Venous · IR Playbook
Ultrasound-Guided Foam Sclerotherapy for varicose veins
Ultrasound-guided foam sclerotherapy (UGFS) is the percutaneous injection of a sclerosant detergent mixed with gas into an incompetent saphenous trunk, tributary or perforator under real-time duplex control, producing endothelial destruction and fibrotic occlusion. Foam displaces blood and increases endothelial contact time, so it is far more potent than the equivalent volume of liquid sclerosant. It is cheap, repeatable and needs no tumescence, but current SVS/AVF/AVLS and ESVS guidance places physician-compounded UGFS below endovenous thermal ablation for truncal axial reflux because of higher recanalisation and lower long-term quality-of-life gain, while endorsing it for tributaries, recurrent varices and veins unsuitable for thermal ablation.
What this playbook covers
- Indications
- Contraindications
- Pre-procedure
- Anatomy and Planning
- Equipment
- Procedure Steps
- Technical Endpoints
- Variants
- Comparisons
- Troubleshooting
- Complications
- Post-procedure Care
- References
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