The History of Sclerosing Foams

Fluoroscopy-guided foam sclerotherapy with sodium morrhuate for peripheral venous malformations: Preliminary experience

“…[12][13][14] Nitecki et al, 15 Tan et al, 16 and Yamaki et al 17 The imaging tool to guide foam sclerotherapy was at all times duplex ultrasound in these reports, both for varicose veins and vascular malformations. [3][4][5][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] The ultrasound-guided technique is not perfect, however, and correlative complications have been reported. Complications due to difficulties in visualization of the needle tip with ultrasound imaging include accidental extravascular, intra-arterial, or deep venous injections.…”

“…[3][4][5][12][13][14][15][16][17] These are not obtainable in China, however; only sodium morrhuate is available to make the foam sclerosant. Sodium morrhuate is one of the detergent sclerosants.…”

“…The use of liquid sclerosants has the limitations of their dilution and progressive inactivation in a great hematic volume and the irregular distribution of the liquid sclerosant on the endothelium. 3 Duplex-guided foam sclerotherapy has become popular worldwide for the treatment of vascular malformations and varicose veins in recent decades. 4,5 However, it is difficult to check for the venous outflow of the sclerosing agent and for extravasation when only an ultrasound guidance is used, and duplex ultrasound examination requires experience.…”

Minimally invasive techniques in the treatment of saphenous varicose veins

“…In classic sclerotherapy, the air block technique (in which an air bubble is injected before injecting the sclerosant) has been used to enhance the duration of contact with the venous wall and to reduce the ''wash out'' of the agent injected in the veins. 11 In UGFS, a foam (eg, 1 cc of aethoxysclerol/polidocanol or sodium tetradecyl sulfate 1% to 3% in Europe and the United States, respectively, mixed with 3 to 4 cc air) is created by connecting two syringes (Luer Lock) using a two-or three-way stopcock. One of the syringes is filled with the agent and the other with air, (Fig 2, A).…”

Neurological complications of sclerotherapy for varicose veins

“…3 Although early attempts to treat varicose veins with sclerosing agents were fraught with complications, predominantly consisting of infections, phlebitis, and gangrene, such that cessation of their use was advised by a panel of experts at a surgical congress in Lyon in the 1800s, the development of newer sclerosants and techniques to improve efficacy has led to a wide acceptance of foam sclerotherapy, which is now considered by many to be a highly successful treatment strategy with minimal side effects. 4 Foam sclerotherapy is used to treat truncal incompetence, perforating veins, and primary and secondary varicosities as well as reticular and spider veins. It is also used in combination with traditional surgery or endovenous thermal ablation.…”