Foam sclerotherapy for the management of varicose veins: a critical reappraisal

Foam sclerotherapy is often presented as a new method for the management of varicose veins. However, several reports established most of its principles approximately 50 years ago. Minor modifications in the way foam is produced, as well as the use of ultrasound to guide it to all of the sites of venous reflux, have resulted in a renewed interest in this technique. Recently, we have progressed from observational studies that established the efficacy and safety of this technique to the first randomized controlled trials. We need long-term follow-up in properly controlled randomized studies before we can claim that ultrasound-guided foam sclerotherapy has reached maturity and can be performed with the fully informed consent of our patients.