Liquid sclerotherapy

Systematic reviews Foam and liquid sclerotherapy for primary varicose veins in the legs have been compared in a review of the literature [86 ]. For treatment of saphenous veins, six trials were considered. Despite containing much less sclerosing agent, foam sclerotherapy was markedly more effective, the difference being 20-50%. In a metaanalysis of four comparisons, foam sclerotherapy had an efficacy of 77% and liquid sclerotherapy 40%. The adverse reactions that were reported did not differ between the two forms of sclerotherapy, although visual disturbances seemed to be more common with foam sclerotherapy. 

Yamaki T, Nozaki M, Iwasaka S. Comparative study of duplex-guided foam sclerotherapy and duplex-guided liquid sclerotherapy for the treatment of superficial venous insuffidency. Dermatol Surg 2004 30(5) 718-22. 

Another report describes the balloon-occluded retrograde transvenous obliteration, which is traditionally based on liquid sclerotherapy. However, overdose and systemic spillage of liquid sclerosant can cause severe complications, such as haemolysis that can lead to haemoglobinuria, allergy, acute respiratory distress S5mdrome and other disorders. 

In a literature survey of randomized controlled trials, meta-analyses, and observational studies using survival analysis for long-term outcomes, foam was more effective than liquid for ultrasound-guided sclerotherapy [87 ]. The two types of sclerosants are equally effective for sclerotherapy of small veins, but little else is known, according to this study, about the optimal preparation of foam sclerosants and the best technique for administering foam. 

Hamel-Desnos C, Allaert FA. Liquid versus foam sclerotherapy. Phlebology 2009 24(6) 240-6. 

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