Outcomes and Side effects of Duplex-Guided Sclerotherapy in the Treatment of Great Saphenous Veins with 1% versus 3% Polidocanol Foam

Polidocanol Concentration and Time Affect the Properties of Foam Used for Sclerotherapy

“…In clinical practice, the greater stability of POL foam 3% than 1% does not seem to translate into greater effectiveness, as demonstrated in several clinical studies 13,14 . In these clinical studies, POL foam 3% was associated with more adverse events such as phlebitis and hyperpigmentation but was equally effective.…”

Review of Published Information on Foam Sclerotherapy

“…Three weeks after foam sclerotherapy of the great saphenous vein, the occlusion rate with a 3% polidocanol foam was 96%, whereas it was only 88% when a 1% polidocanol foam was used, although after 2 years, the study by Hamel‐Desnos and colleagues no longer found any difference 22 (Table 4). In contrast, in other populations, there was still a difference of 10% in favor of higher foam concentrations 24 . Ceulen and colleagues calculated a statistically significant superiority of the higher concentrations with larger sample sizes, 24 although the higher foam concentration was also associated with an insignificant increase in side effects (thrombophlebitis, hyperpigmentation) 24 …”

“…In contrast, in other populations, there was still a difference of 10% in favor of higher foam concentrations 24 . Ceulen and colleagues calculated a statistically significant superiority of the higher concentrations with larger sample sizes, 24 although the higher foam concentration was also associated with an insignificant increase in side effects (thrombophlebitis, hyperpigmentation) 24 …”

Clinical Methods for Sclerotherapy of Varicose Veins

“…Efficacy rates were highest for POL 1.5% or STS as compared to 3% or more dilute concentrations in a study investigating saphenous veins and their tributaries. 101 No exclusion criteria were made in this study with regards to the diameter of the GSV. After 2 years, the success rates were 69% in patients treated with POL 3% foam and 68% in those treated with POL 1% foam.…”

“…96 A similar study investigating POL for UGFS of GSVs less then 8 mm found short term (3 week) success rates of 96% and 88% in subjects receiving POL 3% foam and POL 1% foam, respectively (difference was not statistically different). 100,101 Side effects A foam bolus can even occur when a small quantity of foam is injected. 88 Ceulen et al 100 initially found a significant difference in efficacy rates of UGFS between 1% and 3% POL foam at 1-year follow-up (69.5% and 80.1%, respectively).…”