ABSTRACT
Foam ultrasound-guided sclerotherapy (UGS) is a flexible modality used to treat incompetent lower limb veins and venous malformations (VMs). Foam sclerosants are detergent-based agents that upon exposure to the vessel wall result in endothelial lysis. The ultimate aim of foam sclerotherapy is to induce endovascular fibrosis as against thrombosis. Foam agents have the additional advantage of displacing the intravascular blood, hence reducing the deactivation and neutralization of the active sclerosant. Foam sclerosants are introduced into target vessels by direct percutaneous injections or via catheter-guided delivery. The procedure is performed under ultrasound or fluoroscopic guidance. Foam sclerotherapy is best used to treat small to medium-sized VMs. Larger VMs and those with thicker walls are best treated with endovenous laser ablation (EVLA). The efficacy of the procedure is improved with the infiltration of perivenous tumescent fluid, which provides internal compression of the target veins.
