Phlebology 2007;22:219-222
Catheter directed foam Sclerotherapy
Kolbel T, Hinchliffe RJ, Lindblad B

ABSTRACT
The authors present results on chemical ablation of 50 great saphenous veins (GSVs) using 3% polidocanol foam delivered via a standard coaxial endovenous sheath. The sheath was steadily withdrawn with one hand, while injecting between 5 and 8cc of sclerosing foam out the endhole. The amount of sclerosant was a function of the length of the treated vein.

All 50 veins were occluded at the 1-week follow-up visit which included examination by color flow duplex imaging. One vein had a 10 cm long open segment in the middle of the thigh. One patient suffered a pulmonary embolus post-procedure. Most patients had advanced disease, 43 veins were in limbs with CEAP class 4-6. There was no mention of vein diameter in the study. The authors correctly point out that vasospasm in the GSV caused by catheterization may alter the flow of the foam and result in its unintended distribution. The authors also mention a newly launched catheter-assisted vein sclerotherapy device (KAVS, F care Systems NV, Aartselaar, Belgium) which comprises a balloon catheter capable of occluding the GSV without occluding the common femoral vein. They had no results or experience with the device.