Ultrasound Guided Foam Sclerotherapy (Nitrogen Free foam)


The term “sclerotherapy” comes from the Greek word “sclero” which means ‘to make hard’.

Ultrasound Guided Sclerotherapy

When liquid sclerosant is placed into a vein, it causes inflammation and death of the cells lining the wall of the vein. This leads to the vein becoming hard to the touch. The body absorbs the vein over several months leaving a thin cord-like scared and shrunken vein behind.

It should be noted that sclerotherapy works best when the sclerosant material can directly contact the vein wall. This means that it works best in small (<6mm) veins and veins that are relatively “empty” of blood.

UGS refers to the injection of sclerosant material into abnormal veins under ultrasound guidance.

In order to improve the efficacy of sclerotherapy, several modifications of the original technique have occurred. The most popular of these being “foam sclerotherapy”. The sclerotherapy liquid can be mixed with gas to form a “foam”, so named for its similar appearance to shaving foam. When injected into a vein, the foam displaces the blood improving contact of the sclerotherapy agent with the vein wall and efficacy of the treatment.

Ultrasound Guided Sclerotherapy

Injection of foam sclerotherapy under ultrasound guidance is commonly referred to as UGFS (ultrasound guided foam sclerotherapy).

Nearly all clinics offering foam sclerotherpy use room air to produce foam. The nitrogen in the air however, does not dissolve very well in the blood and in some people (particularly those with a history of migraine), may pass through a small hole in the heart directly to the brain. In most people, side effects are few and mainly consist of temporary (20 min) visual disturbance. In order to reduce this side effect, The Vein Clinic uses a “nitrogen free foam” pure oxygen or carbon-dioxide gas, which greatly reduces the risk of any such problems.

Whilst some proponents of UGFS claim it is suitable for treatment of all malfunctioning and varicose veins, The Vein Clinic does not believe the medical literature or consensus opinion of experts supports this view. Our position is that it is an excellent treatment for eliminating tributary vessels when used in conjunction with EVLA and can be used for primary treatment of small (<6mm) malfunctioning truncal veins.

In skilled hands, ultrasound guidance ensures accurate and safe placement of the sclerosant material. Usually several injections will be needed along the vein to ensure that the targeted vein is collapsed completely. As the session progresses, the doctor will be able to see the effect of each individual injection through the monitor, and so ensure the safety of any adjacent blood vessels.

If injection is performed into an artery rather than the vein or into the correct one, serious consequences can occur.

The accurate injecting small veins under ultrasound guidance is a skill that takes years to perfect. Dr. Matar the director of The Vein Clinic has over 15yrs experience in performing ultrasound guided injections and takes great care and pride in the accuracy of his treatments.

UGS & UGFS do not require hospitalization and recovery time is minimal. Patients do however need to wear compression stockings and walk daily to promote blood flow and prevent thrombosis and pigmentation.

For more information about Ultrasound Guided Foam Sclerotherapy, click the Enquire Now button above.

Symptomatic & Cosmetic varicose veins

49yr woman with painful and unsightly varicose veins for over 20yrs. Pre - Prominent veins anterior and lateral thigh Post - 5mths Following EVLA (endovenous laser ablation) & UGS (ultrasound guided sclerotherapy) All symptoms have gone along with prominent veins.

  • University of Melbourne