Foam Sclerotherapy

Clinical results prove that foam sclerotherapy combined with photothermolysis based on laser therapy increases the efficiency of the varicose veins treatment (Trelles et al., 2011). The foamed form of the detergent sclerosing drugs has resulted in improvements in the efficacy of sclerotherapy. Foam sclerotherapy reduces the dose and concentration of injected drug and assures a better intimate contact of the active substance with the target tissues. Concerning the foaming procedure, it is recommended to achieve a compromise between the bubbles dimension and the foam stability in time, so that the value of the surface tension is big enough to produce sclerosis of the target tissue and, nevertheless, the foam does not self destroy too quickly and dilutes in the blood stream before acting on the vein. On the other hand, pulsed Nd:YAG lasers emitting at 1,064 nm offer important advantages for treating varicose veins of the lower limbs. They penetrate more and are less absorbed by melanin, which means that they can treat dark phototypes. A laser pulse at 1,064 nm converts Hb into the more spherically shaped MetHb, which has a 4 times higher absorption coefficient. After initial irradiation, further delivering of energy is more effective at heating blood and the surrounding vessel (Kunishige et al., 2007). In order to produce penetration, high fluences are required and hence, treatment is painful and requires cooling and even topical anesthesia, which are considered as disadvantages of this treatment method.  Application of polidocanol in Varicose Vein Treatment Assisted by Exposure to Nd.YAG Laser Radiation