Sealing Microfoam in therapy of truncal varicose veins
Sealing Microfoam is a modification of ethoxyclerol microfoam commonly used for sclerotherapy.
With the success of the vein super glue the idea was close to develop the microfoam. Sclerosis and sealing simultaneously is one of the possible variations.
The microfoam for the treatment of varicose veins has been known since 1938. He established himself in the 90s as a solid therapy of varicose veins and spider veins. The treatment management of the varicose disease was clearly facilitated and the therapy was gentle. Since 2010, the United States Food and Drug Administration (FDA) has approved micro foam therapy using ethoxyclerol foam for the treatment of varicose veins and has declared it the „gold standard“ of spider vein and retinal vein therapy.
Meanwhile, as with many other specialists, all micro foam therapies are performed sonographically. We also have special micro foam catheters available.
In particular, the efficacy of large side branches and perforator veins, as well as the therapy of incomplete and complete truncal veins are on the current program.
The European vascular surgeons have put the micro foam therapy of truncal varicous veins in their guidelines before stripping.
News: Sealing Foam
Saphenion has been using micro foam therapy for 13 years. We have – over the years – introduced some changes in injection technique and microfoam. The nearly seven year successful work with the vein glue „VenaSeal“ suggested the idea to give the micro foam additionally an glue effect.
These technical improvements, the modifications of the foam and the permanent use of ultrasound, the therapy of side branches and partially or completely insufficient truncal varicose veins (up to a maximum of 4 – 5 mm in diameter) is possible. It is also recommended after diagnosis in all clinically possible cases. Even with cost aspects – especially the self – payer – the sealing microfoam is an excellent alternative, since we no longer have to use only the expensive thermal catheter procedures or the vein glue for the treatment of truncal veins or larger side branches. The closure rate is between 88 – 95%.
The results of sealing truncal veins with microfoam show a higher success rate over a period of 35 months than radical surgical stripping with significantly fewer side effects, a tissue sparing treatment and immediate mobilization.
Since December 2006, we have performed over 13730 micro foam sessions. In the last 35 months (5/2016 – 4/2019) Saphenion has been used in 3996 cases for the treatment of varicose veins. In 352 cases truncal veins were treated. Specifically, this involved the SSV in 133 cases, the GSV in 108 patients, and accessory veins in 111 cases. The mean age of the patients was 45 years (18 – 86 years). The therapy of incomplete varicous veins is 100% successful in the period of 35 months. The SSV was closed in 93.9% (125 veins). The GSV was closed in 88.8% (96 veins) over the 35 months period.
Thus, the micro foam therapy is also predestined for use in cosmetically treatment and for the elderly patients.
Less side effects
But not only the closure effect has been significantly improved. We also see much less frequently the ugly post therapeutic brown lines and spots, so-called hyperpigmentations.
Ecchymoses (bleedings under skin) have become very rare (< 5%). We have seen phlebitis in 7 cases. A partial deep vein thrombosis of lower leg veins was seen in 2 cases. This has led us to carry out a single thrombosis prophylaxis for all microfoam therapies in truncal veins (the guideline for microfoam therapy does not demand this!).
In one case we had multiple puncture ulcers, but here was working outside with ointments and sprays, so that the cause is not clearly stated. In no case we have been reported to have any sensory or post treatment sensation of numbness.
In addition to visible small puncture hematomas, our patients reported primarily extruded and pressure pain over the treated vein. Muscular catlike symptoms also appeared (this is similar to the symptoms after sealing veins with super glue VenaSeal ).
Other side effects did not occur in any case. Thus, sealing microfoam therapy is a very good, effective and inexpensive alternative to the also frequently used catheter methods laser, radio wave, hot steam, clarivein and vein glue.
Additional commentary by Saphenion:
To the mixture practiced by some colleagues with autologous blood collection, coagulation of the withdrawn blood in the warm water bath and mixture with Ethoxisklerol followed by the reinjection into the varicose veins we have a distanced attitude. This method, which is known from natural medicine, is initially disputed in terms of its efficacy, and there are also considerable side effects such as chills and fever after the therapy.
Also the pure saline solution is not comparably effective with side branches and truncal veins and has – as already communicated by the first describer Paul Linser 1921 – considerable side effects. Due to the considerable complication rates after saline solution sclerotherapy, this method had already been critically scrutinized in the mid-1920`s and replaced by glucose solution.
van den Bos R. et al. : Metaanalyse randomisierter klinischer Studien und Fallserien, J.Vasc. Burg., 2008, Aug.8
Bier,Braun Kümmel: Chirurgische Operationslehre, begründet. von F. Sauerbruch; Johann Ambrosius Barth, Leipzig; 1958