Expanding foam: The newest treatment against varicose veins
(8 May 2005: VIDYYA MEDICAL NEWS SERVICE) -- An injectable foam that expands in the blood vessels can successfully treat troublesome varicose veins, which afflict between 20% and 30% of adults, usually later in life or during pregnancy.
As well as looking unpleasant, varicose veins can ache, throb and itch.
More than 50 patients at Ealing Hospital in London have received the foam therapy with good results, says consultant Mr George Geroulakos.
If they are small, varicose veins may be controlled with conservative methods, such as compression bandages or stockings.
But larger or more complicated varices cases will need surgery.
This can involve stripping the veins, tying them off or injecting an agent to close the vein, which is called sclerotherapy.
Sclerotherapy has some advantages over surgical stripping.
It can be done under local rather than general anaesthetic and leaves only one small scar in the groin rather than numerous scars on the leg.
"With the conventional stripping technique, the patient has to stay off work for about eight days after.
With the foam therapy, they can go back within days," said Mr Geroulakos, who is also a consultant for the Hammersmith Hospitals NHS Trust.
Doctors have been using liquid sclerotherapy for years. But a newer way is to use a foam, guided with the help of ultrasound imaging.
In contrast to liquid, foam is not diluted once injected, so less is needed and it remains in the vein for a longer time.
The foam works by pushing the blood out of the way and is able to make better contact with the inside of the vein walls.
All of these factors mean it could work better than liquid sclerotherapy.
"Sometimes the liquid can leak outside of the vein and this can cause a chemical sore or ulcer.
We think complications should be less common with the foam.
Plus you can see exactly where the foam is with ultrasound. It casts a shadow that can be seen with the machine. You can see every individual vein, which is a major advantage," Mr Geroulakos said.
Mr Geroulakos has been treating patients with the foam technique for two years. "The early and interim results are really promising, but we have not been doing it long enough to know about the long-term results," he said.
About a fifth of patients who have their varicose veins treated with stripping will need repeat treatment within five years because the problem comes back. But it is not yet clear whether the same is true with foam therapy. A single injection of the foam is enough to treat a half metre length of vein.
Afterwards, the patient wears a compression stocking continuously for two weeks and then during the day only for another week.
Return to Vidyya Medical News Service for 8 May 2005