Reverse foam sclerotherapy of the great saphenous vein with sapheno-femoral ligation compared to standard and invagination stripping: a prospective clinical series

Eur J Vasc Endovasc Surg. 2008 Oct;36(4):485-90. doi: 10.1016/j.ejvs.2008.06.029. Epub 2008 Aug 20.


Objectives: Comparison of Reverse Foam Sclerotherapy of the great saphenous vein (GSV) combed with sapheno-femoral junction (SFJ) ligation to standard (Babcock) stripping and invagination (Pin) stripping in a prospective clinical series.

Design: Prospective clinical series.

Materials and methods: 90 consecutive limbs of 82 patients with incompetence of the GSV resulting in varicose veins were prospectively randomised into 3 groups of 30, treated by SFJ ligation and either reverse foam sclerotherapy, standard stripping or invagination stripping of the GSV. Outcomes were assessed post-operatively and at 2-weeks follow-up. Peri-operative blood loss (24 hrs), analgesic requirement, bruising and residual varicosities were assessed. Bruising was assessed by both patients and independent assessors using questionnaires.

Results: SFJ ligation plus reverse foam sclerotherapy of the GSV was associated with significantly less blood loss, bruising and post-op discomfort than either of the stripping techniques. (p<0.001, Mann-Whitney)

Conclusion: Standard stripping of the GSV and invagination stripping are not associated with major discomfort and problems in the early post-operative period. SFJ ligation and GSV reverse foam sclerotherapy yielded greater patient satisfaction with less post-op bruising and discomfort and reduced analgesic requirements.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Blood Loss, Surgical
  • Combined Modality Therapy
  • Female
  • Femoral Vein / surgery*
  • Humans
  • Ligation
  • Male
  • Middle Aged
  • Pain, Postoperative
  • Patient Satisfaction
  • Postoperative Complications
  • Saphenous Vein / surgery*
  • Sclerosing Solutions / administration & dosage
  • Sclerotherapy* / adverse effects
  • Sodium Tetradecyl Sulfate / administration & dosage
  • Varicose Veins / surgery
  • Varicose Veins / therapy*
  • Vascular Surgical Procedures / adverse effects


  • Sclerosing Solutions
  • Sodium Tetradecyl Sulfate