Catheter-directed foam sclerotherapy of great saphenous veins in combination with pre-treatment reduction of the diameter employing the principals of perivenous tumescent local anesthesia

Eur J Vasc Endovasc Surg. 2014 Feb;47(2):187-95. doi: 10.1016/j.ejvs.2013.10.017. Epub 2013 Oct 30.


Objectives: The aim of this study was to evaluate occlusion rates of great saphenous veins (GSV) with a diameter between 5-10 mm that received a pre-treatment size reduction via perivenous tumescent application (TA) followed by catheter-directed foam sclerotherapy (CDFS).

Methods: A prospective blinded randomized clinical trial comparing the occlusion rates of GSV at 1-, 6-, and 12-month follow-up. Fifty patients were included and randomized into two groups. CDFS was performed accessing the GSV at knee level and applying 8 mL of 2% polidocanol-foam (EasyFoam) while the catheter was withdrawn. Strictly perivenous TA was performed in group 1 before applying the sclerosant agent. Occlusion rates and clinical scores were assessed by blinded examiners.

Results: After 12 months in group 1 full occlusion was achieved in 73.9%, partial occlusion in 8.7%, and 17.4% were classified as treatment failure. In group 2, 75% of the targeted GSV were fully occluded, 20% were partially occluded, and 5% were diagnosed as treatment failure. Both groups showed a significant reduction of the vein diameter. Patient's tolerance and satisfaction with the treatment was high in both groups.

Conclusion: No benefit could be found using additional TA to reduce the vein diameter before the treatment.

Keywords: Catheter-directed sclerotherapy; Foam sclerotherapy; Tumescence; Varicose veins; Venous insufficiency.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Intravenous
  • Adult
  • Aged
  • Aged, 80 and over
  • Anesthesia, Local* / adverse effects
  • Catheterization, Peripheral* / adverse effects
  • Endovascular Procedures* / adverse effects
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Pilot Projects
  • Polidocanol
  • Polyethylene Glycols / administration & dosage*
  • Polyethylene Glycols / adverse effects
  • Prospective Studies
  • Saphenous Vein* / diagnostic imaging
  • Sclerosing Solutions / administration & dosage*
  • Sclerosing Solutions / adverse effects
  • Sclerotherapy* / adverse effects
  • Time Factors
  • Treatment Outcome
  • Ultrasonography
  • Venous Insufficiency / diagnosis
  • Venous Insufficiency / therapy*
  • Young Adult


  • Sclerosing Solutions
  • Polidocanol
  • Polyethylene Glycols

Associated data

  • EudraCT/2009-017472-25