One of the barriers preventing the universal acceptance of foam sclerotherapy for superficial tributaries is the real side-effect of post inflammatory hyperpigmentation (PIH) and pain at the site of the sclero-thrombosis. Although a sclerosis is the optimal process to achieve a good result, adequate collapse of the target vein is rarely achieved using eccentric compression… Read More »
Ultrasound guided foam sclerotherapy (UGFS) is an established technique which uses ultrasound to map the direction of foam and gauge the amount required for venous closure. Contrast guided foam sclerotherapy (CGFS) is used for similar indications. However, the images provide greater detail on the behaviour of the injected foam. The amount of foam and the… Read More »
Pelvic venous reflux (PVR) may cause prolonged pressurisation of the veins in the pelvis. This can result in pelvic congestion syndrome (PCS) with non-cyclical pain or a constant dull ache, exacerbated standing or sitting, for over 6 months. It may be associated with dyspareunia and haemorrhoids. If the reflux escapes into the leg it may… Read More »
Sclerotherapy for telangectasias (spider veins) is a common method of treatment. Duplex ultrasound is usually required beforehand to exclude underlying saphenous reflux because this may be contributory to recurrence. Care in identifying and selecting the feeder vessel prior to cannulation improves the immediate results. Nevertheless, recurrence may result in the need for further treatment. There… Read More »
Foam is usually prepared immediately before injection by agitating a sclerosant with a gas using 2 syringes and a three-way tap. This is described as the Tessari method. A disadvantage of this foam preparation is its lack of stability. This is because, after a few minutes, the bubbles coalesce into larger bubbles which will decrease… Read More »
Spider veins or telangiectasias are the commonest clinical CEAP class, documented as C1, with many patients seeking treatment to improve the appearance of their legs. They may be blue or red and are distinguished from reticular veins which have a profile. If they are present around the ankle, then they may be part of a… Read More »