Summary
Since October 2009, the use of Athoxysklerol® foam has been approved in Germany as an option for treating varicose veins. According
to the current guidelines, foam sclerotherapy can be used for all types of varicose
veins. It has proved itself particularly useful for treating branch varicose veins
and perforators, and as a non-surgical alternative for trunk varicose veins.
Apart from the history and clinical examination, the prerequisites for planning and
carrying out foam sclerotherapy include mapping the veins by means of careful duplex
ultrasound scanning of the standing patient. Once a decision for sclerotherapy has
been made, patients must be fully informed about the treatment and give their consent
in writing.
For the venepuncture, patients should be standing or sitting down. If the varicose
veins are clearly visible or the venepuncture is performed under ultrasound guidance,
the patient can be recumbent. The foam should always be applied with the patient lying
down. The Tessari and DSS systems are well-established methods of producing foam.
After injection of the foam, compression should be applied at the injection site,
a local compression bandage applied, and finally a medical compression stocking put
on top.
The adverse effects of foam sclerotherapy do not differ substantially from those of
liquid sclerotherapy. Duplex ultrasonography is appropriate for monitoring therapeutic
success.
Keywords
Foam sclerotherapy - Polidocanol - indication - contraindication
