Ultrasound-guided foam sclerotherapy is safe and effective in the management of superficial venous insufficiency of the lower extremity

Todd V. Cartee, Paul Wirth, Amrit Greene, Chelsey Straight, Daniel P. Friedmann, Chris Pittman, Stephen F. Daugherty, John Blebea, Mark Meissner, Marlin W. Schul, Vineet Mishra

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Background: Superficial venous disease of the lower extremity has a significant impact on quality of life. Both truncal and tributary vein reflux contribute to this disease process. Endovenous foam sclerotherapy is a widely used technique throughout the world for the management of superficial venous reflux and ultrasound guidance improves its safety and efficacy. Methods: A PubMed search for ultrasound-guided foam sclerotherapy (UGFS) was conducted and all abstracts were reviewed to identify clinical trials and systematic reviews for a full-text analysis. Additional articles were also identified through searching the references of the selected studies. Results: The production of foam for sclerotherapy in a 1:3 or 1:4 ratio of air to sclerosant is optimal in a low silicone, low-volume syringe system. Physiologic gas may decrease any side effects, with the trade-off of decreased foam stability. Proper technique with appropriate sterility and cleansing protocols are paramount for safe and effective treatment. The technical success of UGFS for great saphenous vein disease is inferior to endothermal and surgical modalities and retreatment is more common. However, the clinical improvement in patient-reported quality of life is similar between these three modalities. When used for tributary veins in combination with endothermal approaches of the truncal veins, UGFS has high rates of success with excellent patient satisfaction. UGFS has demonstrated an excellent safety profile comparable with or superior to other modalities. Conclusions: With proper technique, UGFS is safe and effective for the management of superficial venous disease.

Original languageEnglish (US)
Pages (from-to)1031-1040
Number of pages10
JournalJournal of Vascular Surgery: Venous and Lymphatic Disorders
Issue number4
StatePublished - Jul 2021

All Science Journal Classification (ASJC) codes

  • Surgery
  • Cardiology and Cardiovascular Medicine


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