It may surprise you to learn that the use of injections to cure varicose veins dates back more than 100 years. In 1942 a physician named Orbach introduced the idea of turning a sclerosant solution into froth before injection into varicose veins. He found that this increased the efficacy of treatment by five times. Fifty years later another physician named Cabrera (1995) went a step further by converting a sclerosant solution into foam (smaller bubbles than froth). This method was soon recognized to be a highly effective way of treating varicose veins.
At about the same time Ultrasound began to be introduced as a method of guiding the injection of sclerosants directly into the source of varicose veins hidden beneath the skin. A positive characteristic of sclerosant in the form of a foam (unlike solution) is that it is readily seen on ultrasound so that its progress through the varicose veins can be tracked. This allows the doctor to follow the movement of the sclerosant and target treatment more precisely.
Why is Foam Sclerosant Better than Liquid Sclerosant?
Sclerosants can only work by coming into direct contact with the internal vein wall. Here the sclerosant acts like a chemical peel removing the internal lining and exposing the collagen underneath so that the vein walls then stick together sealing off the varicose veins. Sclerosants in liquid form quickly become inactivated by proteins in the blood. Foam instead has the advantage of acting like a plug pushing the blood away and internally lathering the vein wall.
This aspect of foam not only means more effective treatment but also allows much lower doses of sclerosant to be used or conversely a given dose can treat much larger segments of varicose veins. This also means that there are less treatment sessions required that would be needed to treat the area using liquid Sclerotherapy.
Over the last decade Ultrasound Guided Foam Sclerotherapy (UGFS) in combination with Endothermal Ablation has led to a revolution in the treatment of varicose veins such that conventional surgical stripping of varicose veins is becoming obsolete.