Ultrasound Guided Foam SclerotherapySclerotherapy in a liquid form has been performed for many decades. The new technology is the discovery of Foam production using the sclerosant solution and air or CO2. In contrast to liquid, Foam with fine bubbles is denser and leads to vein wall damage by exposing it to the chemical for longer duration. This causes the inside of the vein walls to become ‘sticky’ and collapses. The procedure involves a small cannula or needle placed in the vein under ultrasound guidance. The fine Foam is then produced by double pass Tessari technique and injected into the vein. The passage of Foam in the vein is monitored by ultrasound scan and is ensured that it stays within the vein to be treated. Following Foam Sclerotherapy compression stocking and bandage is placed on the leg to keep the vein collapsed. Normal daily activity can be resumed immediately. Discomfort in the treated area may persist for few days and shows that the injections are working. Phlebitis or inflammation and discolouration of overlying skin can occur. Tender lumps over vein tributaries are usual and resolve in a few weeks. They may need to be pricked to let out “trapped blood” and help to resolve the lumps more quickly. Approximately 40% of patients require more than one session. Foam Sclerotherapy is popular especially in Europe and is widely used for treating inner large thigh veins and the bulging veins under the skin. However, Foam Sclerotherapy appears best suited for treatment of recurrent varicose veins and phlebitic veins especially in the presence of skin damage. This technique is also best suited in treatment of perforator veins that are communicators between the deep muscular veins and superficial vein. these are only identified by ulrasound scan and if you develop recurrent veins, you should consult a vascular surgeon.