Ultrasound-guided foam sclerotherapy for varicose veins

The National Institute for Health and Clinical Excellence (NICE) issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on ultrasound-guided foam sclerotherapy for varicose veins in May 2007. NICE has been notified about this procedure and will consider whether to review the current guidance as part of the Institute's work programme.

If this procedure meets the conditions to be re-assessed, the Interventional Procedures Advisory Committee (IPAC) will consider it and NICE will issue an Interventional Procedures Consultation Document about its safety and efficacy for 4 weeks public consultation. IPAC will then review the consultation document in the light of comments received and produce a Final Interventional Procedures Document, which will be considered by NICE before guidance is issued to the NHS in England, Wales, Scotland and Northern Ireland.

In the meantime, the NHS should continue to follow the recommendations in the guidance below.

If you wish to be alerted to developments regarding this procedure, including the release of the consultation document, please express your interest at the top of the page.

Varicose veins are a sign of underlying venous insufficiency and affect around 20-30% of adults. Long saphenous vein insufficiency is the most common form of venous insufficiency in people presenting with symptoms.

Conservative methods such as compression therapy (for example, bandages or stockings) may be considered for patients with small varicose veins. For more complicated cases, the main treatment options are sclerotherapy and/or surgery (such as ligation or stripping). Ultrasound-guided foam sclerotherapy for varicose veins is a variation of established sclerotherapy techniques that use liquid injection. It uses a sclerosant solution that has been transformed into foam by being forcibly mixed with air.

Under local anaesthetic, a needle is inserted into the main affected superficial vein and is monitored using ultrasound imaging. Foam is then injected and monitored. Once the foam has filled the entire main superficial vein, the top end of the vein is depressed to keep the foam in the superficial veins. The foam causes inflammation of the vein wall, obliteration of the vein's lumen and vein occlusion.

Other (see guidance)

Cardiovascular
Surgical procedures

General surgery

Interventional Procedures Programme
National Institute for Health and Clinical Excellence
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71 High Holborn
London
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