Sclerotherapy has made a major evolution with the introduction of microfoam. Traditional sclerotherapy causes damage to the lining of the vein, causing it to collapse and making the walls of the vein then stick together. The vein is then slowly reabsorbed and disappears. Foam sclerotherapy works in the same way only is much more efficient. Foam is made by adding air to a liquid sclerosant, such as, the detergent sodium tetradecyl sulphate. The liquid and the air are agitated to produce a foam mixture. The foam is then injected directly into the vein. Foam is not diluted like the conventional sclerosant,so much less is needed, and it remains in the vein for a longer period of time. Foam also works better because it seems to push the blood out of the vein and making better contact with the vein walls. This enables us to treat much larger veins then with liquid sclerotherapy.
Another advantage to using foam is that it is very echogenic, making it very easy to see on ultrasound. We can track the entire vein that has been treated. We also track the travel of the foam in a particular vein and stop the flow by applying pressure with the ultrasound probe, the flow can then be redirected, if necessary. The selective treatment of veins with foam is more complete than with surgical removal or microphlebectomy.
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