You have been advised that your varicose veins are suitable for treatment with foam sclerotherapy as an alternative to conventional surgery. Here is some information regarding the procedure and aftercare. You will have an opportunity to ask your consultant questions or discuss any aspect of the procedure when you attend for treatment.

The Procedure

Foam sclerotherapy is a treatment for varicose veins that is performed under local anaesthetic on an outpatient basis. The whole episode at the hospital will take about 90 minutes. In patients with varicose veins on both legs, generally only one leg is treated at a time.

In the treatment room your varicose veins will be ultrasound scanned again by the consultant and some pen marks made on the leg. The skin will be anaesthetised using a tiny injection, and then a painless foam injection will be performed into the varicose veins, usually at two sites.

During the procedure, your leg will be supported in a raised position. At the end of the injection procedure your whole leg will have a bandage put on, covered by a white support stocking. You will then be asked to go for a 20 minute walk around the hospital before being discharged. If you need to drive home, you should plan to wait one hour after the procedure.

Care after discharge

You will be required to wear both the bandage and the stocking continuously for 1 week following foam sclerotherapy. During this time you can engage in normal activities such as driving and returning to work. However, you are advised not to engage in vigorous physical activity such as jogging or aerobics for the first week following foam sclerotherapy as this is likely to dislodge the bandage.

After one week you can remove the bandage, but replace and keep wearing the white support stocking day and night for a further week. During this time, the stocking can be removed for showering etc.

You should not plan to fly for 4-6 weeks following foam sclerotherapy.

Progress after discharge

Most patients will experience some bruising following foam sclerotherapy. It is quite common to get some lumpy tenderness in the treated vein for a while (phlebitis), although this is usually mild and can be helped by taking anti-inflammatory tablets such as Ibuprofen. You will be advised about treatment for this in the review clinic. Varicose veins treated with foam sclerotherapy usually shrivel up in 4-6 weeks following treatment.

Complications following Foam Sclerotherapy

Foam sclerotherapy is a very safe local anaesthetic procedure and complications occur only rarely.

Your leg bandage will have been placed firmly, but not tightly, at the end of the procedure. If your bandage becomes too tight, or if your notice any discolouration of the toes, then you should remove the bandage and attend the hospital for further advice. There is a very small reported incidence of deep venous thrombosis (DVT) following foam sclerotherapy, as there is with conventional surgery. If you experience sudden swelling of the treated leg, then you should seek medical advice. There is also a very small incidence of transient visual disturbance lasting a few minutes.

About 10% of patients may get some pale brown discolouration over the treated varicose vein as the bruising settles, and these areas may take several months for the discolouration to fade.

A small break in the skin (ulcer) is rare and occurs only in 1 in 500 injections. This is kept clean and dry and will heal to a small white mark.

Review after Foam Sclerotherapy

You will normally be seen in the outpatient clinic by the consultant after your procedure. The consultant will examine your leg(s) during that visit, and advise on the progress of the treatment. If there are any particularly prominent areas of treated varicose vein, then the lumpy area (which is actually clotted blood within the vein) may be drawn off with a needle under local anaesthetic in the clinic.

You will have the opportunity at your review visits to ask your consultant any questions or discuss any aspect of your treatment