Sclerotherapy of large varicose veins

Prior to chemical sclerotherapy, polidocanol (Aethoxysklerol® or Sclerovein®) is mixed with air to form a foam. Thereafter, the foam is injected into the lumen of the varicosities under ultrasound guidance. Ultrasound is indispensable to place the needle where it needs to be. Furthermore, due to the echogenic nature of air, ultrasound allows to observe and control the spread of the foam.

The foam causes irritation and damage of the veins, leading to their blockage with blood clot. Thereafter, the veins are gradually decomposed by the organism. The success rate of sclerotherapy is about 80 %, which is clearly lower than after thermal ablation. Therefore, several treatments are often required.

Foam sclerotherapy is preferably applied to varicose branches. However, the elimination of reflux in truncal veins, i.e. in long or short saphenous veins, is also possible.

Foam sclerotheraphy is particularly well suited to eliminate recurrent varicose veins. We use it often in combination with other modalities, in particular with thermal ablation or/and phlebectomies.

Possible side effects of foam sclerotherapy include temporary palpable and often tender indurations of the tissue, which disappear over time. Moreover, pigmentations, i.e. local darkening of the skin along the treated veins can occur due to deposition and decomposition of blood components.

The costs of sclerotherapy are usually covered by health insurance.

Endovenous thermal ablation