaction.
Unless you want multiple treatment failures, nasty hypopigmentation and a painfull procedure dont try IPL on leg telangiectasias. Sclero is best. I think the legs are a higher pressure system than the face where IPl works best - but i still sometimes do microsclerotharapy on facial vessels esp large ones.
Excellent information i too agree that sclerotherapy the best treatment for varicose and spider veins removal.Thanks for sharing