Ultrasound Guided Foam Sclerotherapy (UGFS)
Non-surgical vein closure procedure for varicose veins & venous insufficiency.
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Ultrasound guided foam sclerotherapy (UGFS) is a minimally invasive method of closing off unwanted veins. It is a type of nonthermal vein ablation that does not require heat from a laser. Instead, a chemical foam, called a sclerosant agent, is injected into the vein. Because the foam has tiny air bubbles in it, ultrasound imaging can be used to accurately guide its placement. The foam displaces blood and irritates the vein walls, resulting in dehydration, inflammation, and eventual closure of the vein. The unwanted vein fades in appearance, and blood is rerouted through other healthy veins.
Foam sclerosant was approved for use by the FDA in 2013, and since its approval, sclerotherapy with foam has been commonly used to treat venous reflux in the great saphenous vein. Foam sclerotherapy with ultrasound guidance can be used to treat both the cosmetic appearance of large varicose veins (≥6 mm) as well as the persistent symptoms of vein disease such as swelling and pain.
We are VIP Specialists, and we’re to help you get your legs back to health. Our Vascular and Interventional Specialists provide a full suite of screening, diagnostic, and treatment services for spider veins, varicose veins, and more advanced stages of venous insufficiency.
Our vein treatment center is conveniently located in downtown Visalia, California at the corner of Locust Street and East Acequia Avenue. Schedule your visit today!
Dr. Ashkan Shahkarami
Vascular & Interventional Specialist
Dr. Bennett K. Abe
Vascular & Interventional Specialist
Dr. Francisco E. Valles
Vascular & Interventional Specialist
Dr. Glade Roper
Vascular & Interventional Specialist
Dr. Daniel Hightower
Vascular & Interventional Specialist
UGFS Procedure in Visalia, CA
Still, most patients are able to tolerate UGFS. Common contraindications for vein treatment include pregnant women, individuals at increased risk of clotting, and patients with known patent foramen ovale. A Vein Specialist at VIP can help you determine if ultrasound guided foam sclerotherapy is the best treatment option for you.
UGFS Procedure in Visalia, CA
While one session of ultrasound-guided foam sclerotherapy is moderately successful for treating saphenous veins, additional treatment sessions may increase the long-term success rate. Treatment success can be limited by vein recurrence, which can occur if there is recanalization, or the return of blood flow to a previously cleared vein. In one study trial, saphenous vein recanalization occurred in 27% of patients at 1 year post treatment and in 64% of patients at 5 years post treatment [4]. In another review, 90% of great saphenous veins treated did not undergo recanalization after two sessions of foam sclerotherapy over a mean 3.25 years of follow-up [5].
Importantly, UGFS treatment success has a variety of meanings for different people. Vein recurrence or recanalization may occur, yet symptoms might still be well controlled and clinical improvement may be maintained in the long-term [4,6]. In one study, where saphenous vein recanalization occurred, 70% of patients did not have worsened clinical symptoms [4].
Sclerotherapy is the only method of endovenous closure that does not require a catheter to be placed along the length of the vein. Therefore, its greatest advantage is in treating large, deep veins that are highly branched and twisted. A foam sclerosant is able to displace blood rather than mix with it to dilute the blood volume. This results in greater efficacy of treatment, as a lower concentration of foam is needed to achieve the same therapeutic effect as a liquid agent.
UGFS Procedure in Visalia, CA
Specific side effects depend on the type of sclerosing agent used. Most side effects are temporary and resolve within a few months after the procedure.
Minimally invasive vein closure is the ‘gold standard’ treatment for symptomatic varicose veins, and has clear advantages over more conservative and more surgical approaches. A Vein Specialist at VIP Specialists can help you evaluate your options and decide if UGFS or a different minimally invasive vein treatment is right for you!
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References
[1] Scovell, S. Liquid, foam, and glue sclerotherapy techniques for the treatment of lower extremity veins. UpToDate. Accessed April 2020.
[2] Morrison, N., Gibson, K., Vasquez, M., Weiss, R., Cher, D., Madsen, M., & Jones, A. (2017). VeClose trial 12-month outcomes of cyanoacrylate closure versus radiofrequency ablation for incompetent great saphenous veins. Journal of Vascular Surgery: Venous and Lymphatic Disorders, 5(3), 321–330.
[3] Biemans AA, Kockaert M, Akkersdijk GP, van den Bos RR, de Maeseneer MG, Cuypers P, Stijnen T, Neumann MH, Nijsten T. Comparing endovenous laser ablation, foam sclerotherapy, and conventional surgery for great saphenous varicose veins. J Vasc Surg. 2013 Sep;58(3):727-734.e1. Epub 2013 Jun 13.
[4] Coleridge Smith, P. (2009). Sclerotherapy and foam sclerotherapy for varicose veins. Phlebology, 24(6), 260–269.
[5] Chen CH, Chiu CS, Yang CH. Ultrasound-guided foam sclerotherapy for treating incompetent great saphenous veins–results of 5 years of analysis and morphologic evolvement study. Dermatologic Surg., June;38(6):851. Epub 2012 Apr 27.
[6] Chapman-Smith, P., & Browne, A. (2009). Prospective five-year study of ultrasound-guided foam sclerotherapy in the treatment of great saphenous vein reflux. Phlebology, 24(4), 183–188.
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