Microsclerotherapy

The minimally invasive microsclerotherapy performed at the Venenzentrum am KuDamm is a gentle injection procedure that represents the gold standard in varicose vein therapy for the treatment of side branch varicosis and perforating vein insufficiencies.

Trunk veins can also be treated and closed, up to a certain diameter, under ultrasound guidance through the injection of microsclerosing foam.

What is microfoam?

The sclerotherapy treatment using liquid Aethoxysklerol (a sclerosing agent) in varying concentrations has been used since around 1960 for the treatment of varicose veins and spider veins, yielding good results. A resurgence of this method occurred in the early 2000s. With the aim of making varicose vein treatment more gentle, minimally invasive, and effective, the microfoam therapy was established. When Aethoxysklerol is mixed and agitated with a gas (air), a stable foam forms.

The advantage of microfoam sclerotherapy, compared to liquid sclerotherapy, lies in the stability of the foam. This ensures complete and prolonged contact between the entire vessel wall and the sclerosing agent. In liquid sclerotherapy, the contact time of the agent with the vessel wall is much shorter. Liquid sclerotherapy is more suitable for smaller vessel diameters, such as spider veins. The closure rate of foam sclerotherapy, at approximately 84%, is significantly higher than that of liquid sclerotherapy (64%). For larger-caliber vessels, microfoam sclerotherapy should now be the standard.

Spider Vein Sclerotherapy

A Brief Excursion into Chemistry

Aethoxysklerol: Microfoam Therapy and its Mechanism

Aethoxysklerol is an aqueous polidocanol solution. When mixed intensively with a gas (typically air) and agitated, it forms a stable foam. Specialized syringes and instruments are used to prepare this microfoam for injection purposes.

Upon contact with the cell membranes of varicose veins or spider veins, polidocanol damages the phospholipid bilayer of endothelial cells, resulting in cell death and subsequent vascular necrosis.

In foam sclerotherapy, two types of foam are distinguished:

Liquid Foam: Contains bubbles larger than 50 micrometers.
Viscous Foam: Contains bubbles smaller than 50 micrometers, has a creamy texture, and remains stable for a longer duration.

The stability and contact time of the foam with the endothelium (the inner lining of the vessel wall) are directly proportional to the degree of endothelial damage it causes. Viscous foam, made using 1–4% Aethoxysklerol and air in a mixing ratio of 1:4, ensures optimal results.

This technique allows for the gentle and effective treatment of tributary varicose veins in the great and small saphenous veins, as well as primary varicosis in both the upper and lower leg.

Duplex-guided Microfoam Sclerotherapy at the Venenzentrum am KuDamm

To treat the visible, twisted side branch varicose veins, portions of the main veins, or insufficient perforator veins and permanently close them, the viscous sclerosant foam is injected locally and precisely into the vein sections through a thin catheter under sonographic control.

The vessel wall is completely wetted by the foam. Intravasally (inside the vessel), the foam causes toxic damage to the endothelium (the inner lining of the vessel) and subsequently leads to a sterile inflammation of the entire vessel wall. The vessel shrinks, closes, and is gradually broken down by the body.

Diagnosis of varicose veins

Overview and facts about the veins.berlin microfoam treatment and varicose vein sclerotherapy:

Treatment duration

Approximately 30 – 45 minutes

Anesthesia

No general anesthesia | no local anesthesia required | fasting not necessary

Outpatient treatment

Outpatient treatment during office hours

After the treatment

The adhesive dressings should be removed by the evening at the latest | Showering is possible immediately | Ultrasound control after 10-14 days depending on the treatment plan | Strenuous exercise can be resumed after one week – gymnastics can be done the day after | Travel is possible after 14 days | Compression therapy for 7-14 days | No sick leave required | UV radiation should be strictly avoided for 4-6 weeks.