Foam Sclerotherapy can fail in big varicose veins

A gentleman who had ultra sound guided foam sclerotherapy to treat large varicose veins, just over a year ago, says that all his veins are starting to come back now. Is this normal?

Well, it is not normal and here at The Whiteley Clinic we would be very concerned if he only had foam sclerotherapy for large veins. Although we know that foam sclerotherapy is very good as an adjunct, in other words to be used with something like an Endovenous laser or radio frequency, it is, in our experience, rarely successful in the long term in very big varicose veins.

There are some enthusiasts who use it, but when we see patients who come to us afterwards, we quite often find that the veins have opened up again.

What Professor Whiteley has suggested is for the gentleman to have a venous duplex ultra sound scan to find out whether it is the same veins that have come up again, because the foam has actually not closed the veins securely, or whether he has developed new veins.

It reminded him of a couple of patients who visited the Clinic, who had foam sclerotherapy somewhere else in the past. Initially they believed they had a good result as the foam caused clots in the veins – not dangerous clots, not deep vein thrombosis or anything like that – but what is called thrombophlebitis. These clots initially close the varicose veins so they look as if they have disappeared but then slowly over a few months to a year or so, the veins open up again as the clots dissolve. This actually means that they have really had very little done for the long term.

Our preference is to not use just foam sclerotherapy for the large veins, but to use it in conjunction with different catheter techniques such as laser and radio frequency that we know work in large veins.