Ultrasound-guided foam sclerotherapy using physician-compounded foam: Position statement from the American vein and lymphatic society

Background: Chronic venous disease has a major impact on the quality of life of millions of patients. Large randomized controlled trials have established ultrasound-guided foam sclerotherapy (UGFS) as a safe and effective treatment option for both saphenous vein insufficiency and tributary disease. Ultrasound guidance is a critical component of sclerotherapy of non-visible veins. Method: An expert panel of the American Vein and Lymphatic Society (AVLS) was convened to review the literature and write a Position Statement with recommendations for the use of UGFS with physician-compounded foam for patients with venous insufficiency. Result: Consensus recommendations from the expert panel highlight the advantages and safety of high-quality physician-compounded foam. These recommendations were reviewed, edited and approved by the Guidelines Committee of the AVLS. Conclusion: UGFS with in-office, physician-compounded foam is a safe primary treatment option for varicose, tributary, and truncal veins of the lower extremities and is an important adjunct therapy for tributary disease following or concomitant to endovenous ablation procedures.