Foam Sclerotherapy for Reticular Veins and Nontruncal Varicose Veins of the Legs: A Retrospective Review of Outcomes and Adverse Effects

• Published in: Dermatologic surgery 2010-06, Vol.36 (Sup 2), p.1026-1033
• Main Authors: PALM, MELANIE D., GUIHA, ISABELLA C., GOLDMAN, MITCHEL P.
• Format: Article
• Language: English
• Subjects: Female; Humans; Leg - blood supply; Male; Microbubbles; Middle Aged; Retrospective Studies; Sclerosing Solutions - administration & dosage; Sclerosing Solutions - adverse effects; Sclerotherapy - adverse effects; Sclerotherapy - methods; Severity of Illness Index; Treatment Outcome; Varicose Veins - therapy
• ISSN: 1076-0512; 1524-4725
• DOI: 10.1111/j.1524-4725.2010.01496.x

BACKGROUND Sclerotherapy is the criterion standard of treatment for reticular veins. Foam sclerotherapy is safe and effective, although current guidelines limit the volume of foam used per session. OBJECTIVE To demonstrate the safety and efficacy of large‐volume foam sclerotherapy for the treatment of reticular and nontruncal leg veins. METHODS & MATERIALS A retrospective review was conducted on all patients undergoing sclerotherapy from 2003 to 2009. Contacted patients graded side effect severity and the degree of vein resolution on a 4‐point scale (0–3). The occurrence of cardiovascular or pulmonary events was also recorded. Sclerosant volumes were retrieved from patient records. RESULTS One thousand one hundred eighty‐seven patients underwent sclerotherapy; 419 were successfully contacted of whom 325 had received foam sclerotherapy. The average volume of foam used per session was 16.9 mL. The average rating of adverse events was minimal to mild for all categories including hyperpigmentation (0.35), ulceration (0.06), pain (0.22), and matting or new vessel formation (0.70). The average improvement score was 1.94 (moderate improvement). No serious adverse events occurred. CONCLUSION Large‐volume foam sclerotherapy appears to be safe and effective in the treatment of intracutaneous leg varicosities. Serious adverse events are a rare occurrence, even with sclerosant treatment volumes exceeding current guidelines. The authors have indicated no significant interest with commercial supporters.