Foam sclerotherapy is a minimally invasive technique for men and women to eliminate unsightly varicose veins and spider veins

The procedure involves injecting a foam sclerosant in a blood vessel to close it. The blood reroutes itself through healthy veins, restoring more normal blood flow.
Cosmetic procedures are generally not covered by insurance. Medically necessary procedures are generally covered by insurance; foam sclerotherapy may be covered by insurance unless it is considered cosmetic.

What is the foam sclerotherapy procedure?

The foam sclerotherapy procedure is performed in our office in a session lasting approximately 30–40 minute session. Small amounts of a sclerosing (ablating or sealing) agent are injected using a tiny needle inserted into the vein. The number of sessions depends on the number of veins to be treated. Generally, more than one session is required.

During this procedure, air is mixed with the sclerosing agent. Polidocanol (Asclera®) or sodium tetradecyl sulfate, known as “STS” (Sotradecol®) is used. The solution has the consistency of shaving cream; it is visible via ultrasound and can be easily tracked and guided to the source of the problematic vein. The sclerosing foam becomes less diluted than liquid when injected into the vein, allowing the solution to come into contact with the entire vein wall. As a result, less solution can be used to achieve an optimal result. The medicine causes the problematic vein to shrink up or “sclerose.”

When the problematic veins close, it allows the blood to reroute to other healthier veins.

Why do foam sclerotherapy? Are there other treatments for varicose and spider veins?

Foam sclerotherapy is used cosmetically to eliminate unattractive peripheral varicose or spider veins, as well as to treat heaviness and tiredness of the legs.

There are a variety of treatments available, depending on your particular situation. Sometimes, what appears to be a cosmetic problem may end up covering up a more serious, underlying vein problem. In such cases, other treatments, such as non-foam sclerotherapy, ambulatory phlebectomy, laser ablation and radio frequency ablation, may be more appropriate for your particular situation. During your initial consultation, we can determine which vein treatment is best for you.

What is the difference between sclerotherapy and foam sclerotherapy?

Both procedures use the same ‘sclerosing’ agent — sodium tetradecyl sulfate (STS). With “sclerotherapy,” the solution is injected in its liquid form. Generally, it is used in cosmetic procedures. With foam sclerotherapy, air is mixed with the sclerosing agent to achieve a consistency similar to shaving cream. This foam is more useful in the treatment of longer and larger veins. Insurance is more likely to cover the foam procedure. RIA Endovascular can provide guidance on which vein therapy is best for you.

Am I a candidate for foam sclerotherapy?

To find out if foam sclerotherapy— or another procedure — is right to treat your spider and varicose veins, an initial clinical evaluation is required.
We will do:

  • History and physicial exam
  • Detailed assessment of your legs
  • Pictures of varicosities for our chart and insurance company
  • Explanation of potential procedures
  • Possibly an ultrasound of the legs will be required

An ultrasound of the legs is called a Non-Invasive Vascular Assessment (NIVA). Performed by a sonographer, the exam takes approximately 30-45 minutes per leg. An ultrasound is considered a diagnostic procedure and is likely to be covered by your insurance plan unless it is for a cosmetic-only procedure.

Next you will have a clinical evaluation. You will meet with one of our staff and then your interventional radiologist to review and explain the results of your NIVA ultrasound, discuss treatment recommendations, and provide a prescription for compression stockings if needed.

What will the foam sclerotherapy procedure feel like?

First, when you come to the office, be sure to bring a pair of shorts and your compression stockings. We will explain the procedure, describe the benefits and risks, and ask you to sign a consent form.

Thin needles are inserted in the vein, which is a little uncomfortable for some patients. Not everyone is uncomfortable. Generally, you may feel the needle, then perhaps a little burning feeling which is followed by an itchy feeling. This goes away after a few minutes.

The procedure is considered relatively minor, and is well worth it because your legs will both look and feel better. Right after the procedure, we will help you put on the compression hose.

What can I expect after the procedure?

You should experience symptomatic relief, including reduced leg heaviness and the cessation of itching and burning shortly after the treatment. The treated veins will gradually be reabsorbed by your body and disappear.
You will receive a sheet of post-procedure instructions. Wear your compression hose for the first day and night. After that, wear the hose for a week during the day except for showering. We recommend two daily walks during first week after the procedure. In the first week, do not do rigorous lower-body exercise.
What you should know about this procedure:

  • Most people need more than one treatment.
  • This procedure treats currently visible spider veins.
  • It does not prevent the development of new spider veins.

Does insurance cover foam sclerotherapy?

Foam sclerotherapy is generally covered by insurance. If so, we will obtain pre-certification for any upcoming procedures from your insurance company.

Why use RIA Endovascular?

RIA Endovascular offers the most comprehensive treatment for varicose and spider veins. Our board-certified physicians use state-of-the-art technology in a beautiful, relaxing andprofessional environment. We provide complete vein care treatment — both medical and cosmetic — using the newest proven techniques. Our goal is healthy, beautiful legs!

  • Extensive experience — more than 10,000 image-guided endovascular procedures performed
  • Dedication to the treatment of vein diseases
  • In-office diagnosis and treatment, with no need for a hospital visit
  • Ultrasound evaluation with immediate report
  • Minimally invasive procedures with quick recovery time – no stitches!

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